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McDonald SD, Narvey M, Ehman W, Jain V, Cassell K. DIRECTIVE CLINIQUE CONJOINTE DE LA SOGC ET DE LA SCP: Directive clinique n o 424 : Prise en charge du cordon ombilical chez le nourrisson prématuré ou à terme. Paediatr Child Health 2022; 27:254-255. [PMID: 35859677 DOI: 10.1093/pch/pxac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/04/2021] [Indexed: 11/12/2022] Open
Abstract
Objectif Évaluer l'effet du clampage retardé du cordon et de la traite du cordon ombilical sur les risques de mortalité et de morbidité maternelles et néonatales en contexte de grossesses monofœtale ou gémellaire. Population cible Femmes enceintes dont la grossesse monofœtale ou gémellaire est à terme ou avant terme. Bénéfices risques et coûts Chez les prématurés de grossesse monofœtale, le clampage retardé de 60 à 120 secondes idéalement, mais d'au moins 30 secondes, réduit le risque de mortalité et de morbidité. Chez les jumeaux prématurés, le clampage retardé est associé à certains bénéfices. Chez les nourrissons de grossesse monofœtale à terme, le clampage retardé de 60 secondes améliore les paramètres hématologiques. Chez les grands prématurés, la traite du cordon ombilical augmente le risque d'hémorragie intraventriculaire. Données probantes Une recherche a été effectuée au moyen des bases de données Medline, PubMed, Embase et Cochrane Library, de leur création jusqu'à mars 2020, à partir de termes MeSH et de mot-clés liés au clampage retardé du cordon et à la traite du cordon ombilical. Le présent document est un résumé des données probantes et non pas une revue méthodologique. Méthodes de validation Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique d'évaluation, de développement et d'évaluation (GRADE). Voir l'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et conditionnelles [faibles]).
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Scott Z, O'Curry S, Mastroyannopoulou K. Factors associated with secondary traumatic stress and burnout in neonatal care staff: A cross-sectional survey study. Infant Ment Health J 2021; 42:299-309. [PMID: 33449411 DOI: 10.1002/imhj.21907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
INTRODUCTION High rates of secondary traumatic stress and burnout have been found across nursing populations. However, few studies have focused on neonatal staff. OBJECTIVE The objectives of this article are to explore the prevalence and severity of secondary traumatic stress (STS) and burnout in neonatal staff, and identify risk factors and protective factors for STS and burnout within this population with the aim of informing future staff support. METHODS A quantitative, cross-sectional study using a survey design was conducted; 246 neonatal staff reported measures of STS, burnout, self-compassion and satisfaction with ward climate. RESULTS Neonatal staff reported high rates of moderate-severe STS and burnout. STS and burnout were negatively associated with self-compassion and satisfaction with ward climate, suggesting them to be protective factors against STS and burnout. STS was found to be a risk factor for burnout and vice versa. CONCLUSION Interventions that increase understanding of STS and burnout, nurture self-compassion, provide support and enhance stress management could help mitigate the impact of STS and burnout amongst neonatal staff.
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Affiliation(s)
- Zoe Scott
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Sara O'Curry
- Addenbrookes Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
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Ochoa T, Loli S, Mendoza K, Carcamo C, Bellomo S, Cam L, Castaneda A, Campos M, Jacobs J, Cossey V, Zegarra J. Effect of bovine lactoferrin on prevention of late-onset sepsis in infants <1500 g: a pooled analysis of individual patient data from two randomized controlled trials. Biochem Cell Biol 2020; 99:14-19. [PMID: 32931708 DOI: 10.1139/bcb-2020-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We previously conducted two randomized controlled trials with bovine lactoferrin (bLF) for the prevention of late-onset sepsis (LOS) in infants with a birth weight <2500 g (Study 1) and <2000 g (Study 2). The aim of this study was to determine the preventative effects of bLF on culture-proven or probable LOS in infants with a birth weight <1500 g from both studies, and to determine the effect of bLF in relation to intake of human milk. Both trial designs had similar inclusion and exclusion criteria, the same dose of bLF [200 mg·(kg body mass)-1·day-1], and used the same control (maltodextrin). We fitted multivariate Cox regression models to estimate the effect of bLF on the risk of development of the composite outcome, adjusting for covariates. We included 335 neonates with a mean birth weight of 1162 ± 244 g; 27.5% were <1000 g. There were 33 first episodes of LOS in the bLF treatment group and 48 in the control group (19.5% vs. 28.9%). bLF had a protective effect on the risk of development of LOS [hazard ratio (HR) = 0.64; %95 CI = 0.41-0.99; p = 0.048]; particularly among infants weighing <1000 g [HR = 0.46; %95 CI = 0.22-0.96; p = 0.039] and infants with a low intake of human milk [HR = 0.40; %95 CI = 0.19-0.84; p = 0.015]. Therefore, bLF supplementation protects infants <1500 g from LOS, particularly those infants not receiving human milk.
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Affiliation(s)
- Theresa Ochoa
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Doctoral School of Biomedial Sciences, KU Leuven, Belgium
| | - Sebastian Loli
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karina Mendoza
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar Carcamo
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sicilia Bellomo
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.,Hospital Cayetano Heredia, Lima, Peru
| | - Luis Cam
- Hospital Nacional Alberto Sabogal, Lima, Peru
| | | | - Miguel Campos
- Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jan Jacobs
- Department of Microbiology and Immunology, KU Leuven, Belgium.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Veerle Cossey
- Department of Development and Regeneration, KU Leuven, Belgium
| | - Jaime Zegarra
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.,Hospital Cayetano Heredia, Lima, Peru
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McDonald FB, Khawaja AM, Imran AA, Ellis ME, Chandrasekharan K, Hasan SU. Thermal and cytokine responses to endotoxin challenge during early life. Can J Physiol Pharmacol 2017; 95:1488-1492. [PMID: 28881142 DOI: 10.1139/cjpp-2017-0167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sudden infant death syndrome (SIDS) remains the leading cause of infant mortality beyond the neonatal period. An increase in body temperature as a result of high environmental temperature, overwrapping of infants, and (or) infection are associated with SIDS. Endotoxins such as lipopolysaccharide (LPS) and heat stress may perturb cardiorespiratory function and thermoregulation. Although LPS-mediated body temperature and cytokine responses are well documented in older animals, the capacity of LPS to induce fever and cytokine response in young rats remains unclear. Therefore, we sought to investigate the acute effects of LPS on body temperature and cytokine concentrations in rat pups. Postnatal day 7 rat pups were divided into 3 groups: Group 1, rats were administered LPS intraperitoneally (200 μg/kg); Group 2, rats received saline at volume equal to that administered in the LPS group; Group 3, rats received no treatment. Pups were placed in custom-made chambers maintained at ambient temperature of 33 °C. Body surface temperature was continuously monitored for 4 h. Thereafter, the rats were euthanized and serum was collected for cytokine analysis. We demonstrate that LPS treatment increased MIP-1α, IL-10, MCP-1, IP-10, fractalkine, and TNF-α with no concurrent rise in body surface temperature. Although neonatal rats produced an array of cytokines in response to LPS, there was no evidence of fever.
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Affiliation(s)
- Fiona B McDonald
- a Department of Physiology and Pharmacology, and Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Ahmad M Khawaja
- b Department of Pediatrics, Alberta Children's Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Ahmad A Imran
- b Department of Pediatrics, Alberta Children's Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Margot E Ellis
- b Department of Pediatrics, Alberta Children's Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Kumaran Chandrasekharan
- b Department of Pediatrics, Alberta Children's Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Shabih U Hasan
- b Department of Pediatrics, Alberta Children's Hospital Research Institute, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
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Ronsmans C, Cresswell JA, Goufodji S, Agbla S, Ganaba R, Assarag B, Tonouhéoua O, Diallo C, Meski FZ, Filippi V. Characteristics of neonatal near miss in hospitals in Benin, Burkina Faso and Morocco in 2012-2013. Trop Med Int Health 2016; 21:535-45. [PMID: 26892469 DOI: 10.1111/tmi.12682] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study is to explore the usefulness of neonatal near miss in low- and middle-income countries by examining the incidence of neonatal near miss and pre-discharge neonatal deaths across various obstetric risk categories in 17 hospitals in Benin, Burkina Faso and Morocco. METHODS Data were collected on all maternal deaths, maternal near miss, neonatal near miss (based on organ-dysfunction markers), Caesarean sections, stillbirths, neonatal deaths before discharge and non-cephalic presentations, and on a sample of births not falling in any of the above categories. RESULTS The burden of stillbirth, pre-discharge neonatal death or neonatal near miss ranged from 23 to 129 per 1000 births in Moroccan and Beninese hospitals, respectively. Perinatal deaths (range 17-89 per 1000 births) were more common than neonatal near miss (range 6-43 per 1000 live births), and between a fifth and a third of women who had suffered a maternal near miss lost their baby. Pre-discharge neonatal deaths and neonatal near miss had a similar distribution of markers of organ dysfunction, but unlike pre-discharge neonatal deaths most neonatal near miss (63%, 81% and 71% in Benin, Burkina Faso and Morocco, respectively) occurred among babies who were not considered premature, low birthweight or with a low 5-min Apgar score as defined by WHO's pragmatic markers of severe neonatal morbidity. CONCLUSION Whether the measurement of neonatal near miss adds useful insights into the quality of perinatal or newborn care in settings where facility-based intrapartum and early newborn mortality is very high is uncertain. Perhaps the greatest advantage of adding near miss is the shift in focus from failure to success so that lessons can be learned on how to save lives even when clinical conditions are life-threatening.
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Iganus R, Hill Z, Manzi F, Bee M, Amare Y, Shamba D, Odebiyi A, Adejuyigbe E, Omotara B, Skordis-Worrall J. Roles and responsibilities in newborn care in four African sites. Trop Med Int Health 2015; 20:1258-64. [PMID: 26031746 PMCID: PMC5008199 DOI: 10.1111/tmi.12550] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives To explore roles and responsibilities in newborn care in the intra‐ and postpartum period in Nigeria, Tanzania and Ethiopia. Methods Qualitative data were collected using in‐depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. Results We found that birth attendants were the main decision‐makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first‐time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision‐maker in the family. Conclusion Interventions should move beyond a focus on the mother–child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change.
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Affiliation(s)
- R Iganus
- Department of Community Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Z Hill
- Institute of Global Health, University College London, London, UK
| | - F Manzi
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - M Bee
- Institute of Global Health, University College London, London, UK
| | - Y Amare
- Consultancy for Social Development, Addis Ababa, Ethiopia
| | - D Shamba
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - A Odebiyi
- Post-Graduate School, Lead City University, Ibadan, Nigeria
| | - E Adejuyigbe
- Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-ife, Nigeria
| | - B Omotara
- Department of Community Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
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Vogel ER, Britt RD, Trinidad MC, Faksh A, Martin RJ, MacFarlane PM, Pabelick CM, Prakash YS. Perinatal oxygen in the developing lung. Can J Physiol Pharmacol 2014; 93:119-27. [PMID: 25594569 DOI: 10.1139/cjpp-2014-0387] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Lung diseases, such as bronchopulmonary dysplasia (BPD), wheezing, and asthma, remain significant causes of morbidity and mortality in the pediatric population, particularly in the setting of premature birth. Pulmonary outcomes in these infants are highly influenced by perinatal exposures including prenatal inflammation, postnatal intensive care unit interventions, and environmental agents. Here, there is strong evidence that perinatal supplemental oxygen administration has significant effects on pulmonary development and health. This is of particular importance in the preterm lung, where premature exposure to room air represents a hyperoxic insult that may cause harm to a lung primed to develop in a hypoxic environment. Preterm infants are also subject to increased episodes of hypoxia, which may also result in pulmonary damage and disease. Here, we summarize the current understanding of the effects of oxygen on the developing lung and how low vs. high oxygen may predispose to pulmonary disease that may extend even into adulthood. Better understanding of the underlying mechanisms will help lead to improved care and outcomes in this vulnerable population.
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Affiliation(s)
- Elizabeth R Vogel
- a Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Hammami R, Ouali S, Naffeti I, Hammas S, Kacem S, Gribaa R, Remedi F, Boughzela E. [Neonatal hypertrophic cardiomyopathy of difficult etiologic diagnosis]. Pan Afr Med J 2011; 10:60. [PMID: 22384306 PMCID: PMC3290890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 12/14/2011] [Indexed: 11/16/2022] Open
Abstract
La cardiomyopathie hypertrophique néonatale est une entité rare, hétérogène regroupant plusieurs formes cliniques et donc de diagnostic étiologique difficile. Nous rapportons l'observation d'un nouveau né issu d'une grossesse gémellaire, ayant présenté à la naissance un tableau d'insuffisance cardiaque, l’échocardiographie avait conclut à une cardiomyopathie hypertrophique obstructive. Le bilan étiologique était négatif notamment une mère non diabétique. L’évolution était favorable avec régression de l'hypertrophie 2 semaines après la naissance. L’étiologie finalement suggérée était une cardiomyopathie secondaire à l'injection anténatale de corticoïdes dans le but d'accélérer la maturation pulmonaire. L’établissement par les sociétés savantes d'un consensus de bilan étiologique minimal standard selon une chronologie bien déterminée serait d'un grand apport dans la prise en charge de cette anomalie.
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Affiliation(s)
- Rania Hammami
- Service de cardiologie de Sahloul, Sousse, Tunisie,Corresponding author: Rania Hammami, Service de cardiologie de Sahloul, Sousse, Tunisie
| | - Sana Ouali
- Service de cardiologie de Sahloul, Sousse, Tunisie
| | | | - Sami Hammas
- Service de cardiologie de Sahloul, Sousse, Tunisie
| | - Slim Kacem
- Service de cardiologie de Sahloul, Sousse, Tunisie
| | - Rim Gribaa
- Service de cardiologie de Sahloul, Sousse, Tunisie
| | - Fahmi Remedi
- Service de cardiologie de Sahloul, Sousse, Tunisie
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