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[PMID]:29186633
[Au] Autor:Yu YT; Hsieh WS; Hsu CH; Lin YJ; Lin CH; Hsieh S; Lu L; Cherng RJ; Chang YJ; Fan PC; Yao NJ; Chen WJ; Jeng SF
[Ad] Endereço:School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
[Ti] Título:Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial.
[So] Source:Phys Ther;97(12):1158-1168, 2017 Dec 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Family-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies. Objective: The aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of <1,500 g) in Taiwan over the outcomes seen with a usual care program (UCP). Design: This was a multicenter, single-blind, randomized controlled trial study. Setting: Three medical centers in northern and southern Taiwan were the locations for the study. Participants: The participants were 251 VLBW preterm infants without severe perinatal complications. Intervention: The infants were randomly assigned to receive the FCIP or the UCP during hospitalization. Measurements: Infant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group. Results: The FCIP promoted earlier full enteral feeding (ß = -1.1 weeks; 95% CI = -1.9 to -0.2 weeks) and hospital discharge (ß = -0.6 week; 95% CI = -1.1 to -0.1 weeks), greater weight gain (ß = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (ß = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants' neurobehavioral performance and weight gain (r = .20-.31; all Ps < .05). Limitations: The findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions. Conclusions: Family-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.
[Mh] Termos MeSH primário: Enfermagem Familiar
Doenças do Prematuro/terapia
Terapia Intensiva Neonatal/organização & administração
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Recém-Nascido de muito Baixo Peso
Masculino
Método Simples-Cego
Taiwan
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx089


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[PMID]:28470164
[Au] Autor:Park JE; Lee BS
[Ad] Endereço:Department of Nursing, Uiduk University, Gyeongju, Korea.
[Ti] Título:[Experience of Becoming a Father of a High Risk Premature Infant].
[So] Source:J Korean Acad Nurs;47(2):277-288, 2017 Apr.
[Is] ISSN:2093-758X
[Cp] País de publicação:Korea (South)
[La] Idioma:kor
[Ab] Resumo:PURPOSE: This study was performed to identify the experience of becoming a father of a high risk premature infant. METHODS: Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used. RESULTS: For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was 'striving through with belief and patience'. The phenomenon was 'being frustrated in an unrealistic shock'. Contextual conditions were 'uncertainty in the health status of the premature baby' and 'no one to ask for help' and intervening conditions were 'possibility in the health recovery of the premature baby' and 'assistance from significant others'. Action/interaction strategies were 'withstanding with belief in the baby' and 'enduring with willpower as head of the family' and the consequence was 'becoming a guardian of the family'. CONCLUSION: For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.
[Mh] Termos MeSH primário: Pai/psicologia
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adulto
Relações Pai-Filho
Idade Gestacional
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Entrevistas como Assunto
Masculino
Poder Familiar
Nascimento Prematuro
Autoeficácia
Apoio Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4040/jkan.2017.47.2.277


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[PMID]:29237535
[Au] Autor:Li HH; Shan L; Wang B; Jia FY
[Ad] Endereço:Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China. ttian_2332@163.com.
[Ti] Título:[Application of movement recognition technology in assessing spontaneous general movements in preterm infants].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1306-1310, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Preterm birth is a major factor which induces neurological and motor impairments, particularly cerebral palsy, in high-risk infants. Early identification of potential neurodevelopmental impairments provides the opportunity to improve neurodevelopmental outcomes in preterm infants through early rehabilitation interventions. Clinically, the general movement assessment is a pivotal tool to predict neurodevelopmental outcomes, especially motor developmental outcomes, in high-risk infants. Movement recognition can continuously capture relevant limb movements and perform objective and quantitative assessment using computerized approaches. Various methods of recording and analyzing spontaneous general movements for infants at a risk of cerebral palsy have been extensively explored. This article summarizes the general movement assessment method and reviews the translational research on using movement recognition technology for the assessment of spontaneous general movements of preterm infants.
[Mh] Termos MeSH primário: Recém-Nascido Prematuro/fisiologia
Movimento
[Mh] Termos MeSH secundário: Encéfalo/crescimento & desenvolvimento
Desenvolvimento Infantil
Seres Humanos
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:29237525
[Au] Autor:Wang CJ; Zhao SL; Shen L; Hu B; Pu XQ; Cai YI; Xiao C; Zhang YP
[Ad] Endereço:Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing 400037, China. 465616386@qq.com.
[Ti] Título:[Analysis of the Test of Infant Motor Performance data from 642 infants with a postconceptual age of 38-58 weeks].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1252-1256, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To investigate the differences between the Test of Infant Motor Performance (TIMP) data from the infants at 38-58 weeks of postconceptual age in three hospitals in Chongqing, China and the America norms, and to provide a reference for the introduction and application of TIMP in China. METHODS: TIMP was used to assess 642 infants with 38-58 weeks of postconceptual age who visited the departments of preterm infants or child healthcare in the Second Affiliated Hospital of Army Medical University, Shapingba Maternal and Child Health Hospital in Chongqing, and Chongqing Maternal and Child Health Hospital between January and December, 2016. The assessment scores were analyzed and compared with the America norms. RESULTS: The TIMP scores increased with the increasing postconceptual age, with 37±5 points in the 38-39 week group and 83±12 points in the 56-57 week group. All age groups had a significantly lower mean score than the America norms (P<0.001). CONCLUSIONS: TIMP scores can reflect the motor performance in infants with various postconceptual ages. The TIMP scores from the infants with a postconceptual age of 38-58 weeks in three hospitals in Chongqing are significantly different from the America norms, suggesting that it is very necessary in China to establish the Chinese norms for assessing motor performance in infants using TIMP.
[Mh] Termos MeSH primário: Comportamento do Lactente
Destreza Motora
[Mh] Termos MeSH secundário: Idade Gestacional
Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:29173311
[Au] Autor:Bhatt D; Travers C; Patel RM; Shinnick J; Arps K; Keene S; Raval MV
[Ad] Endereço:Division of Neonatology, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA. Electronic address: darshna.bhatt@vcuhealth.org.
[Ti] Título:Predicting Mortality or Intestinal Failure in Infants with Surgical Necrotizing Enterocolitis.
[So] Source:J Pediatr;191:22-27.e3, 2017 Dec.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare existing outcome prediction models and create a novel model to predict death or intestinal failure (IF) in infants with surgical necrotizing enterocolitis (NEC). STUDY DESIGN: A retrospective, observational cohort study conducted in a 2-campus health system in Atlanta, Georgia, from September 2009 to May 2015. Participants included all infants ≤37 weeks of gestation with surgical NEC. Logistic regression was used to model the probability of death or IF, as a composite outcome, using preoperative variables defined by specifications from 3 existing prediction models: American College of Surgeons National Surgical Quality Improvement Program Pediatric, Score for Neonatal Acute Physiology Perinatal Extension, and Vermont Oxford Risk Adjustment Tool. A novel preoperative hybrid prediction model was also derived and validated against a patient cohort from a separate campus. RESULTS: Among 147 patients with surgical NEC, discrimination in predicting death or IF was greatest with American College of Surgeons National Surgical Quality Improvement Program Pediatric (area under the receiver operating characteristic curve [AUC], 0.84; 95% CI, 0.77-0.91) when compared with the Score for Neonatal Acute Physiology Perinatal Extension II (AUC, 0.60; 95% CI, 0.48-0.72) and Vermont Oxford Risk Adjustment Tool (AUC, 0.74; 95% CI, 0.65-0.83). A hybrid model was developed using 4 preoperative variables: the 1-minute Apgar score, inotrope use, mean blood pressure, and sepsis. The hybrid model AUC was 0.85 (95% CI, 0.78-0.92) in the derivation cohort and 0.77 (95% CI, 0.66-0.86) in the validation cohort. CONCLUSIONS: Preoperative prediction of death or IF among infants with surgical NEC is possible using existing prediction tools and, to a greater extent, using a newly proposed 4-variable hybrid model.
[Mh] Termos MeSH primário: Técnicas de Apoio para a Decisão
Enterocolite Necrosante/diagnóstico
Doenças do Prematuro/diagnóstico
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Enterocolite Necrosante/mortalidade
Enterocolite Necrosante/fisiopatologia
Enterocolite Necrosante/cirurgia
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/mortalidade
Doenças do Prematuro/fisiopatologia
Doenças do Prematuro/cirurgia
Modelos Logísticos
Masculino
Prognóstico
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28450434
[Au] Autor:Li X; Gao J; Wang M; Zheng J; Li Y; Hui ES; Wan M; Yang J
[Ad] Endereço:From the Department of Radiology (X.L., J.G., M. Wang, Y.L., J.Y.).
[Ti] Título:Characterization of Extensive Microstructural Variations Associated with Punctate White Matter Lesions in Preterm Neonates.
[So] Source:AJNR Am J Neuroradiol;38(6):1228-1234, 2017 Jun.
[Is] ISSN:1936-959X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Punctate white matter lesions are common in preterm neonates. Neurodevelopmental outcomes of the neonates are related to the degree of extension. This study aimed to characterize the extent of microstructural variations for different punctate white matter lesion grades. MATERIALS AND METHODS: Preterm neonates with punctate white matter lesions were divided into 3 grades (from mild to severe: grades I-III). DTI-derived fractional anisotropy, axial diffusivity, and radial diffusivity between patients with punctate white matter lesions and controls were compared with Tract-Based Spatial Statistics and tract-quantification methods. RESULTS: Thirty-three preterm neonates with punctate white matter lesions and 33 matched controls were enrolled. There were 15, 9, and 9 patients, respectively, in grades I, II, and III. Punctate white matter lesions were mainly located in white matter adjacent to the lateral ventricles, especially regions lateral to the trigone, posterior horns, and centrum semiovale and/or corona radiata. Extensive microstructural changes were observed in neonates with grade III punctate white matter lesions, while no significant changes in DTI metrics were found for grades I and II. A pattern of increased axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy was found in regions adjacent to punctate white matter lesion sites seen on T1WI and T2WI. Unchanged axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy were observed in regions distant from punctate white matter lesion sites. CONCLUSIONS: White matter microstructural variations were different across punctate white matter lesion grades. Extensive change patterns varied according to the distance to the lesion sites in neonates with severe punctate white matter lesions. These findings may help in determining the outcomes of punctate white matter lesions and selecting treatment strategies.
[Mh] Termos MeSH primário: Recém-Nascido Prematuro
Substância Branca/ultraestrutura
[Mh] Termos MeSH secundário: Anisotropia
Ventrículos Cerebrais/diagnóstico por imagem
Ventrículos Cerebrais/patologia
Ventrículos Cerebrais/ultraestrutura
Corpo Caloso/diagnóstico por imagem
Corpo Caloso/patologia
Corpo Caloso/ultraestrutura
Estudos Transversais
Imagem de Tensor de Difusão
Feminino
Seres Humanos
Recém-Nascido
Masculino
Tratos Piramidais/diagnóstico por imagem
Tratos Piramidais/patologia
Tratos Piramidais/ultraestrutura
Substância Branca/diagnóstico por imagem
Substância Branca/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.3174/ajnr.A5226


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[PMID]:29390342
[Au] Autor:Zhang X; Zhou M; Yin H; Dai Y; Li Y
[Ad] Endereço:Department of Neonatology.
[Ti] Título:The predictive value of early oral motor assessments for neurodevelopmental outcomes of moderately and late preterm infants.
[So] Source:Medicine (Baltimore);96(50):e9207, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Oral motor assessment is used to identify abnormal sucking patterns which may reflect neurodevelopmental problems in preterm infants, but few studies have focused on moderately and late preterm infants. We enrolled 118 moderately and late preterm infants (mean gestational age, 35.04 weeks; mean birth weight, 2347.59 g) and analyzed the relationship between the Neonatal Oral-Motor Assessment Scale scores of these infants and the Chinese revision of Bayley Scales of Infant Development outcomes at 6 months corrected age. And the infants with abnormal sucking pattern had significantly lower Mental Development Index and Psychomotor Development Index and showed a higher rate of below average scores than control group (P = .003, P = .029, P = .022). The incoordination of suck-swallow-respiration was a risk factor for adverse neurodevelopment (RR = 3.67, 95% CI: 1.42-9.45). These indicate that abnormal sucking patterns in moderately and late preterm infants might provide some predictive value for short-term neurodevelopmental outcomes, but the clinical predictive value for developmental delay need to be determined in a longer term follow-up. This finding may offer a basis for early intervention.
[Mh] Termos MeSH primário: Deficiências do Desenvolvimento/diagnóstico
Deficiências do Desenvolvimento/fisiopatologia
Recém-Nascido Prematuro/crescimento & desenvolvimento
Desempenho Psicomotor/fisiologia
Comportamento de Sucção/fisiologia
[Mh] Termos MeSH secundário: China
Feminino
Idade Gestacional
Seres Humanos
Lactente
Masculino
Valor Preditivo dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009207


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[PMID]:29386437
[Au] Autor:Nagasato A; Nakamura M; Kamimura H
[Ad] Endereço:Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University.
[Ti] Título:[Comparative Study of the Efficacy and Safety of Caffeine and Aminophylline for the Treatment of Apnea in Preterm Infants].
[So] Source:Yakugaku Zasshi;138(2):237-242, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo: Methylxanthine is widely administered for the treatment of apnea of prematurity in many countries, and previous reports have clearly established that caffeine is effective for the treatment of apnea of prematurity. In Japan, caffeine has been available since December 2014. Thus, we compared the efficacy and safety of caffeine with that of aminophylline in our hospital. There was no significant difference between the caffeine group and aminophylline group regarding the characteristics of the study patients. The mean efficacy rate from day 1 to day 10 was 89.5% in the caffeine group, and 81.9% in the aminophylline group, although the rate of improvement in apnea episodes each day from day 1 to day 10 was not significantly different between the two groups. On the other hand, the adverse event rates in the caffeine group and the aminophylline group were 70.6% and 75.0%, respectively. No significant difference was observed in the adverse event rates between the two groups. Moreover, suspected abdominal distension due to the drug administration was more frequently observed with the aminophylline group. Our findings indicate that caffeine is as effective as aminophylline, while it is superior to aminophylline regarding its overall safety.
[Mh] Termos MeSH primário: Aminofilina/administração & dosagem
Apneia/tratamento farmacológico
Cafeína/administração & dosagem
Recém-Nascido Prematuro
[Mh] Termos MeSH secundário: Administração Oral
Aminofilina/efeitos adversos
Apneia/etiologia
Cafeína/efeitos adversos
Feminino
Seres Humanos
Recém-Nascido
Infusões Intravenosas
Masculino
Segurança
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
27Y3KJK423 (Aminophylline); 3G6A5W338E (Caffeine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00144


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[PMID]:29317459
[Au] Autor:Battersby C; Santhalingam T; Costeloe K; Modi N
[Ad] Endereço:Department of Medicine, Neonatal Data Analysis Unit, Section of Neonatal Medicine, Chelsea and Westminster campus, Imperial College London, London, UK.
[Ti] Título:Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review.
[So] Source:Arch Dis Child Fetal Neonatal Ed;103(2):F182-F189, 2018 Mar.
[Is] ISSN:1468-2052
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To conduct a systematic review of neonatal necrotising enterocolitis (NEC) rates in high-income countries published in peer-reviewed journals. METHODS: We searched MEDLINE, Embase and PubMed databases for observational studies published in peer-reviewed journals. We selected studies reporting national, regional or multicentre rates of NEC in 34 Organisation for Economic Co-operation and Development countries. Two investigators independently screened studies against predetermined criteria. For included studies, we extracted country, year of publication in peer-reviewed journal, study time period, study population inclusion and exclusion criteria, case definition, gestation or birth weight-specific NEC and mortality rates. RESULTS: Of the 1888 references identified, 120 full manuscripts were reviewed, 33 studies met inclusion criteria, 14 studies with the most recent data from 12 countries were included in the final analysis. We identified an almost fourfold difference, from 2% to 7%, in the rate of NEC among babies born <32 weeks' gestation and an almost fivefold difference, from 5% to 22%, among those with a birth weight <1000 g but few studies covered the entire at-risk population. The most commonly applied definition was Bell's stage ≥2, which was used in seven studies. Other definitions included Bell's stage 1-3, definitions from the Centers for Disease Control and Prevention, International Classification for Diseases and combinations of clinical and radiological signs as specified by study authors. CONCLUSION: The reasons for international variation in NEC incidence are an important area for future research. Reliable inferences require clarity in defining population coverage and consistency in the case definition applied. PROSPERO INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER: CRD42015030046.
[Mh] Termos MeSH primário: Países Desenvolvidos/estatística & dados numéricos
Enterocolite Necrosante/epidemiologia
Doenças do Recém-Nascido/epidemiologia
[Mh] Termos MeSH secundário: Seres Humanos
Incidência
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/epidemiologia
Recém-Nascido de muito Baixo Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2017-313880


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[PMID]:28747364
[Au] Autor:Lorenz L; Marulli A; Dawson JA; Owen LS; Manley BJ; Donath SM; Davis PG; Kamlin COF
[Ad] Endereço:Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.
[Ti] Título:Cerebral oxygenation during skin-to-skin care in preterm infants not receiving respiratory support.
[So] Source:Arch Dis Child Fetal Neonatal Ed;103(2):F137-F142, 2018 Mar.
[Is] ISSN:1468-2052
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Skin-to-skin care (SSC) has proven benefits in preterm infants, but increased hypoxic and bradycardic events have been reported. This may make clinicians hesitant to recommend SSC as standard care. We hypothesised that regional cerebral oxygenation (rStO ) measured with near infrared spectroscopy is not worse during SSC compared with standard incubator care. DESIGN: Prospective, observational, non-inferiority study. SETTING: Single tertiary perinatal centre in Australia. PATIENTS: Forty preterm infants (median (IQR) 30.6 (29.1-31.7) weeks' gestation) not receiving respiratory support were studied on day 14 (8-38). INTERVENTIONS: Recordings during 90 min of incubator care, followed by 90 min of SSC. Each infant acted as their own control and caregivers were blinded to the rStO measurements. MAIN OUTCOME MEASURES: The primary outcome was the mean difference in rStO between SSC and incubator care. The prespecified margin of non-inferiority was -1.5%. Secondary outcomes included heart rate (HR), peripheral oxygen saturation (SpO ), time in quiet sleep, temperature and hypoxic (SpO <80% for >5 s) or bradycardic events (HR <80 bpm for >5 s) and time spent in cerebral hypoxia (rStO <55%) and hyperoxia (rStO >85%). RESULTS: Mean (SD) rStO was lower during SSC compared with incubator care: 73.6 (6.0)% vs 74.8 (4.6)%, mean difference (95% CI) 1.3 (2.2 to 0.4)%. HR was 5 bpm higher, SpO 1% lower and time in quiet sleep 24% longer during SSC. Little evidence of a difference was observed in temperature. The number of hypoxic or bradycardic events as well as the proportion of time spent in cerebral hypoxia and hyperoxia was very low in both periods. CONCLUSIONS: Mean rStO was marginally lower during SSC without observed differences in hypoxic or bardycardic events but an increase in time spent in quiet sleep. TRIAL REGISTRATION NUMBER: This trial is linked to Australian New Zealand Clinical Trials Registry: identifier 12616000240448. It was registered pre-results.
[Mh] Termos MeSH primário: Circulação Cerebrovascular/fisiologia
Recém-Nascido Prematuro
Método Canguru/métodos
Oxigênio/sangue
[Mh] Termos MeSH secundário: Austrália
Feminino
Seres Humanos
Lactente Extremamente Prematuro
Recém-Nascido
Masculino
Oximetria
Estudos Prospectivos
Espectroscopia de Luz Próxima ao Infravermelho
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2016-312471



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