RESUMO
AIM: Prolonged hospitalisation in the neonatal intensive care unit (NICU) can emotionally tax newborn infants and their families, resulting in developmental adversities and inadequate parent-infant bonding. This study aimed to assess the feasibility and value of the Baby@Home program in reducing prolonged hospital stays. METHODS: This is a retrospective cohort study of 26 infants from a tertiary neonatology department, using qualitative data (gathered through interviews with parents (n = 15) and professionals (n = 5)) and quantitative data (retrieved from medical records and the Luscii application). RESULTS: Our study included 26 newborn infants. 76% were premature, born at an average term of 35 weeks and 2 days. During the study period, all infants thrived, and only two adverse events occurred (an allergic reaction and respiratory incident necessitating readmission). Interviews were conducted based on six major themes concerning the feasibility and value of the program. Despite the challenges of application utilisation, the program's overall value was evident. CONCLUSION: The Baby@Home program effectively facilitated early discharge, promoted family reunification, and yielded favourable safety and health outcomes. Innovative solutions such as Baby@Home have the potential to pave the way for more sustainable and patient-centred care models.
Assuntos
Recém-Nascido Prematuro , Alta do Paciente , Humanos , Recém-Nascido , Estudos Retrospectivos , Masculino , Feminino , Tempo de Internação/estatística & dados numéricos , Estudos de Viabilidade , Avaliação de Programas e Projetos de Saúde , Unidades de Terapia Intensiva NeonatalRESUMO
BackgroundThis study aimed to investigate the effect of nutrition and growth during the first 4 weeks after birth on cerebral volumes and white matter maturation at term equivalent age (TEA) and on neurodevelopmental outcome at 2 years' corrected age (CA), in preterm infants.MethodsOne hundred thirty-one infants born at a gestational age (GA) <31 weeks with magnetic resonance imaging (MRI) at TEA were studied. Cortical gray matter (CGM) volumes, basal ganglia and thalami (BGT) volumes, cerebellar volumes, and total brain volume (TBV) were computed. Fractional anisotropy (FA) in the posterior limb of internal capsule (PLIC) was obtained. Cognitive and motor scores were assessed at 2 years' CA.ResultsCumulative fat and enteral intakes were positively related to larger cerebellar and BGT volumes. Weight gain was associated with larger cerebellar, BGT, and CGM volume. Cumulative fat and caloric intake, and enteral intakes were positively associated with FA in the PLIC. Cumulative protein intake was positively associated with higher cognitive and motor scores (all P<0.05).ConclusionOur study demonstrated a positive association between nutrition, weight gain, and brain volumes. Moreover, we found a positive relationship between nutrition, white matter maturation at TEA, and neurodevelopment in infancy. These findings emphasize the importance of growth and nutrition with a balanced protein, fat, and caloric content for brain development.
Assuntos
Encéfalo/crescimento & desenvolvimento , Substância Cinzenta/crescimento & desenvolvimento , Fenômenos Fisiológicos da Nutrição do Lactente , Substância Branca/crescimento & desenvolvimento , Anisotropia , Gânglios da Base/diagnóstico por imagem , Encéfalo/fisiologia , Cognição , Imagem de Tensor de Difusão , Feminino , Substância Cinzenta/fisiologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Imageamento por Ressonância Magnética , Masculino , Destreza Motora , Análise Multivariada , Estudos Retrospectivos , Tálamo/diagnóstico por imagem , Fatores de Tempo , Aumento de Peso , Substância Branca/fisiologiaRESUMO
Severe Persistent pulmonary hypertension of the newborn (PPHN) can be effectively treated with a PDE3 inhibitor as first-line treatment during neonatal transport when iNO is not readily available. Starting iNO as soon as possible is strongly advised because of the complementary actions of both therapeutics.