Prevención de la obstrucción meconial en recién nacidos prematuros de muy bajo peso / Prevention of meconium obstruction in very low birth weight preterm infants

Introducción: El retraso en la expulsión de meconio es una causa de obstrucción intestinal en el recién nacido (RN) extremadamente prematuro (< 28 SEG) con un peso inferior a 1.500 g al nacimiento. Objetivo: Evaluar la eficacia del tratamiento conservador en la prevención de la obstrucción meconial en RN prematuros de muy bajo peso. Método: Estudio descriptivo y retrospectivo realizado en la Unidad de Cuidados Intensivos Neonatales de un hospital de nivel terciario. Se incluyó a todos los RN prematuros extremos de bajo peso que nacieron durante el periodo del estudio, desde agosto del 2016 hasta enero del 2017, y que presentaban obstrucción meconial. Resultados: Se obtuvo una muestra de 42 RN. Respecto a la expulsión de meconio, un 57,1% de la muestra expulsó meconio de forma espontánea, mientras que un 42,9% recibió los diferentes tratamientos conservadores. De estos, un 72,2% fueron tratados con enemas de suero fisiológico. Del 27,8% restante, un 16% con enemas de N-acetilcisteína, 16% con Gastrografin(R) y ninguno precisó tratamiento quirúrgico. Conclusión: El tratamiento conservador parece ser una medida terapéutica efectiva para la prevención de la obstrucción meconial en los RN prematuros de muy bajo peso, ya que logró la expulsión de meconio sin tener que aplicar tratamiento quirúrgico

Introduction: Delayed meconium expulsion is a cause of bowel obstruction in the extremely premature newborn (< 28 WGE) weighing less than 1500 g at birth. Objective: To evaluate the efficacy of conservative treatment in the prevention of meconium obstruction in very-low-birt- weight preterm infants. Method: Descriptive and retrospective study performed at the Neonatal Intensive Care Unit of a tertiary level hospital. All very-low-birth-weight preterm infants who were born during the study period, from August 2016 to January 2017, and who had meconium obstruction were included. Results: A sample of 42 newborn infants was obtained. Regarding the expulsion of meconium, 57.1% of the sample spontaneously ejected meconium, while 42.9% received different treatments. Of these, 72.2% were treated with saline enemas, 16% with acetylcysteine enemas, 16% with Gastrografin(R) and none required surgical treatment. Conclusion: Conservative treatment seems to be an effective therapeutic measure for the prevention of meconium obstruction in very-low-birth-weight preterm infants since it achieved the expulsion of meconium without having to apply surgical treatment

[Nursing procedures carried out with an intestinal obstruction]. / Soins infirmiers lors d'une occlusion intestinale.

In addition to the evacuation of the liquid which has accumulated above the intestinal obstruction, the nurse performs various tasks such as the monitoring of the patient's hydration status. She also follows up the patient in the event of complications and if the doctor decides to perform a coelioscopy or laparotomy.

Clinical supervision in the palliative care team setting: a concrete approach to team wellness.

Clinical supervision is a structured, case-based approach to learning that is used most often in the mental health field. An established palliative care consultation service at a large, academic medical center implemented a modified clinical supervision model in an effort to improve team members' awareness of their own emotions and the way those emotions impact behavior during, primarily, clinical encounters. This report discusses clinical supervision in detail and, by way of a case, illustrates the power of this intervention as a source of self-care and a concrete approach to managing palliative care team well-being.

Pyloric atresia in the neonate.

Bowel obstruction is a common cause for admission into the NICU, but pyloric atresia (PA) is a very rare cause of bowel obstruction. This article illustrates the development of the fetal gastrointestinal tract, most specifically the stomach and pylorus. Pathophysiology, typing, and treatment of PA are also explored. Presented are two cases of PA that occurred in a Level III NICU one month apart. Management of this condition is surgical in nature. Long-term prognosis is usually excellent because this defect is often isolated.

Nurses' experiences caring for patients and families dealing with malignant bowel obstruction.

Malignant bowel obstruction (MBO) is a well-recognised complication of advanced abdominal and pelvic cancers. Often surgical intervention is not feasible, resulting in complex symptoms and an unpredictable course. Although symptom management is a crucial part of nursing care, psychosocial and emotional issues frequently emerge for patients and families. This qualitative study explored the perspectives of nurses from a palliative care unit, in-patient acute care oncology units, ambulatory cancer setting, and the community on their experiences of caring for patients with MBO and their families. Six individual interviews and two focus groups were conducted. Eight overarching messages were identified related to nurses' experiences. Highlights include aspects of patients' and families' emotional distress, and the nurse-patient relationship in relieving suffering. Nurses have an important and privileged role that involves identifying MBO signs and symptoms, having knowledge of treatment and symptom management options, and helping patients transition from a curative to a palliative philosophy of care.

Urgent treatment of patients with intestinal obstruction.

This article reviews the management in emergency departments of acutely unwell patients with intestinal obstruction. It describes the diagnostic tests and management required for patients with this condition, suggests that reflecting on practice can help practitioners evaluate the quality of the care they gave and presents a case study involving a woman with intestinal obstruction.

Responding to 4 gastrointestinal complications in cancer patients.

If your patient has cancer, be prepared to help her manage such serious GI complications as bowel obstruction, peritonitis, fistula formation, and intestinal perforation.

Manejo anestésico en pacientes pediátricos con diagnóstico de obstrucción intestinal en el hospital Manuel de Jesús Rivera La Mascota noviembre 2004 / I manage anesthetic in patient pediatric with diagnosis of intestinal obstruction in the hospital Manuel of Jesus Rivera The Mascot November 2004

Presenta estudio de caso realizado en el Hospital Manuel de Jesús Rivera en el año 2004, sobre Manejo anestésico en pacientes pediátricos con diagnóstico de obstrucción intestinal, lo constituyó un paciente de 13 años de edad que fue atendido de emergencia por traslado del Hospital Infantil Fernando Vélez Paiz, se selecciono como muestra a un paciente equivalente al 100 porciento del universo a través del muestreo aleatorio simple. Se somete a cirugia y la anestesia empleada fue una Anestesia General Orotraquial Balanceada la cual se basa en la combinación de fármacos y técnicas, cada una con peculiaridad y efectos específicos, pero con efectos secundarios superpuestos. Los fármacos utilizados fue un halogenado de alto solubilidad en la sangre además de relanjantes musculares de media duración. Al valorar el manejo anestesico, se puede decir que fue una cirugia y anestesia exitosa sin ningún problema durante el pre-trans y post-quirurgicoel paciente se mantuvo sin complicaciones.

Acute abdomen in infants of adolescent mothers: diagnostic challenges.

Caring for children of adolescent parents presents unique challenges. Because adolescent parents may lack parenting skills and knowledge of medical terminology, symptoms of life-threatening illnesses may be misinterpreted. We present two cases of unexpected acute abdomen in young infants with adolescent mothers. The first case involves midgut volvulus, which was discovered during a routine newborn visit. The second case, involving pyloric stenosis, presented a clinical management challenge when the adolescent mother refused diagnostic studies.

Palliation of gastrointestinal obstructive disorders.

Gastrointestinal and biliary obstructive disorders are complications encountered in advanced cancer nursing that are associated with significant morbidity and mortality. Patients with bowel gastric, or hepatobiliary obstruction require prompt and accurate diagnosis, so that appropriate care is initiated to treat the obstruction and related symptoms. Intensive nursing care aimed at comfort, psychological support, and patient/family education is essential for the well-being of patients suffering from a gastrointestinal obstructive disorder.

Bowel obstruction.

Bowel obstruction is a serious problem requiring prompt medical intervention to relieve intestinal distention, restore intravascular volume, and correct fluid and electrolyte balance. If these efforts fail, either curative or palliative surgical interventions become necessary. Oncology nurses are important members of the healthcare team caring for patients with bowel obstructions. Accurate nursing assessments are critical to monitoring the effects of these therapies and key to reducing the risk of preoperative and/or postoperative complications.

Metastases involving the gastrointestinal system.

OBJECTIVES: To provide a review of metastases involving the gastrointestinal system, including the specific problems of liver metastasis, bowel obstruction, ascites, biliary obstruction, and gastrointestinal fistulas. DATA SOURCES: Research studies, review articles, and book chapters. CONCLUSIONS: When metastasis involves the gastrointestinal tract, the emotional distress is coupled with debilitating symptoms and marked nutritional deficits. Treatment decisions must consider potential benefits and risks and affect on quality of life. IMPLICATIONS FOR NURSING PRACTICE: An understanding of the disease process and alternative treatment interventions will assist nurses to effectively anticipate and manage symptoms that may develop and educate patients and families so they can participate in decisions regarding their treatment.