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1.
rev.cuid. (Bucaramanga.2010) ; 13(1): 1-13, 20221213.
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1369073

RESUMO

Introdução: Conhecer a prematuridade pela percepção das famílias de recém-nascidos internados na Unidade de Terapia Intensiva Neonatal sob a perspectiva Transcultural. Materiais e Métodos: Pesquisa qualitativo, descritiva e exploratória. Foram realizadas Observação participante e entrevistas semiestruturadas com 16 familiares de recém-nascidos internados na unidade neonatal de uma maternidade pública do interior baiano. Utilizou-se o software Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaires® e análise de conteúdo. Resultados: Emergiram quatro categorias: O prematuro em suas particularidades na percepção da família; Sentimentos familiares ocasionados pela prematuridade; A espiritualidade como estratégia para significar a prematuridade; A prematuridade por meio dos cuidados profissionais. Discussões: Compreender as experiências das famílias no ambiente neonatal pode contribuir com os profissionais de saúde e instituições na reorientação às suas práticas, visando uma assistência voltada para integralidade, identificando as singularidades de cada família e o reconhecimento da diversidade cultural. Conclusão: Entender a família, em suas necessidades e cultura, colabora com uma assistência mais humana e eficaz, onde a família fará parte do planejamento e da tomada de decisão para cuidar do prematuro amplamente, respeitando o biológico, como também, fatores sociais e psicológicos, contemplando integralmente, o prematuro e sua família.


Introduction: To understand premature birth through perceptions of families with premature babies admitted to neonatal intensive care unit from a cross-cultural perspective. Materials and methods: An exploratory-descriptive qualitative study was conducted through participant observation and semi-structured interviews with 16 relatives of premature babies admitted to the neonatal intensive care unit of a maternity hospital in the state of Bahia. R Software was used for multidimensional analysis of texts and questionnaires and content analysis. Results: Four categories were established: premature babies with their particularities in family's perceptions; family's feelings caused by premature birth; spirituality as a strategy to give meaning to premature birth; and premature birth from professional healthcare. Discussion: Understanding the experiences of families in the neonatal environment can contribute to healthcare professionals and institutions reorienting their practices to target integrality of care by identifying the particularities of each family and recognizing their cultural diversity. Conclusions: Understanding the needs and culture of families contributes to the provision of more humane and effective care in which the family plays a part in planning and decision making on integral care of their premature baby, not only highlighting biological factors but also social and psychological factors that comprehensively involve the premature baby and their family.


Introducción: Entender la prematuridad a través de la percepción de las familias de los recién nacidos ingresados en una Unidad de Cuidados Intensivos desde una perspectiva transcultural. Materiales y métodos: Investigación cualitativa, descriptiva y exploratoria. A través de una observación participante, se llevaron a cabo entrevistas semiestructuradas con 16 familiares de recién nacidos prematuros hospitalizados en la unidad neonatal de un hospital materno en el estado de Bahía. Se hizo uso del software Interfaz de R para el análisis multidimensional de textos y cuestionarios, y análisis de contenido. Resultados: Se establecieron cuatro categorías: el recién nacido prematuro con sus particularidades en la percepción de la familia; sentimientos en la familia generados por la prematuridad; la espiritualidad como estrategia para darle significado a la prematuridad; la prematuridad atendida a través del cuidado profesional. Discusión: La comprensión de las experiencias de las familias en el ambiente neonatal puede contribuir a los profesionales e instituciones de salud a reorientar sus prácticas, a fin de apuntar a una atención centrada en la integralidad al identificar las particularidades de cada familia y reconocer su diversidad cultural. Conclusiones: Entender las necesidades y la cultura de las familias contribuye a prestar una atención más humana y eficaz en la que la familia hace parte de la planificación y toma de decisiones en el cuidado integral del recién nacido prematuro al no resaltar solamente los aspectos biológicos, sino también los factores sociales y psicológicos que incluyen al recién nacido prematuro y su familia de una forma integral.


Assuntos
Humanos , Feminino , Recém-Nascido , Recém-Nascido Prematuro , Família , Unidades de Terapia Intensiva Neonatal , Enfermagem Transcultural
2.
Rev. urug. enferm ; 17(2): 1-14, dic. 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1391902

RESUMO

Objetivo: Avaliar as características das internações de recém-nascidos em uma unidade de terapia intensiva neonatal do extremo sul do Brasil durante um curto período de tempo. Método: Estudo observacional, com 85 neonatos, por dados secundários de pacientes internados na Unidade de Terapia Intensiva Neonatal, nos meses de maio de 2020 a outubro de 2020. Resultados: A prevalência das internações foi do sexo masculino, com diagnóstico de prematuridade, que pesavam entre 1500g e 2499g, não receberam leite materno na primeira hora de vida, receberam visitas dos pais, colo e leite materno durante a internação. As mães tinham mais de 6 consultas de pré-natal e os bebês nasceram de cesárea. Conclusão: O atendimento prestado de forma holística, baseado na ciência e maneira humanizada aos recém-nascidos e aos pais, pode reduzir a mortalidade infantil, trazer maior segurança aos pais e confi ança na equipe assistencial, além de evitar complicações futuras no desenvolvimento infantil.


Objetivo: Evaluar las características de las hospitalizaciones de recién nacidos en una unidad de cuidados intensivos neonatales en el extremo sur de Brasil durante un corto período de tiempo. Método: Estudio observacional, con 85 neonatos, con base en datos secundarios de pacientes hospitalizados en la Unidad de Cuidados Intensivos Neonatales, de mayo de 2020 a octubre de 2020. Resultados: La prevalencia de hospitalizaciones fue del sexo masculino, con diagnóstico de prematuridad, que pesaron entre 1500g y 2499g, no recibió leche materna en la primera hora de vida, recibió visitas de los padres, regazo y leche materna durante la hospitalización. Las madres tuvieron más de 6 consultas prenatales y los bebés nacieron por cesárea. Conclusión: La atención brindada de forma holística, basada en la ciencia y de forma humanizada a los recién nacidos y a los padres, puede reducir la mortalidad infantil, brindar mayor seguridad a los padres y confi anza en el equipo de atención, además de prevenir futuras complicaciones en el desarrollo del niño.


Objective: To evaluate the characteristics of hospitalizations of newborns in a neonatal intensive care unit in the extreme south of Brazil during a short period of time. Method: Observational study, with 85 neonates, based on secondary data from patients hospitalized in the Neonatal Intensive Care Unit, from May 2020 to October 2020. Results: The prevalence of hospitalizations was male, with a diagnosis of prematurity, who weighed between 1500g and 2499g, did not receive breast milk in the fi rst hour of life, received visits from parents, lap and breast milk during hospitalization. The mothers had more than 6 prenatal consultations and the babies were born by cesarean section. Conclusion: The care provided in a holistic way, based on science and in a humanized way to newborns and parents, can reduce infant mortality, bring greater security to parents and confidence in the care team, in addition to preventing future complications in child development.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Criança , Adolescente , Adulto , Adulto Jovem , Qualidade da Assistência à Saúde , Unidades de Terapia Intensiva Neonatal , COVID-19/epidemiologia , Hospitalização , Fatores Socioeconômicos , Fatores de Tempo , Brasil/epidemiologia , Mortalidade Infantil , Estudos Retrospectivos , Estudos Longitudinais , Humanização da Assistência , Saúde Holística
3.
PLoS One ; 17(9): e0273946, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36054141

RESUMO

INTRODUCTION: In very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants. METHODS: This quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared. RESULTS: A total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015). CONCLUSIONS: Our standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes.


Assuntos
Hipotermia , Doenças do Prematuro , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/prevenção & controle , Humanos , Hipotermia/prevenção & controle , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/prevenção & controle , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal
4.
Neoreviews ; 23(9): e625-e634, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36047753

RESUMO

Albumin is the most abundant protein in human blood with distinctive functions throughout the human body. Low albumin levels are a predictor of mortality as well as disease outcome in children and adults. However, the clinical significance of hypoalbuminemia and the role of albumin infusions in NICUs remain unclear and controversial.


Assuntos
Hipoalbuminemia , Unidades de Terapia Intensiva Neonatal , Adulto , Criança , Humanos , Hipoalbuminemia/diagnóstico , Hipoalbuminemia/tratamento farmacológico , Recém-Nascido , Albumina Sérica/metabolismo
5.
Bol Med Hosp Infant Mex ; 79(4): 237-247, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36100208

RESUMO

BACKGROUND: Respiratory distress syndrome (RDS) is Mexico's second leading cause of neonatal mortality. The 75% reduction in mortality due to RDS has been attributed to the use of nasal continuous positive airway pressure (nCPAP). A survey was conducted to determine the perception of the medical staff regarding the availability of nCPAP equipment and supplies in Mexican hospitals with neonatal intensive care units (NICUs). METHODS: We sent a survey via e-mail to several neonatologists in each state of the country, requesting only one response per hospital. We performed statistical analysis with SPSS software. RESULTS: We received 195 surveys from private (HPri) and public (HPub) hospitals with NICUs nationwide: 100% of HPri and 39% of HPub. More than 75% of the nursing and medical staff had received formal training in nCPAP in 11% of HPri and 5% of HPub. The perceived availability of CPAP equipment was 83.7% vs. 52.1%; nasal cannula supply, 75.5% vs. 36.3%; air/oxygen blender availability, 51.0% vs. 32.9%, in HPri and HPub, respectively. The observed differences were statistically significant. Significant differences were also found among healthcare institutions. CONCLUSIONS: The availability of CPAP equipment and consumables between HPub and HPri is unbalanced and is lower in public institutions. Bubble CPAP is not included essential equipment in the national catalog of instruments and equipment for public hospitals, and its request is complicated. The training of CPAP staff and the availability of bubble CPAP and supplies in public hospitals should be improved.


INTRODUCCIÓN: El síndrome de dificultad respiratoria (SDR) es la segunda causa de mortalidad neonatal en México. La reducción del 75% de la mortalidad por SDR se le ha atribuido al uso de la presión positiva nasal continua de las vías respiratorias (nCPAP). Se realizó una encuesta con el objetivo de conocer la percepción del personal médico acerca de la disponibilidad del equipo e insumos para nCPAP en hospitales de México que cuenten con unidades de cuidados intensivos neonatales (UCIN). MÉTODOS: La encuesta se envió por correo electrónico a varios neonatólogos de cada estado del país y se solicitó una sola respuesta por cada hospital. El análisis estadístico se realizó con el software SPSS. RESULTADOS: Se recibieron 195 encuestas respondidas tanto de hospitales privados (HPri) como públicos (HPub) que cuentan con UCIN a escala nacional: el 100% de HPri y el 39% de HPub. Más del 75% del personal de enfermería y médico recibió una capacitación formal en nCPAP en el 11% de HPri y el 5% de HPub. La percepción de disponibilidad de equipos de presión positiva continua de las vías respiratorias (CPAP) fue del 83.7% vs. el 52.1%; el abasto de cánulas nasales, del 75.5% vs. el 36.3%; la disponibilidad del mezclador aire/oxígeno, del 51.0 % vs. el 32.9%, en HPri y HPub, respectivamente. Las diferencias fueron estadísticamente significativas. También se encontraron diferencias significativas entre las instituciones de salud. CONCLUSIONES: La disponibilidad de equipo y material de consumo para CPAP entre HPub y HPri es desequilibrada, y es menor en las instituciones públicas. El CPAP burbuja no se encuentra incluido en el cuadro básico de equipo médico y se dificulta su solicitud. Debe mejorarse la capacitación del personal en CPAP y la disponibilidad de CPAP burbuja e insumos en los hospitales públicos.


Assuntos
Neonatologia , Síndrome do Desconforto Respiratório do Recém-Nascido , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Percepção
6.
Bol Med Hosp Infant Mex ; 79(4): 228-236, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36100210

RESUMO

BACKGROUND: Kangaroo mother care (KMC) offers several benefits for neonates and mothers. Although many studies have evaluated the effectiveness of KMC on infants, only few studies have examined the effects on mothers. This study aimed to evaluate the effectiveness of KMC on maternal resilience and breastfeeding self-efficacy via the role-play method in a neonatal intensive care unit. METHODS: We conducted a randomized controlled trial. Mothers were randomized into two groups. Mothers in the intervention group were trained using the role-play method. Questionnaires were administered before and after the intervention. Data were analyzed with SPSS version 22. RESULTS: The training demonstrated a statistically significant difference in resilience score and breastfeeding self-efficacy in each group after the intervention. In addition, a statistically significant difference was revealed between both groups in resilience scores and breastfeeding self-efficacy after the intervention. CONCLUSIONS: KMC training with the role-play method was most effective. Role-play and routine methods are recommended as methods of therapeutic care in clinical settings to improve maternal resilience and breastfeeding self-efficacy.


INTRODUCCIÓN: El cuidado madre canguro ofrece una gran cantidad de beneficios para el neonato y la madre. Aunque muchos estudios han evaluado la eficacia del cuidado madre canguro en los bebés, solo pocos estudios han examinado los efectos en las madres. El propósito del presente estudio fue evaluar la efectividad del cuidado madre canguro sobre la resiliencia de la madre y la autoeficacia de la lactancia mediante el método de juego de roles en la unidad de cuidados intensivos neonatales. MÉTODOS: Se llevó a cabo un ensayo controlado aleatorio. Las madres se asignaron en dos grupos al azar. Las madres del grupo de intervención fueron capacitadas mediante el método de juego de roles. Se aplicaron cuestionarios antes y después de la intervención. Los datos se analizaron utilizando SPSS versión 22. RESULTADOS: El entrenamiento demostró una diferencia estadísticamente significativa en la puntuación de la resiliencia y la autoeficacia de la lactancia en cada grupo después de la intervención. Además, se reveló una diferencia estadísticamente significativa entre ambos grupos en la puntuación de resiliencia y la autoeficacia de la lactancia después de la intervención. CONCLUSIONES: La capacitación del cuidado madre canguro mediante el método de juego de roles fue más efectiva. Se recomienda el juego de roles y los métodos de rutina como métodos de atención terapéutica en entornos clínicos para mejorar la resiliencia de la madre y la autoeficacia de la lactancia.


Assuntos
Método Canguru , Aleitamento Materno , Criança , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Mães , Autoeficácia
7.
Enferm. clín. (Ed. impr.) ; 32(5): 294-305, Sep-Oct 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-207824

RESUMO

Objetivo: Determinar la validez y confiabilidad del instrumento CUIDAR en madres de niños prematuros. Método: Estudio de validación de corte transversal. Se realizó en dos etapas. Primera etapa: revisión de literatura, adecuación semántica y juicio con 7 expertos para establecer la validez de contenido. En la segunda etapa se evaluaron las propiedades psicométricas del instrumento mediante análisis factorial exploratorio tras su aplicación a 207 madres de niños prematuros. Resultados: En el juicio de expertos se obtuvo un índice de validez de contenido mayor a 0,8 que indicó una adecuada representatividad de los ítems. El acuerdo entre jueces fue moderado con un Kappa de Fleiss de 0,51. El análisis factorial exploratorio estableció la idoneidad de la muestra con estadístico Kaiser-Mayer-Olkin de 0,859 y prueba de esfericidad de Bartlett 2953,9 (p=0,00). Tras plantear diversos escenarios, un modelo de 7 dimensiones y 33 ítems explicó el 57,9% de la varianza, con un alfa de Cronbach global de 0,852. Las pruebas de bondad de ajuste permitieron establecer mediante significación estadística del χ2 de 0,01, un CFI=0,92, un BIC=> 10 y un RMSEA=0,05 indicando que el modelo tiene buen ajuste. Conclusiones: Se identificó un nuevo modelo a partir de los ítems y dimensiones del instrumento CUIDAR que permite valorar la competencia de las madres para el cuidado de sus hijos prematuros de forma válida y confiable.(AU)


Objective: To determine the validity and reliability of the CUIDAR instrument in mothers of premature infants. Method: Cross-sectional validation study. The study was conducted in two stages. First stage: literature review, semantic adequacy, and judgement with 7 experts to establish content validity. In the second stage, the psychometric properties of the instrument were evaluated by exploratory factor analysis after its application to 207 mothers of premature infants. Results: In the expert's judgment, the content validity index was higher than 0.8, which indicated adequate representativeness of the items. Agreement between judges was moderate with a Fleiss Kappa of 0.51. The exploratory factor analysis established the adequacy of the sample with a Kaiser-Mayer-Olkin statistic of 0.859 and Bartlett's test of sphericity 2953.9 (p=.000). After considering various scenarios, a 7-dimensional, 33-item model explained 57.9% of the variance, with an overall Cronbach's alpha of 0.852 and adequate goodness-of-fit indices. The goodness-of-fit tests allowed us to establish through statistical significance χ2=0.01, CFI=0.92, BIC=> 10 and RMSEA=0.05 indicating that the model has a good fit. Conclusions: A new model was identified based on the items and dimensions of the CUIDAR instrument, which allows us to assess the competence of mothers to care for their premature children in a valid and reliable way.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Mães , Recém-Nascido Prematuro , Cuidado da Criança , Reprodutibilidade dos Testes , Enfermagem Neonatal , Unidades de Terapia Intensiva Neonatal , Estudos Transversais , Enfermagem
9.
Artigo em Inglês | MEDLINE | ID: mdl-36078666

RESUMO

Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns' sleep may be at risk due to medical and nursing care, environmental stimuli and manipulation. This review aims to identify the nurses' interventions that promote sleep in preterm newborns in the Neonatal Intensive Care Units. An integrative review was conducted following Whittemore and Knafl's methodology and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The research was carried out on the electronic databases PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ScienceDirect, with a timeframe from 2010 to 2021. A total of 359 articles were initially identified. After selection and analysis, five studies were included in the sample. Interventions by nursing staff that promote sleep in preterm newborns in the Neonatal Intensive Care Units fall within three categories: environmental management, relaxation techniques and therapeutic positioning. Nurses play a vital role in implementing interventions that promote preterm newborns' sleep. They can positively affect preterm newborns' sleep by controlling environmental stimuli and applying relaxation techniques and therapeutic positioning to their care practices.


Assuntos
Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Humanos , Recém-Nascido , Sono
10.
BMC Pediatr ; 22(1): 521, 2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056306

RESUMO

BACKGROUND: Ethanol intoxications in newborns are generally due to false preparation of formula with alcoholics or alcohol consumption by the breastfeeding mothers. Rarely, intoxications occur in hospitalized newborns, e.g., from excessive use of alcoholic hand sanitizers. We herein report a strange case of acute ethanol intoxications in our NICU. CASE PRESENTATION: An extremely premature infant (23 0/7 weeks gestational age, birthweight 580 g) suffered from repeated life-threatening events with hemodynamic compromise, apnea, and lactic acidosis while being treated in our neonatal intensive care unit (NICU). Symptomatic treatment with intravenous fluids and, if necessary, intubation and catecholamine therapy led to recovery after several hours each time. The episodes eventually turned out to be severe ethanol intoxications brought about by breast milk contaminated with ethanol. The breast milk was supplied by the infant's mother, who consumed non-trivial amounts of alcohol to build up her strength and make herself produce more milk, which was recommended to her by a family member. Additionally, she supplemented her own mother's milk with cow's milk because she was worried her baby was underserved with her milk. The mother admitted to this in intensive conversations with our team and a professional translator. CONCLUSIONS: This unique case underlines how different cultural dynamics can attribute to life-threatening events in the care of premature infants. It is important for us to emphasize that intensive communication and building a confident relationship with the parents of patients is essential to the work on NICUs. Child safeguarding issues and possibilities of intoxications have to stay in mind even in a supposedly safe space like the NICU.


Assuntos
Intoxicação Alcoólica , Unidades de Terapia Intensiva Neonatal , Intoxicação Alcoólica/diagnóstico , Intoxicação Alcoólica/terapia , Animais , Aleitamento Materno , Bovinos , Etanol , Feminino , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Leite Humano , Mães
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 455-458, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085849

RESUMO

An efficient face detector could be very helpful to point out possible neurological dysfunctions such as seizure events in Neonatal Intensive Care Units. However, its development is still challenging because large public datasets of newborns' faces are missing. Over the years several studies introduced semi-automatic approaches. This study proposes a fully automated face detector for newborns in Neonatal Intensive Care Units, based on the Aggregate Channel Feature algorithm. The developed method is tested on a dataset of video recordings from 42 full-term newborns collected at the Neuro-physiopathology and Neonatology Clinical Units, AOU Careggi, Firenze, Italy. The proposed system showed promising results, giving (mean ± standard error): log-Average Miss Rate = 0.47 ± 0.05 and Average Precision Recall = 0.61 ± 0.05. Moreover, achieved results highlighted interesting differences between newborns without seizures, newborns with electro-clinical seizures, and newborns with electrographic-only seizures. For both metrics statistically significant differences were found between patients with electro-clinical seizures and the other two groups. Clinical Relevance- The proposed method, based on quantitative physio-pathological features of facial movements, is of clinical relevance as it could speed up pain or seizure assessment of newborns in Neonatal Intensive Care Units.


Assuntos
Unidades de Terapia Intensiva Neonatal , Convulsões , Algoritmos , Benchmarking , Humanos , Recém-Nascido , Itália
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1327-1330, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085912

RESUMO

Preterm babies in the Neonatal Intensive Care Unit (NICU) have to undergo continuous monitoring of their cardiac health. Conventional monitoring approaches are contact-based, making the neonates prone to various nosocomial infections. Video-based monitoring approaches have opened up potential avenues for contactless measurement. This work presents a pipeline for remote estimation of cardiopulmonary signals from videos in NICU setup. We have proposed an end-to-end deep learning (DL) model that integrates a non-learning-based approach to generate surrogate ground truth (SGT) labels for supervision, thus refraining from direct dependency on true ground truth labels. We have performed an extended qualitative and quantitative analysis to examine the efficacy of our proposed DL-based pipeline and achieved an overall average mean absolute error of 4.6 beats per minute (bpm) and root mean square error of 6.2 bpm in the estimated heart rate.


Assuntos
Infecção Hospitalar , Aprendizado Profundo , Frequência Cardíaca , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Monitorização Fisiológica
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2663-2667, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086120

RESUMO

Children are the future of our generation, so reducing child mortality is very critical in developing countries. There are lots of asserting factors of child mortality but malnutrition is one of the prominent factors. Medically, it has been proven that breastfeeding is one of the sources of nutrients and it is being always appreciated to have mothers' milk to a child in the early days. However, with the increasing participation of women in the workforce, the child care load on breastfeeding mothers is very high. This forces many of them to take long career breaks. Here, in this paper, we have an automatic formula milk dispensing unit that will be used in Neonatal Intensive Care Units (NICUs) and for breastfeeding mothers at home. The device has inbuilt sterilization and pasteurization units that would maintain the overall hygiene and sterilization of baby milk bottles. Currently, the device has a few buttons through which we can control the functionality of the device.


Assuntos
Aleitamento Materno , Leite Humano , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Mães , Esterilização
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 678-681, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086438

RESUMO

Premature infants are at risk of developing serious complications after birth. Communicative interventions performed in neonatal intensive care units (NICUs), such as music therapy interventions, can reduce the stress experienced by these infants and promote the development of their autonomic nervous system. In this study we investigated the effects of music therapy interventions, consisting of singing, humming, talking or rhythmic reading, on premature infants by investigating the effects on their heart rate variability (HRV). A total of 27 communicative intervention from 18 patients were included in this study. The NN-intervals were extracted from the ECG and the mean ± SEM values for the 6 different features (HR, SDNN, RMSSD, pNN50, pDec and SDDec) was investigated. Median feature values for the pre- and communicative intervention were compared using the Wilcoxon signed-rank test. An increase in values for the SDNN, RMSSD and pNN50 was found in the 20 minutes preceding the communicative intervention, when caregiving activities were performed, and was followed by an immediate decrease at the start of the intervention. Features' variability during the intervention appeared to be smaller than in the pre-communicative intervention, indicating improved autonomic regulation. This difference was, however, not statistically significant possibly due to different types of activities applied during the communicative intervention per patient.


Assuntos
Musicoterapia , Sistema Nervoso Autônomo/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Unidades de Terapia Intensiva Neonatal
15.
Nutrients ; 14(16)2022 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-36014815

RESUMO

Bronchopulmonary dysplasia (BPD) represents a severe sequela in neonates born very prematurely. The provision of adequate nutritional support in this high-risk population is challenging. The development of the lungs and physical growth are closely linked together in infants with BPD. Growth deficiency has been associated with pulmonary dysfunction, whereas improvement in respiratory status results in growth acceleration. Currently, there is not enough data regarding optimal nutritional strategies in this population. Nutrition in these infants should provide sufficient calories and nutrients to establish growth, avoid growth retardation and assist alveolarization of the lungs. Meticulous follow-up is mandatory during and after discharge from the Neonatal Intensive care Unit (NICU) to minimize growth retardation and improve lung function. Despite the significant literature supporting the contribution of growth and nutrition in the avoidance of BPD, there is limited research regarding interventions and management of infants with established BPD. Our aim was to review clinical strategies applied in everyday clinical practice and identify debates on the nutritional approach of newborns with BPD. Well-organized interventions and clinical trials regarding the somatic development and nutrition of infants with BPD are warranted.


Assuntos
Displasia Broncopulmonar , Displasia Broncopulmonar/epidemiologia , Displasia Broncopulmonar/terapia , Transtornos do Crescimento/complicações , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Estado Nutricional , Alta do Paciente
16.
Artigo em Inglês | MEDLINE | ID: mdl-36031333

RESUMO

Growing evidence suggests that early-life events can predispose the newborn to a variety of health problems in postnatal life, which can lead to the need for specialized care in the neonatal intensive care unit (NICU). These events may be caused by factors intrinsically related to the mother (i.e., lifestyle, socioeconomic conditions), and this interplay between maternal exposure factors and negative outcomes in the neonate can be efficiently monitored through effect biomarkers, such as DNA damage. Thus, the present study aimed to evaluate the DNA damage and the maternal and neonatal factors associated with the genotoxic outcome using newborns admitted to the NICUs of three hospitals located in the extreme south of Brazil. A total of 81 newborns were evaluated. DNA damage was assessed using the comet assay, and according to the result obtained for the evaluated parameters (tail length, % of tail DNA and tail moment). The investigation of associated factors was performed using the bivariate and multivariate Poisson regression analysis. As a result, we observed that the tail moment was the most sensitive parameter to detect differences between variables and genetic outcomes in newborns from NICU. Birthweight and the presence of respiratory diseases were associated with greater risks of DNA damage. Furthermore, the variables family income, sex, head circumference, preterm, birthweight and the presence of respiratory and/or infectious diseases showed a significant statistical difference regarding the groups with and without DNA damage (based on the median of the parameter). While the results of this study will serve as the basis for investigating genetic damage, we encourage that similar studies should be conducted elsewhere in order to confirm these and other outcomes as associated factors with DNA damage in newborns.


Assuntos
Dano ao DNA , Unidades de Terapia Intensiva Neonatal , Peso ao Nascer , Brasil , Feminino , Humanos , Recém-Nascido , Análise de Regressão
17.
Einstein (Sao Paulo) ; 20: eRC6698, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36000623

RESUMO

This case report describes the holistic performance of the multidisciplinary team in a context of approaching the moment of death of a newborn, in a cross-cultural approach, and its impact on the working group. We report the clinical case of a neonate diagnosed as severe congenital heart disease, who evolved with early surgical intervention and died on the second day of life. Considering the neonatal intensive care unit an area requiring performance of a specialized team that addresses, with a high level of complexity, in a broad way, the patient, and his family, the death of a child breaks the logic of the life cycle. The multiprofessional and family management of the newborn in question illustrates the opportunities that are still being improved in the care of mourning in the neonatal period. Demonstrating that the care process does not end at the time of death, and the period of mourning is still a challenge for the neonatal team. Even so, parents can be welcomed, with care provided in a private and secure manner, with their needs, and preserved individuality. We observe the need for professional qualification and support for mourning and the need for specific institutional policies, since the health organizations must be attentive and take care of those who care, be cared for with a different look at their emotions.


Assuntos
Pesar , Pais , Criança , Família , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Política Organizacional , Pais/psicologia
18.
BMC Pregnancy Childbirth ; 22(1): 655, 2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-35987566

RESUMO

BACKGROUND: Hypothermia during the newborn period is widely regarded as a major contributory cause of significant morbidity and mortality of newborn infants. Thermoprotective behaviours such as skin-to-skin care (SSC) or the use of appropriate devices have been recommended as simple tools for the avoidance of neonatal hypothermia. We examined the relation between the duration of skin-to-skin care and infant temperature change after birth in suboptimal delivery room temperatures. METHODS: We reviewed the medical charts of all vaginally born infants of gestational age ≥ 35 weeks born January-July 2018 and admitted to the well-baby nursery. After SSC was discontinued, the infant's rectal temperature was measured to determine the frequency and severity of hypothermia. RESULTS: The charts of 688 vaginally born infants were examined. Our mean delivery room temperature was 21.7 (SD 2.2) °C, well below the WHO recommendation of 25 °C. After SSC 347 (50.4%) infants were normothermic (temperature 36.5-37.5 °C), 262 (38.0%) were mildly hypothermic (36.0-36.4 °C), and 79 (11.4%) were moderately hypothermic (32.0-35.9 °C). The mean skin-to-skin time in infants was 63.9 (SD 20.9) minutes. SSC duration was associated with increase in rectal temperature for patients of gestational ages ≥ 38 weeks and with decrease in rectal temperature in patients of gestational age < 38 weeks. CONCLUSION: SSC is effective, even at suboptimal delivery room temperatures, for promoting normothermia in infants of ≥ 38 weeks' gestation but may not provide adequate warmth for infants of < 38 weeks.


Assuntos
Hipotermia , Idade Gestacional , Humanos , Hipotermia/prevenção & controle , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Higiene da Pele , Temperatura
19.
Neonatal Netw ; 41(5): 302-304, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36002273

RESUMO

Parents very rarely walk into the NICU with a medical degree and it creates barriers between parents and professionals from the start. Add in the barriers of cultural, language and systemic racism and the gap grows wider, leaving the families in utter confusion and stress. Everyone deserves respect, which is so eloquently told by Jenny McCormick.


Assuntos
Unidades de Terapia Intensiva Neonatal , Idioma , Humanos , Recém-Nascido , Amor , Pais , Respeito
20.
Neonatal Netw ; 41(5): 273-280, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36002275

RESUMO

Positioning and handling is a core measure of developmental care that has been universally difficult to implement in the technical NICU environment. Appropriate positioning has been shown to not only improve postural and musculoskeletal outcomes, but enhance sensory development, physiologic stability, thermal regulation, behavioral organization, sleep facilitation, and brain development. In order to improve the developmental positioning practices of bedside nurses in a level III neonatal intensive care unit, a quality improvement project was initiated. Guided by the Iowa Model for Evidence-Based Practice, this project included an evidence-based educational intervention and a standardized positioning assessment tool. After the intervention, there was improvement in knowledge scores, and positioning scores increased from an average of 8.81 +/- 0.19 to 10.93 +/- 0.15.


Assuntos
Unidades de Terapia Intensiva Neonatal , Melhoria de Qualidade , Prática Clínica Baseada em Evidências , Humanos , Recém-Nascido
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