Ashley Robson Canyon Creek Dr. Mckinney, TX 75070
|
|
- Randolf Owen
- 5 years ago
- Views:
Transcription
1 1 Ashley Robson 2212 Canyon Creek Dr. Mckinney, TX September 2 nd 2014 Debra Brandon PhD, RN, CCNS, FAAN Duke University School of Nursing Durham, NC Dear Mrs. Brandon- I would like the opportunity to submit a manuscript to Advances in Neonatal Care. The manuscript will be a review of the use of probiotics for the prevention of Necrotizing Entercolitis in the neonate. It has been studied that prevention of Necrotizing Entercolitis can possibly be accomplished by the use of prophylactic enteral probitoics. This has thought to play a role in reducing the morbidity and mortality associated with NEC. This manuscript will include study related information on the prevention of NEC in the preterm infant. Also, the economic, emotional and social impact will be discussed. The evidence-based practice around the use of probiotics will be discussed. I have over eight years of nursing experience, caring for the neonate and families. I began my career as an intern in the Newborn Nursery and upon graduation from nursing school completed my residency nursing program in a Neonatal Intensive Care Unit. I am currently completing my Master of Science in Nursing in pursuit of becoming a neonatal nurse practitioner and will graduate in December 2014, I can have the manuscript completed by November 20, 2014, or sooner if that better
2 2 meets your publication needs. Please me at with any questions. Thank you for your consideration. Sincerely, Ashley Robson, BSN, RNC-NIC
3 3 Title Page: Manuscript of the use of Probiotics in the Prevention of Necrotizing Entercolitis in Neonates Author: Ashley Robson, BSN, RNC-NIC Address: 2212 Canyon Creek Dr. McKinney, TX 75070
4 4 Abstract: The use of probiotics in the neonatal population might prevent the development of Necrotizing Entercolitis. The problem statement is: Could the use of probiotics prevent the development of Necrotizing Entercolitis? The approach of this practice change is to provide as much research as possible to make an accurate decision on the use of probiotics. The result is that there is still further research that needs to be conducted to come up with an outcome. The development of Necrotizing Entercolitis is detrimental to the infant, families, and hospital and having an simple intervention that could prevent that warrants further investigation The following manuscript has never been published and is not currently under consideration by another company. Also, there weren t any conflicts of interest identified in this manuscript.
5 5 Introduction Necrotizing Entercolitis (NEC) is an acute inflammatory disease with multiple factors and controversial etiology. Research has proposed NEC to be caused from a reperfusion injury that activates an inflammatory cascade reaction; partial or full-thickness necrosis then occurs leading to perforation of the intestinal tract (Springer, 2014). NEC occurs in about ten percent of neonates weighing less than 1500 grams, and mortality occurs in fifty percent of those infants (Springer, 2014). NEC is the most common medical and surgical emergency in neonates (Springer, 2014). Although studies have not identified a definite cause of NEC, there are several proposed pathologies. Maternal Pathophysiology Maternal factors identified as correlating to NEC cases include: drug use, hypertension, infection, and any problem that leads to decreased placental blood flow (Gephart, McGrath, Effken, & Halpern, 2012). Correlation of cocaine use with NEC have been identified in previous studies, with infants of cocaine abusing mothers developing NEC at a higher percentage than those of mothers who did not use drugs (Gephart et al., 2012). Hypertensive mothers, both chronic and pregnancy-induced, have been found to have infant s with higher rates of developing NEC although the association of magnesium use for hypertension was not found as a risk factor. Maternal infections, such as human immunodeficiency
6 6 virus (HIV), have been found to have an increased risk of birthing infants who later develop NEC. Fetal Pathophysiology Although further research is needed in relating fetal pathophysiology to NEC, studies have found hypoxic-ischemic compromise and bacterial infections in utero to have a distinct correlation with developing NEC (Gephart et al., 2103). Hypoxic-ischemic compromise of: maternal cardiac arrest, umbilical cord prolapse, and placental abruption have been found to be intra-partum risk factors relating to NEC (Gephart et al., 2013). Bacterial colonization is also indicated as a causative factor due to the decreased number or complete absence of anaerobe bacteria in preterm infant s intestines. The lack of anaerobic bacteria causes a reduction in the anti-inflammatory effects and mucosal defense of probiotic organisms (Martin et al., 2011). Impact of the maternal condition on the fetus Maternal hypertensive disorders reduce blood flow from the placenta to the fetus causing a variable degree of hypoxia and intrauterine growth restriction. Intrauterine growth restriction is a finding in many research studies connecting hypertension and NEC (March, Gupta, Modest, Hacker, Martin, & Rana, 2014).
7 7 Intrauterine growth restriction is also a causative factor in low birth weight, which is a major correlating factor in NEC. Clinical manifestations and diagnostic evaluation of the neonate Preterm infants with low birth weights are at highest risk of developing NEC. Symptoms usually develop two to three weeks after birth, but have been seen as early as one to three days after birth (Springer, 2014). Clinical manifestations seen in patients with NEC are generally subtle signs of feeding intolerance that progress over several hours. Symptoms can include: tenderness to the abdomen, increased abdominal girth, vomiting, bloody stools, bloody gastric residuals, visible bowel loops, apnea, bradycardia, circulatory collapse, decreased perfusion to extremities, and temperature instability (Springer, 2014). Pnuematosis intestinalis upon abdominal x-ray is a classic sign of NEC. Usually there is some underlying disease including: anemia, asphyxia, cardiopulmonary disease, polycythemia, and abnormal bacterial colonization. Differential diagnoses of NEC include hypoplastic left heart syndrome, intestinal malrotation, volvulus, bacterial meningitis, sepsis, omphalitis, urinary tract infections, and prematurity. Therapeutic approaches and treatment options
8 8 The treatment varies based on symptoms and the degree of the disease process. Bowel rest should be provided by eliminating feeds from the infant s nutritional plan and providing nutrition with intravenous dextrose, amino acid, and electrolytes. Decompression of the stomach from low intermittent suction via a replogle tube will aid in bowel rest. A blood culture should be performed initially prior to antibiotic therapy to determine the presence of an infection, a complete blood count should be drawn and monitored throughout the course of illness to monitor white blood cell counts and hemoglobin and hematocrit. Serial abdominal x-rays should be obtained to monitor the intestines for perforation. Antibiotic therapy should begin after blood culture is drawn and should continue for days. Ampicillin and gentamycin should be started and antibiotic therapy changes can be made based upon the blood culture results. If advanced NEC is present signs and symptoms of apnea, increased need of respiratory support, hypotension, decreased urine output, redness in the abdominal area, fluid or gas in the abdominal cavity, and lactic acid build up will be present. A surgical consult should be requested and exploratory surgery and removal of necrotic bowel should be performed. Pertinent theories and Evidence Based Practice Although research is limited in defining the causative factor or NEC, there are some methods to prevent NEC. Initiating trophic feedings soon after delivery
9 9 to prime the intestinal tract and using only expressed breast milk, which has mucosal protection, have been shown to reduce the risks of developing NEC. Antenatal steroids have mixed research outcomes on the benefits of reducing NEC, some suggest a reduction in the NEC cases by fifty percent and others suggest antenatal steroids increase the risk of NEC. Probiotics have been studied and show potential in reducing the incidence of NEC, but preparation is still undergoing studies (Springer, 2013). The presence of probiotics in the intestinal tract is important to protect the integrity of the mucosa. Probiotics improve the quality of the intestinal mucus, improve gut motility, and control the cytokine production (Springer, 2013). Probiotics will also compete against pathogenic bacteria to limit the overgrowth of pathogens in the intestines (Springer, 2013). There are many factors that can contribute to pathogenic bacterial colonization of the intestinal tract: type of delivery, amniotic fluid characteristics, diet, environmental exposure, and antibiotic use. With increasing factors of pathogenic bacteria colonization, the use of probiotics might prevent the prevalence of NEC by decreasing pathogenic bacteria. The four main types of organisms studied with the use of probiotics are: Strepococcus, Lactobacillus, Sacchormyces, and Bifodbacterium; streptococcus being a main infection causing bacteria in the preterm infant population. In the United States, the only probiotic is Good Start Natural Cultures with Bifidobacterium lactis for infants. (Ladd & Ngo, 2009).
10 10 Economic, emotional and social implications on the family unit When discussing the economic implication of the family unit when their child is faced with a devastating disease such as Necrotizing Entercolitis is profound. With this illness or any illness, families will have increased stress, have a difficult time concentrating at work, feel guilty, and have reduced self-esteem. All of these things could potentially have an effect on the parents as a unit. The amount of time the parents are at the hospital may cause areas in their life to be affected including: household tasks, family and community ties, and leave the family with a feeling of isolation. Resources need to be provided to all the families of infants in the Neonatal Intensive Care Unit including resources for economic, emotional, and social needs of the family unit. Conclusion In conclusion, past research has presented us with information to believe that probiotic use in the Neonatal Intensive Care Unit (NICU) could prevent the development of NEC. Further research still needs to be done in this area. The development of Necrotizing Entercolitis is detrimental to the infant, families, and hospital and having an simple intervention that could prevent that warrants further investigation.
11 11 References Springer, S.C., (2014). Necrotizing Enterocolitis. Retrieved from: overview. Fanaroff, A. A., & Martin, J. M. (2013). Klaus & Fanaroff s care of the high-risk neonate 6th ed. Philadelphia, PA: Saunders. Gephart, S. M., McGrath, J. M., Effken, J. A., & Halpern, M. D. (2013). Necrotizing enterocolitis risk. Advanced Neonatal Care. 12(2) Ladd, N., Ngo, Tiffany. (2009). The use of probiotics in the prevention of necrotizing enterocolitis in preterm infants. Baylor University Medical Center Proceedings. 22(3): March, M. I., Gupta, M., Modest, A. M., Hacker, M. R., & Rana, s. (2014). Maternal risk factors for neonatal necrotizing enterocolitis. Journal of Maternal Fetal Neonatal Medicine. 1-6.
The Case Begins. The case continued. Necrotizing Enterocolitis
Bugs, Drugs and Things that go Bump in the Night From ghoulies to ghosties and long leggety beasties & things that go bump in the night, good lord deliver us Old Cornish Prayer Caring for premature infant
More informationGastric Residuals in Preterm Infants
Neonatal Nursing Education Brief: Gastric Residuals in the Preterm Infant https://www.seattlechildrens.org/healthcareprofessionals/education/continuing-medical-nursing-education/neonatalnursing-education-briefs/
More informationOur Journey Toward Elimination of. Necrotizing Enterocolitis 4/16/2018. Disclosure. Presentation Outline. Clinical Presentation of NEC
Our Journey Toward Elimination of Necrotizing Enterocolitis RAY SATO, M.D. TACOMA GENERAL HOSPITAL NICU APRIL 2018 Disclosure Ray Sato, MD has no financial relationship to disclose or conflicts of interest
More informationSWISS SOCIETY OF NEONATOLOGY. Spontaneous intestinal perforation or necrotizing enterocolitis?
SWISS SOCIETY OF NEONATOLOGY Spontaneous intestinal perforation or necrotizing enterocolitis? June 2004 2 Stocker M, Berger TM, Neonatal and Pediatric Intensive Care Unit, Children s Hospital of Lucerne,
More information4/15/2014. Nurses Take the Lead to Improve Overall Infant Growth. Improving early nutrition. Problem Identification
Nurses Take the Lead to Improve Overall Infant Growth Cathy Lee Leon, RN, BSN, MBA, NE-BC California Pacific Medical Center-San Francisco Improving early nutrition Standardized feeding protocol Problem
More informationMinimal Enteral Nutrition
Abstract Minimal Enteral Nutrition Although parenteral nutrition has been used widely in the management of sick very low birth weight infants, a smooth transition to the enteral route is most desirable.
More informationThe Use of Simulated Amniotic Fluid in Preventing Feeding Intolerance and Necrotizing Enterocolitis
St. Catherine University SOPHIA Master of Arts in Nursing Theses Nursing 12-2011 The Use of Simulated Amniotic Fluid in Preventing Feeding Intolerance and Necrotizing Enterocolitis Grethe Mortensen St.
More informationNecrotizing Enterocolitis: The Role of the Immune System
Necrotizing Enterocolitis: The Role of the Immune System Patricia Denning, M.D. Associate Professor in Pediatrics Division of Neonatology Emory University School of Medicine What is NEC? What is NEC? Necrotizing
More informationNEC. cathy e. shin childrens hospital los angeles department of surgery university of southern california keck school of medicine
NEC cathy e. shin childrens hospital los angeles department of surgery university of southern california keck school of medicine Necrotizing enterocolitis (NEC) the most common and most lethal disease
More informationResuscitating neonatal and infant organs and preserving function. GI Tract and Kidneys
Resuscitating neonatal and infant organs and preserving function GI Tract and Kidneys Australian and New Zealand Resuscitation Council Joint Guidelines Outline Emphasis on the infant - PICU Kidney Gastrointestinal
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A AAP. See American Academy of Pediatrics (AAP) Acyclovir dosing in infants, 185 187 American Academy of Pediatrics (AAP) COFN of, 199 204 Amphotericin
More informationTABLE I-1: RESIDENT INFANT DEATHS PER 1,000 LIVE BIRTHS, BY RACE AND ETHNICITY, FLORIDA AND UNITED STATES, CENSUS YEARS AND
TABLE I-1: RESIDENT INFANT DEATHS PER 1,000 LIVE BIRTHS, BY RACE AND ETHNICITY, FLORIDA AND UNITED STATES, CENSUS YEARS 1970-2000 AND 2004-2014 FLORIDA 1 UNITED STATES 1 YEAR WHITE2 BLACK2 HISPANIC3 WHITE2
More informationINTESTINAL OBSTRUCTION ESCAPED SURGERY: MECONIUM PLUG
7 INTESTINAL OBSTRUCTION ESCAPED SURGERY: MECONIUM PLUG Oluwayemi IO 1 *, Ade-Ojo IP 2, Olofinbiyi BA 2 1. Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
More informationGastroschisis Sequelae and Management
Gastroschisis Sequelae and Management Mary Finn Gillian Lieberman, MD Primary Care Radiology Beth Israel Deaconess Medical Center Harvard Medical School April 2014 Outline I. Definition and Epidemiology
More informationNeonatal sepsis INCIDENCE RISK FACTORS RISK FACTORS 5/18/2015
Angelica Floren MD.FAAP. Caring for Little Miracles 6 Th Annual Care Of the Sick Newborn Conference Neonatal sepsis Neonatal sepsis is a disease that may start with minimal or nonspecific symptoms and
More informationHypoglycaemia of the neonate. Dr. L.G. Lloyd Dept. Paediatrics
Hypoglycaemia of the neonate Dr. L.G. Lloyd Dept. Paediatrics Why is glucose important? It provides 60-70% of energy needs Utilization obligatory by red blood cells, brain and kidney as major source of
More informationPrenatal and neonatal gut maturation
Department of Veterinary Clinical and Animal Sciences Prenatal and neonatal gut maturation Thomas Thymann Comparative Pediatrics and Nutrition Dept. Vet. and Animal Science P.W. Nathanielsz Whom signals
More informationRD s In Practice: Advancing Pediatric Nutrition
RD s In Practice: Advancing Pediatric Nutrition A Strong Beginning Mindy Morris, DNP, NNP-BC, CNS Extremely Low Birth Weight Program Coordinator Objectives Understand the challenges associated with the
More informationETIOLOGY AND PATHOGENESIS OF HYPOXIC-ISCHEMIC ENCEPHALOPATHY
ETIOLOGY AND PATHOGENESIS OF HYPOXIC-ISCHEMIC ENCEPHALOPATHY HYPOXIC-ISCHEMIC ENCEPHALOPATHY Hypoxic-İschemic Encephalopathy Encephalopathy due to hypoxic-ischemic injury [Hypoxic-ischemic encephalopathy
More informationNEC- What Lies Under the Big Umbrella?
NEC- What Lies Under the Big Umbrella? Instructor in Surgery Associate Surgical Director, Center for Advanced Intestinal Rehabilitation Department of Surgery, Boston Children's Hospital Harvard Medical
More informationNecrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability
Necrotizing Enterocolitis: the role of ultrasound in the assessment of bowel viability Ricardo Faingold, MD. Department of Medical Imaging The Montreal Children s Hospital McGill University SPR Vancouver
More informationINTRODUCING YOUR GUT BACTERIA
INTRODUCING YOUR GUT BACTERIA Microflora Intestinal flora 1.5 kg We would die with 5 years of birth if we did not have them as we would not develop a proper immune system 1000 species and 5000 strains
More informationEvidence-Based Update: Using Glucose Gel to Treat Neonatal Hypoglycemia
Neonatal Nursing Education Brief: Evidence-Based Update: Using Glucose Gel to Treat Neonatal Hypoglycemia http://www.seattlechildrens.org/healthcare-professionals/education/continuing-medicalnursing-education/neonatal-nursing-education-briefs/
More informationAdmission/Discharge Form for Infants Born in Please DO NOT mail or fax this form to the CPQCC Data Center. This form is for internal use ONLY.
Selection Criteria Admission/Discharge Form for Infants Born in 2016 To be eligible, you MUST answer YES to at least one of the possible criteria (A-C) A. 401 1500 grams o Yes B. GA range 22 0/7 31 6/7
More informationGUIDELINE PHYSIOLOGY OF BIRTH ASPHYXIA
GUIDELINE PHYSIOLOGY OF BIRTH ASPHYXIA The newborn is not an adult, nor a child. In people of all ages, death can occur from a failure of breathing and / or circulation. The interventions required to aid
More informationThe Pathophysiology of Necrotizing Enterocolitis
Article gastroenterology The Pathophysiology of Necrotizing Enterocolitis Michael S. Caplan, MD,* and Tamas Jilling, MD Objectives After completing this article, readers should be able to: 1. Describe
More informationNecrotizing Enterocolitis
CHAPTER 1 CHAPTER Necrotizing Enterocolitis Fawn C. Lewis and Daniel A. Bambini Incidence The incidence of necrotizing enterocolitis (NEC) in the United States is 1-3 cases per thousand live births, or
More informationClinical evaluation Jaundice skin and mucous membranes
JAUNDICE Framework The definition of Neonatal Jaundice Billirubin Metabolism Special characteristic in neonates Dangerous of the Hyperbillirubinemia The diseases in relation with Neonatal Jaundice Objectives:
More informationExchange Transfusion
Approved by: Exchange Transfusion Gail Cameron Director, Maternal, Neonatal & Child Health Programs Neonatal Nursery Policy & Procedures Manual : Next Review March 2016 Dr. Ensenat Medical Director, Neonatology
More informationSWISS SOCIETY OF NEONATOLOGY. Neonatal pneumatosis coli a mild form of classical necrotizing enterocolitis?
SWISS SOCIETY OF NEONATOLOGY Neonatal pneumatosis coli a mild form of classical necrotizing enterocolitis? August 2008 2 Steurer M, Stocker M, Caduff JH, Neonatal and Pediatric Intensive Care Unit (SM,
More informationNutrition in the premie World
SURVIVAL AND GROWTH NUTRITION ESSENTIALS Nutrition in the premie World DR VISH SUBRAMANIAN MD MRCP (UK) FAAP NEONATAL CRITICAL CARE MERCY CHILDRENS HOSPITAL., SPRINGFIELD MO Prematurity Nutritional Requirements
More informationHyaline membrane disease. By : Dr. Ch Sarishma Peadiatric Pg
Hyaline membrane disease By : Dr. Ch Sarishma Peadiatric Pg Also called Respiratory distress syndrome. It occurs primarily in premature infants; its incidence is inversely related to gestational age and
More informationWHAT IS THE EVIDENCE FOR PROBIOTIC SUPPLEMENTATION?
WHAT IS THE EVIDENCE FOR PROBIOTIC SUPPLEMENTATION? Roger F. Soll, MD H. Wallace Professor of Neonatology University of Vermont President Vermont Oxford Network 19 th International Symposium on Neonatology
More informationRECTAL PROLAPSE objectives
RECTAL PROLAPSE objectives 1.Classify rectal prolapse 2. Enumerate the causes of rectal prolapse 3. Differentiate between complete rectal prolapse and intussusception 4. List the modalities of treatment
More informationMedical Follow-up of the High-Risk NICU Graduate
Medical Follow-up of the High-Risk NICU Graduate Silvia Fajardo-Hiriart, M.D. Medical Director High-Risk Infant Follow-Up/Early Intervention Program University of Miami Miller School of Medicine Department
More informationDaniel Hirsch, MD Director of Neonatology Somerset Medical Center Assistant Professor of Pediatrics UMDNJ RWJMS
Daniel Hirsch, MD Director of Neonatology Somerset Medical Center Assistant Professor of Pediatrics UMDNJ RWJMS Daniel Hirsch, MD Director of Neonatology Somerset Medical Center Assistant Professor of
More informationThe high risk neonate
The high risk neonate Infant classification by gestational (postmenstrual) age Preterm. Less than 37 completed weeks (259 days). Term. Thirty-seven to 416/7 weeks (260-294 days). Post-term. Forty-two weeks
More informationAPPENDIX A. Comparability Ratios for the Major Causes of Death in North Carolina Vital Statistics, Volume 2
APPENDIX A Comparability Ratios for the Major Causes of Death in North Carolina Vital Statistics, Volume 2 The comparability ratio is an adjustment factor that is applied to the number of deaths coded
More informationReview of Neonatal Respiratory Problems
Review of Neonatal Respiratory Problems Respiratory Distress Occurs in about 7% of infants Clinical presentation includes: Apnea Cyanosis Grunting Inspiratory stridor Nasal flaring Poor feeding Tachypnea
More information3/25/2012. numerous micro-organismsorganisms
Congenital & Neonatal TB A Case of Tuberculosis Congenital or Acquired? Felicia Dworkin, MD NYC DOHMH Bureau TB Control World TB Day March 23, 2012 Congenital TB: acquired by the fetus during pregnancy
More informationADMISSION/DISCHARGE FORM FOR INFANTS BORN IN 2019 DO NOT mail or fax this form to the CPQCC Data Center. This form is for internal use ONLY.
1 Any eligible inborn infant who dies in the delivery room or at any other location in your hospital within 12 hours after birth and prior to admission to the NICU is defined as a "Delivery Room Death."
More informationNeonatal Perforated Gut: Etiology and Risk Factors
Cronicon OPEN ACCESS EC PAEDIATRICS Research Article Mostafa Kotb 1 * and Marwa Beyaly 2 1 Pediatric Surgery Department, Alexandria Faculty of Medicine, Egypt. 2 Human Genetics Department, Medical Research
More informationEfficacy of Breast Milk Gastric Lavage in Preterm Neonates. Archana B. Patel and Samiuddin Shaikh
Research Papers Efficacy of Breast Milk Gastric Lavage in Preterm Neonates Archana B. Patel and Samiuddin Shaikh From the Department of Pediatrics and Clinical Epidemiology Unit, Indira Gandhi Medical
More informationA Multi center Randomized Trial of Laparotomy vs. Drainage
A Multi center Randomized Trial of Laparotomy vs. Drainage as the Initial Surgical Therapy for ELBW Infants with Necrotizing Enterocolitis (NEC) or Isolated Intestinal Perforation (IP): Outcomes at 18
More informationPRACTICE GUIDELINES WOMEN S HEALTH PROGRAM
C Title: NEWBORN: HYPOGLYCEMIA IN NEONATES BORN AT 35+0 WEEKS GESTATION AND GREATER: DIAGNOSIS AND MANAGEMENT IN THE FIRST 72 HOURS Authorization Section Head, Neonatology, Program Director, Women s Health
More informationStudy of renal functions in neonatal asphyxia
Original article: Study of renal functions in neonatal asphyxia *Dr. D.Y.Shrikhande, **Dr. Vivek Singh, **Dr. Amit Garg *Professor and Head, **Senior Resident Department of Pediatrics, Pravara Institute
More informationHEMATOPOIETIC GROWTH FACTORS IN NEONATAL MEDICINE
HEMATOPOIETIC GROWTH FACTORS IN NEONATAL MEDICINE Preface Robert D. Christensen xiii Evaluation and Treatment of Severe and Prolonged Thrombocytopenia in Neonates 1 Martha C. Sola Thrombocytopenia is one
More informationNecrotizing Enterocolitis Update Muneef AL-Hathal, MD
Necrotizing Enterocolitis Update Muneef AL-Hathal, MD Neonatal Department Maternity Hospital Kuwait Incidence There is almost fourfolds difference in the rate of NEC in babies < 1500 gm (from 2-7%) The
More informationNECROTIZING ENTEROCOLITIS
Necrotising Enterocolitis (NEC) NECROTIZING ENTEROCOLITIS Atan Baas Sinuhaji Department of Childhealth,School of Medicine,University of North Sumatera Medan Affects 0.5 to 1 per 1000 live births Incidence
More informationSWISS SOCIETY OF NEONATOLOGY. Catastrophic gastrointestinal event in a 10-week-old extremely growth restricted preterm infant
SWISS SOCIETY OF NEONATOLOGY Catastrophic gastrointestinal event in a 10-week-old extremely growth restricted preterm infant APRIL 2011 2 Häberli So, Hausladen Si, Hürlimann Sa, Caduff JH, Esslinger P,
More informationIs It Possible to Prevent Necrotizing Enterocolitis?
Is It Possible to Prevent Necrotizing Enterocolitis? Ravi Mangal Patel, MD MSc Associate Professor of Pediatrics Emory University School of Medicine, Atlanta, GA, USA @institutopgg @ravimpatelmd Disclosures
More informationSlow versus Fast Enteral Feed Advancements in Very Low Birth Weight Infants: A Randomized Controlled Trial. A. Salhotra and S.
Original Article Slow versus Fast Enteral Feed Advancements in Very Low Birth Weight Infants: A Randomized Controlled Trial A. Salhotra and S. Ramji From the Neonatal Division, Department of Pediatrics,
More informationParticipants. probiotic. /placebo)
Table S1. Demographic characteristics of trials included in the meta-analysis. Study Birth weight (mean±sd) Gestation (wk) Feeding patterns Participants (probiotic /placebo) Probiotic agents Dosage Duration
More informationEffects of Probiotics on the Reduction in Incidence of Necrotizing Enterocolitis in Premature (< 37 Weeks Gestation) Neonates
University of Central Florida Honors in the Major Theses Open Access Effects of Probiotics on the Reduction in Incidence of Necrotizing Enterocolitis in Premature (< 37 Weeks Gestation) Neonates 2016 Makenzie
More informationCHAPTER 12 HYPERTENSION IN SPECIAL GROUPS HYPERTENSION IN PREGNANCY
CHAPTER 12 HYPERTENSION IN SPECIAL GROUPS HYPERTENSION IN PREGNANCY v Mild preeclampsia is managed by close observation of the mother and fetus preferably in hospital. If the diastolic blood pressure remains
More informationThe impact of the microbiome on brain and cognitive development
The Gut-Brain Axis The impact of the microbiome on brain and cognitive development Diane Stadler, PhD, RD Oregon Health & Sciences University, Portland, Oregon Lao-American Nutrition Institute With acknowledgements
More informationSatellite Symposium. Sponsored by
Satellite Symposium Sponsored by Management of fluids and electrolytes in the preterm infant in the first week of life Pam Cairns St Michaels Hospital Bristol Healthy, term, breast fed babies Limited intake
More informationNeonatal infections and neonatal seizures. Mohamed Waheed Elsharief Dept. of paediatrics Faculty of medicine Jazan University KSA
Neonatal infections and neonatal seizures Mohamed Waheed Elsharief Dept. of paediatrics Faculty of medicine Jazan University KSA objectives By the end of this lecture the student should Define neonatal
More informationInfant Of Diabetic Mother(IDM)
Infant Of Diabetic Mother(IDM) Sangram Satish Magar 1, Sanskriti Mirashi 2 1. M.D. Sch.(Kaumarbhrutya-Balrog) 2.Guide (Kaumarbhrutya-Balrog), L.R.P.Medical college,islampur,tal- Walwa, dist- Sangli, Maharashtra,
More informationHypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC
Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC Objectives 1. Define Hypoxic-Ischemic Encephalopathy (HIE) 2. Identify the criteria used to determine if an infant qualifies for therapeutic
More informationState of Florida Systemic Supportive Care Guidelines. Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology
State of Florida Systemic Supportive Care Guidelines Michael D. Weiss, M.D. Associate Professor of Pediatrics Division of Neonatology I. FEN 1. What intravenous fluids should be initiated upon admission
More informationAN OUTBREAK OF MULTIDRUG RESISTANT Salmonella typhimurium IN A NURSERY
AN OUTBREAK OF MULTIDRUG RESISTANT Salmonella typhimurium IN A NURSERY Ashok Kumar Gopal Nath B.D. Bhatia V. Bhargava V. Loiwal ABSTRACT A nursery epidemic caused by multidrug resistant Salmonella typhimurium
More informationLavanya Nutankalva,MD Consultant: Infectious Diseases
Lavanya Nutankalva,MD Consultant: Infectious Diseases Introduction The word Probiotic was derived from the Greek phrase meaning for life." was first coined in the 1960s by Lilly and Stillwell. Probiotics
More informationNeonatal Hypoglycemia. Presented By : Kamlah Olaimat 25\7\2010
Neonatal Hypoglycemia Presented By : Kamlah Olaimat 25\7\2010 Definition The S.T.A.B.L.E. Program defines hypoglycemia as: Glucose delivery or availability is inadequate to meet glucose demand (Karlsen,
More informationIs NEC requiring surgery precipitated by a change in feeds? Observations from 50 consecutive cases. David Burge SIGNEC September 2015
Is NEC requiring surgery precipitated by a change in feeds? Observations from 50 consecutive cases. David Burge SIGNEC September 2015 Clinical series Specific cases Other scenarios Published experience
More informationNEONATAL SEPSIS. Dalima Ari Wahono Astrawinata Departemen Patologi Klinik, FKUI-RSCM
NEONATAL SEPSIS Dalima Ari Wahono Astrawinata Departemen Patologi Klinik, FKUI- Background Neonatal sepsis : Early-onset Late-onset Early-onset : mostly premature neonates Within 24 hours 85% 24-48 hours
More informationResearch Article Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes
Gastroenterology Research and Practice Volume 2016, Article ID 6134187, 6 pages http://dx.doi.org/10.1155/2016/6134187 Research Article Bowel Perforation in Premature Infants with Necrotizing Enterocolitis:
More informationEffectiveness of probiotics in reducing Necrotizing Enterocolitis (NEC) severity in preterm or low birth weight infants: A review of the literature
Effectiveness of probiotics in reducing Necrotizing Enterocolitis (NEC) severity in preterm or low birth weight infants: A review of the literature abstract BACKGROUND AND OBJECTIVE: Necrotizing enterocolitis
More information8/20/12. Discuss the importance of thermoregulation in the neonate.
Sharon Rush MSN NNP-BC Discuss the importance of thermoregulation in the neonate. To maintain correct body temperature range in order to: Reduce oxygen consumption Reduce calorie expenditure Maximize metabolic
More informationMaternal and Fetal Physiology
Background Maternal and Fetal Physiology Anderson Lo, DO Fellow, Maternal-Fetal Medicine Wayne State University School of Medicine SEMCME Fetal Assessment Course July 20, 2018 Oxygen pathway Mother Placenta
More informationChapter 2 Hepatitis B Overview
Chapter 2 Hepatitis B Overview 23 24 This page intentionally left blank. HEPATITIS B OVERVIEW Hepatitis B Virus The hepatitis B virus (HBV) belongs to the Hepadnaviridae family and is known to cause both
More informationNeonatal Intensive Care Unit Skills Checklist
_ XXX-XX- Print Name Last 4 of SS # Date Completed Directions Please circle a value for each question to provide us and the interested facilities with an assessment of your clinical experience. These values
More informationHypoglycemia. Objectives. Glucose Metabolism
Hypoglycemia Instructor: Janet Mendis, MSN, RNC-NIC, CNS Outline: Janet Mendis, MSN, RNC-NIC, CNS Summer Morgan, MSN, RNC-NIC, CPNP UC San Diego Health System Objectives State the blood glucose level at
More informationList of Chapters. 5. Care of the sick child Evidence-based pediatrics (page 77 to 80)
Illustrated Textbook of Paediatrics, 4th Edition Tom Lissauer, and Graham Clayden, 2012 List of Chapters 1. The child in society 2. History and examination 3. Normal child development, hearing and vision
More informationWritten by Kate Raines Thursday, 01 December :00 - Last Updated Thursday, 14 September :41
The human microbiome plays a vital role in overall health, and new information about it is discovered nearly every day. Defined as the sum of all microbial life living in or on the human body, the microbiome
More informationA Study of Prevalence and Risk Factors of Polycythemia in Neonatal Nursery in Duhok
ORIGINAL ARTICLE A Study of Prevalence and Risk Factors of Polycythemia in Neonatal Nursery in Duhok Akrem Mohammad Mostefa 1 ABSTRACT OBJECTIVE: To find the prevalence of neonatal polycythemia among neonates
More informationPROBIOTIC RESEARCH REVIEW
Probiotics in the Prevention of Eczema: A Randomised Controlled Trial (Allen at al. 2014) The probiotic formula that is used in GENESTRA BRANDS HMF Baby B and HMF Baby F was found to safely and effectively
More informationThe Egyptian Journal of Hospital Medicine (Apr. 2017) Vol.67 (2), Page
The Egyptian Journal of Hospital Medicine (Apr. 2017) Vol.67 (2), Page 666-671 The Prophylactic Role of Probiotics for Preterm Infants/Neonates Abdulrahman Mohammedsaeed Baqasi 1, Ali Hussain ALAbdullah
More informationNeonatal Life Support Provider (NLSP) Certification Preparatory Materials
Neonatal Life Support Provider (NLSP) Certification Preparatory Materials NEONATAL LIFE SUPPORT PROVIDER (NRP) CERTIFICATION TABLE OF CONTENTS NEONATAL FLOW ALGORITHM.2 INTRODUCTION 3 ANTICIPATION OF RESUSCITATION
More informationIndian Pediatrics - Editorial
Page 1 of 7 Home Past Issue About IP About IAP Feedback Links Author Info. Subscription Original Articles Indian Pediatrics 2004; 41:435-441 Slow versus Fast Enteral Feed Advancements in Very Low Birth
More informationExtensive cystic periventricular leukomalacia following early-onset group B streptococcal sepsis in a very low birth weight infant
SWISS SOCIETY OF NEONATOLOGY Extensive cystic periventricular leukomalacia following early-onset group B streptococcal sepsis in a very low birth weight infant July 2012 2 Berger TM, Caduff JC, Neonatal
More informationNEONATOLOGY Healthy newborn. Neonatal sequelaes
NEONATOLOGY Healthy newborn. Neonatal sequelaes Ágnes Harmath M.D. Ph.D. senior lecturer 11. November 2016. Tasks of the neonatologist Prenatal diagnosed condition Inform parents, preparation of necessary
More informationChapter Outline. Structural defects. Obstructive disorders. Preview from Notesale.co.uk Page 3 of 98. Cleft lip and cleft palate
Structural defects Chapter Outline Cleft lip and cleft palate Page 3 of 98 Esophageal atresia and tracheoesophageal fistula Hernias Obstructive disorders Hypertrophic pyloric stenosis Intussusception Anorectal
More informationהשפעת חיידקים פרוביוטיים
השפעת חיידקים פרוביוטיים החיים בחלל )המעי(... על רון שאול יחידת גסטרו ילדים מרכז רפואי רמב"ם Introduction The intestinal microflora primarily in the large bowel consists mostly on benign bacterial species
More information22. NEONATALOGISTS AT WORK I
22. NEONATALOGISTS AT WORK I PERSISTENT PULMONARY HYPERTENTION (PPH) IN THE NEONATE Dr. David S. Rubenstein Professor of Clinical Pediatrics Sdr26@columbia.edu OVERVIEW: Persistent pulmonary hypertension
More informationEQUIPMENT: Nitrous Oxygen Delivery System:
Policy: Nitrous Oxide Use in the Intrapartum and Immediate Postpartum Period for Obstetrical Patients in the Family Birth Place Approvers: CEO. CNO, Medical Staff President, Anesthesia Chair, OB Medical
More informationGroup B Streptococcus
Group B Streptococcus (Invasive Disease) Infants Younger than 90 Days Old DISEASE REPORTABLE WITHIN 24 HOURS OF DIAGNOSIS Per N.J.A.C. 8:57, healthcare providers and administrators shall report by mail
More informationSOUTHERN WEST MIDLANDS NEWBORN NETWORK
SOUTHERN WEST MIDLANDS NEWBORN NETWORK Hereford, Worcester, Birmingham, Sandwell & Solihull Title : Person Responsible for Review : Management of Gastro-Intestinal Stomata In Neonates R. Wragg & G.Jawaheer
More informationAppendix 1. Causes of Neonatal Deaths. Interval between. Gestation at birth. birth and death. Allocation. (weeks +days ) Cause of death.
Appendix 1. Causes of Neonatal Deaths Interval between Gestation at birth birth and death Allocation (weeks +days ) (days) Cause of death Amnioinfusion 25 +1/7 20 Respiratory and circulatory insufficiency
More informationArabian Gulf University Kingdom of Bahrain Year 5 Pediatrics 3 rd Week Discussion with Dr. Muna Al-Jufairi (Part 2)
Arabian Gulf University Kingdom of Bahrain Year 5 Pediatrics 3 rd Week Discussion with Dr. Muna Al-Jufairi (Part 2) - Case 1: a 32 weeks preterm developed RDS 4 hours after delivery. Chest X-ray shows:
More informationNeonatal Resuscitation. Dustin Coyle, M.D. Anesthesiology
Neonatal Resuscitation Dustin Coyle, M.D. Anesthesiology Recognize complications Maternal-fetal factors Maternal DM PIH Chronic HTN Previous stillbirth Rh sensitization Infection Substance abuse/certain
More informationNUTRITIONAL REQUIREMENTS
NUTRITION AIMS To achieve growth and nutrient accretion similar to intrauterine rates To achieve best possible neurodevelopmental outcome To prevent specific nutritional deficiencies Target population
More informationHome FAQ Archives ABP Topics NeoReviews.org My Bookmarks CME Information Help. Print this Page Add to my Bookmarks Page 3 of 10
Welcome Kristin Ingstrup [ Logout ] SEARCH Home FAQ Archives ABP Topics NeoReviews.org My Bookmarks CME Information Help Overview Editorial Board My Learning Plan January February March May June July August
More informationPediatric Learning Solutions A clinical education program exclusively for pediatric professionals
Pediatric Learning Solutions A clinical education program exclusively for pediatric professionals The following Pediatric Learning Solutions courses align to focus areas of the Neonatal CCRN Exam Content
More informationManaging Residuals, WakeMed 2008 Guidelines
Managing Residuals, WakeMed 2008 Guidelines Management of Aspirates: Background Early in life, gastric motility and muscle tone are decreased, possibly due to several reasons: increased gastrin, poorly
More informationObjectives. Pediatric Mortality. Another belly pain. Gastroenteritis. Spewing & Pooing Child 4/18/16
Gastro-tastrophies A Review of Pediatric GI Emergencies Objectives Discuss common presentations of Pediatric Abdominal Pain complaints Discuss work up and physical exam findings Discuss care, management
More informationNeonatal Nutrition Management Guidelines
Neonatal Nutrition Management Guidelines Nutrition Committee March 2018 Overall Aim 2 Provision of appropriate nutrition to neonates in a timely and safe manner to facilitate adequate growth and development
More informationProbiotics in Pediatric Health. AANP Annual Convention
Probiotics in Pediatric Health AANP Annual Convention Don Brown, ND July 12, 2017 Human Microbiome Richness and Metabolic Markers Human gut microbial composition was studied in 292 Danish adults Individuals
More informationSHORT GUT SYNDROME (SGS) : A MANAGEMENT CHALLENGE!
SHORT GUT SYNDROME (SGS) : A MANAGEMENT CHALLENGE! Muhammad Saaiq DEPARTMENT OF SURGERY,PIMS, ISLAMABAD. Surgical Grand Round, Pakistan Institute of Medical Sciences (PIMS), Islamabad. September 23, 2005.
More information