• 중환자간호학회지
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• 제9권1호
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• pp.40-50
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• 2016

Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

• 가정간호학회지
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• 제17권1호
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• pp.12-20
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• 2010

Purpose: The study examined differences in stress between the parents of sick newborns. Methods: Participants were the mothers (n=57) and fathers (n=57) of newborns in NICU of six university hospitals. An established stress measurement tool (Miles and Carter, 1993) was used. Results: Fathers and mothers displayed the highest stress scores (4.44 and 4.67, respectively) when the baby looked in pain. Maternal overall stress scores were significantly higher than paternal scores. Conclusions: Mothers and fathers experience differing levels of stress concerning their newborn. Further studies are needed to develop customized stress management intervention programs for parents of newborns in the NICU.

• 한국임상약학회지
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• 제30권3호
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• pp.143-148
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• 2020

Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

• Journal of Chest Surgery
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• 제28권11호
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• pp.977-982
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• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• Perinatology
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• 제29권4호
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• pp.175-179
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• 2018

Pneumatocele (PC) is a thin-walled cyst of the lung that can occur at all ages and with various etiologies. However, there is no fully accepted consensus for the management of PC in a neonatal intensive care unit. Although the management of PC is generally expectant, it is difficult to decide how long conservative management should be maintained, especially under Korea's medical care environment and the parents' worry and anxiety. We report a male neonate, born at $27^{+5}weeks$ gestation, weighing 1,000 g, who had a post infectious PC caused by methicillin-resistant Staphylococcus aureus sepsis. We treated conservatively for about 100 days (roughly 14 weeks), but unfortunately after a few days of chest retraction, acute exacerbation occurred, video assisted thoracoscopic surgery (VATS) was deemed necessary and performed. The purpose of this publication is to describe the clinical course, aggravation and relief after VATS management with a review of the literature.

• 여성건강간호학회지
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• 제25권2호
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• pp.194-206
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• 2019

Purpose: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. Methods: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. Results: The education needs of nurses in MFICU had an average of 4.21 points (${\pm}0.50$) and their nursing competence was average 3.38 points (${\pm}0.60$). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' Conclusion: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

• Neonatal Medicine
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• 제28권2호
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• pp.77-82
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• 2021

We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.

• Pediatric Infection and Vaccine
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• 제26권3호
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• pp.199-205
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• 2019

엔테로바이러스 감염은 신생아에게 흔히 일어나며, 경한 감염에서부터 다기관 부전이나 사망에까지 이를 수 있다. 특히, 출생 시 모체로부터 수직 감염된 신생아들의 경우 심각한 질환에 이르게 될 수 있다. 본 증례의 환아는 모체에게서 엔테로바이러스의 수직 감염이 일어났으며, 파종 혈관내 응고장애, 간염, 그리고 심근염으로 빠르게 진행하였다. 환아가 태어난 시기가 엔테로바이러스의 유병률이 높은 6월인 점, 환아의 어머니와 형제에게서 고열이 있었던 점, 임상 증상 등을 고려하여 저자들은 환아가 엔테로바이러스의 수직 감염 가능성이 있다고 보고 검사와 치료를 진행하였다. 이 환아는 빈맥을 동반한 다양한 형태의 부정맥을 보였으며, 일반적인 치료에 반응을 잘 하지 않았으나, 엔테로바이러스 감염을 조기에 의심하고 치료하여 완전히 회복할 수 있었다. 신생아의 엔테로바이러스 감염에서, 응고장애를 동반한 간염과 심근염이 동시에 오는 경우는 드물다. 본 증례에서, 저자들은 응고장애를 동반한 간염과 다양한 형태의 부정맥을 동반한 엔테로바이러스 수직 감염을 조기에 진단하고 성공적으로 치료하였기에 보고하는 바이다.

• Child Health Nursing Research
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• 제17권3호
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• pp.190-197
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• 2011

Purpose: The purpose of this study was to identify factors influencing neonatal pain management by nurses in order to provide evidence-based data for the development of more efficient neonatal pain care programs. Methods: This study used a descriptive research design to survey 204 registered nurses working in neonatal intensive care units and nurseries in Busan. Data collection was done from July to September 2010. General knowledge of pain and pain scale, pain intervention, neonatal pain management, and barriers to pain management were measured. Data were analyzed using stepwise multiple regression with SPSS 17.0. Results: it was found that among the factors affecting neonatal pain management by nurses, the unit where the nurse worked was the most important influential factor, followed by knowledge of pain management, education level, and barriers from medical personnel in that order. The explanatory power of these four variables accounted for 42.0% of neonatal pain management. Conclusion: Study results indicate that it is necessary to develop education programs to increase knowledge of neonatal pain management for nurses caring for neonates. Also, plans for reduction of obstacle factors in medical personnel should be prepared.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.325-330
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• 2002

목 적 : 신생아 집중치료실에서 치료 중인 미숙아에서 적혈구 수혈 후의 백혈구수의 변화를 조사해 보고자 하였다. 그리고 그 정도가 신생아 감염을 의미할 만한 정도인지 알아보고자 하였다. 방 법 : 2년 1개월간 본원 신생아 집중 치료실에서 농축 적혈구를 수혈 받은 환아 33명(총 수혈횟수 48회)을 대상으로 수혈 전후의 백혈구수, 호중구수, 대호중구수를 후향적으로 비교, 분석하였다. 결 과 : 적혈구 수혈 후 최초 8시간(제 1기)에 백혈구와 호중구가 각각 평균값이 $1.33{\times}10^3/mm^3$(P=0.03), $0.55{\times}10^3/mm^3$(P=0.05 )증가하였으나, 수혈 후 17-24시간(제 3기)에는 수혈 전과 큰 차이가 없었다. 대호중구수는 모든 대상 환아에서 수혈 전후에 큰 변화가 없었다. 결 론 : 적혈구 수혈 후 일시적으로 호중구 상승에 의한 백혈구 상승이 나타나지만, 24시간경에는 수혈전 수치에 가까워지고, 초기의 그 상승 정도가 크지 않아 신생아 감염으로 혼동되지는 않을 것 같다.