• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.851-855
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• 2009

Death is not only a medical problem; it is also an ethical problem. When doctors face a dying neonate, their knowledge of bioethics and the opinions of ethical specialists and religious leaders are helpful for them and the family of the dying baby. In recent years, due to the increase of surviving babies who have suffered from severe illness, those born too small or too early, and those with severe anomalies in neonatal intensive care unit (NICU), we have met with complicated bioethical problems frequently. To lessen the burdens of doctors and the parents of the dying baby, I reviewed medical, ethical and religious articles about bioethics in adult death. My suggestions are listed as follows: 1) regular bioethical education and activation of bioethical committees in NICU, 2) a well-controlled nationwide database, 3) a hospice unit space and programs for dying baby in NICU, and 4) social support for pregnant women and financial support for the NICU.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.63-68
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• 2017

Neonates have large inter-individual variability in pharmacokinetic parameters of many drugs due to developmental differences. The aim of this study was to investigate the factors affecting the pharmacokinetic parameters of drugs, which are commonly used in critically ill neonates. Factors that reflect physiologic maturation such as gestational age, postnatal age, postconceptional age, birth weight, and current body weight were correlated with pharmacokinetic parameters in neonates, especially preterm infants. Comorbidity characteristics affecting pharmacokinetics in critically ill neonates were perinatal asphyxia, hypoxic ischemic encephalopathy, patent ductus arteriosus (PDA), and renal dysfunction. Administration of indomethacin or ibuprofen in neonates with PDA was associated with the reduced clearance of renally excreted drugs such as vancomycin and amikacin. Therapeutic hypothermia and extracoporeal membrane oxygenation were influencing factors on pharmacokinetic parameters in critically ill neonates. Dosing adjustment and careful monitoring according to the factors affecting pharmacokinetic variability is required for safe and effective pharmacotherapy in neonatal intensive care unit.

• Korean Journal of Digital Imaging in Medicine
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• v.3 no.1
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

• Proceedings of the KSMRM Conference
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• 2006.11a
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• pp.38-38
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• 2006

• Neonatal Medicine
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• v.18 no.2
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• pp.301-309
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• 2011

Purpose: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). Methods: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. Results: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. Conclusion: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.

• Child Health Nursing Research
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• v.25 no.4
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• pp.377-387
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• 2019

Purpose: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs). Methods: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients. Results: There was a negative correlation (r=-.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001). Conclusion: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.

• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.36-41
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• 2019

Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas the rate of gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There were significant differences in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.119-132
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• 2021

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2-test and repeated measures ANOVA using an SPSS program. Results: The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. Conclusion: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

• Child Health Nursing Research
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• v.22 no.3
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• pp.190-198
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• 2016

Purpose: The purpose of this study was to examine the paternal stress and nursing support as perceived by fathers of high risk infants admitted to Neonatal Intensive Care Units (NICU). Methods: The study participants included 88 fathers of high risk infants in NICUs. Their parental stress and nursing support were measured using a self-report questionnaire. Results: The parental stress level of the fathers was 3.57 of a possible 5. Among the parental stress items, 'Relationship with infant and parental role' had the highest scores. The perceived nursing support level was a relatively high, 3.90 on a 5-point scale. The lowest score was for the item 'showed concern about my well-being.' The parental stress was lower in fathers with low income, higher in fathers in nuclear families and when the infants' condition was serious. Conclusion: The findings indicate that fathers of high risk infants experience intense parental stress. Thus when designing care to provide support for these fathers and their infants, it is necessary to encourage the fathers' engagement, provide information on how to respond to the baby, and include supportive care to the fathers.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.87-93
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• 2016

Purpose: An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea. Methods: We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea. Results: Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications. Conclusions: The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.