• Child Health Nursing Research
• /
• v.26 no.4
• /
• pp.434-444
• /
• 2020

Purpose: The aim of this retrospective study was to analyze the characteristics of peripheral arterial ischemia and tissue necrosis in premature babies, as well as the effects of nitroglycerin. Methods: In total, 513 newborns were enrolled who were admitted to the neonatal intensive care unit with a gestational age of 34 weeks or younger. Data were collected on general personal and clinical information, peripheral arterial ischemia, and nitroglycerin patch application in the premature infants. The collected data were analyzed using the χ² test, t-test, Mann-Whitney U test, logistic regression. Results: Thirty-six (7.0%) infants had peripheral arterial ischemia, while 477 (93.0%) infants did not. Lower gestational age (χ²=35.97, p<.001), lower birth weight (χ²=29.40, p<.001), lower blood pressure (χ²=23.10, p<.001), and insertion of an umbilical artery catheter (p<.001) were significantly associated with the occurrence of peripheral arterial ischemia. Among the preterm infants in whom nitroglycerin patches were applied, 30 (83.3%) premature infants without necrosis improved without complications, 4 (11.1%) showed hypotension, and 2 (5.6%) showed skin damage. Conclusion: Based on a review of our experiences with nitroglycerin patches, we recommend closely observing skin color and using nitroglycerin patches on the skin to help improve flow in premature infants with peripheral arterial ischemia.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.153-156
• /
• 1996

Over a 3 year period, 10 premature infants with less than 37 weeks of gestational age underwent ductal ligation for patent ductus arteriosus. No patient died during operations which were done at a mean age of 30 days. One late death at 2 months after operation was not directly attributed to operative procedure. Follow-ups were done in 9 survived patients from 2 to 26 months. Results suggest that surgical ligation is a feasible and effective method for treating symptomatic premature infants with patent ductus arteriosus.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.3
• /
• pp.274-280
• /
• 2023

Post-hemorrhagic hydrocephalus (PHH) in preterm infant is common, life-threatening and the main cause of bad developmental outcomes. Ventriculoperitoneal (VP) shunt is used as the ultimate treatment for PHH. Low birth weight and low gestational age are the combination of worse prognostic factors while the single most important prognostic factor of VP shunting is age. Aggressive and early intervention have better effect in intraventricular hemorrhage and intracranial pressures control. It reduces infection rate and brain damage resulted in delayed shunt insertion. It is extremely important to let PHH infants get older and gain weight to have internal organs to be matured before undergoing VP shunt. As premature infants undergo shunt after further growth, shunt-related complications would be reduced. So temporary surgical intervention is critical for PHH infants to have them enough time until permanently shunted.

• Child Health Nursing Research
• /
• v.10 no.1
• /
• pp.117-125
• /
• 2004

Purpose: The research was conducted to investigate the experience of maternal role attainment of mothers of premature infants admitted in NICU and to conceptualize the phenomena. Method: The grounded theory method was utilized for data collection and analysis. 8 mothers of premature infants were selected and in-depth interview was performed. Paradigm model was utilized for data analysis and presentation. Result: The central category was 'unstable maternal identity'. The properties of the core phenomena was 'ambivalent feeling to baby' 'negative emotion' 'commitment to baby'. The loss of control due to premature delivery was the causal condition. contextual condition was the 'perceived threats' due to severity of the premature infant and uncerainty of the baby's life. The mother's health status, economic status, and familial and social support was recognized as intervening conditions during the process of maternal role attainment. The strategic action/interactions were emotion-focused coping, reappraisal of the situation, problem-focused coping, and information seeking. The consequence was the maternal role attainment with competence and expectation. Conclusion: The process of maternal role attainment was affected by threats due to severity of the baby and intervening factors and interaction strategy. Further research is recommended to develop adequate intervention method during the process of maternal role attainment.

• Korean Parent-Child Health Journal
• /
• v.4 no.1
• /
• pp.35-55
• /
• 2001

Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.23 no.5
• /
• pp.472-483
• /
• 2020

Purpose: Sodium is an essential nutritional electrolyte that affects growth. A low serum sodium concentration in healthy premature infants beyond 2 weeks of life is called late-onset hyponatremia (LOH). Here, we investigated the association between LOH severity and growth outcomes in premature infants. Methods: Medical records of premature infants born at ≤32 weeks of gestation were reviewed. LOH was defined as a serum sodium level <135 mEq/L regardless of sodium replacement after 14 days of life. Cases were divided into two groups, <130 mEq/L (severe) and ≥130 mEq/L (mild). Characteristics and growth parameters were compared between the two groups. Results: A total of 102 premature infants with LOH were included. Gestational age ([GA] 27.7 vs. 29.5 weeks, p<0.001) and birth weight (1.04 vs. 1.34 kg, p<0.001) were significantly lower in the severe group. GA was a risk factor of severe LOH (odds ratio [OR], 1.328, p=0.022), and severe LOH affected the development of bronchopulmonary dysplasia (OR, 2.950, p=0.039) and led to a poor developmental outcome (OR, 9.339, p=0.049). Growth parameters at birth were lower in the severe group, and a lower GA and sepsis negatively affected changes in growth for 3 years after adjustment for time. However, severe LOH was not related to growth changes in premature infants. Conclusion: Severe LOH influenced the development of bronchopulmonary dysplasia and developmental outcomes. However, LOH severity did not affect the growth of premature infants beyond the neonatal period.

• Child Health Nursing Research
• /
• v.26 no.3
• /
• pp.366-375
• /
• 2020

Purpose: This study was conducted to evaluate the efficacy of a community-based follow-up program on parenting stress, parenting efficacy, and coping among parents with premature infants. Methods: A non-equivalent control group pre-post quasi-experimental design was used. This program consisted of structured home visits and self-help group meetings for 6 months. The experimental group (n=29) received visits by an experienced neonatal intensive care unit (NICU) nurse and the control group (n=27) was visited by a visiting nurse. Data were analyzed using the χ² test, t-test, and analysis of covariance. Results: Parents' coping behavior significantly differed in the experimental group compared to the control group (t=3.14, p=.003). In particular, coping subscale I, for maintaining the family situation (t=2.63, p=.011), and subscale III, for understanding the infant's medical situation (t=4.30, p<.001), showed significant differences in the experimental group. There were no significant between-group differences in parenting stress or parenting efficacy. Conclusion: The findings of this study suggest that home visits by an experienced NICU nurse provided through a community-based follow-up program were an effective intervention to improve coping behavior among parents with premature infants.

• Journal of Korean Clinical Nursing Research
• /
• v.25 no.1
• /
• pp.25-33
• /
• 2019

Purpose: This study was done to develop a program to promote maternal role confidence and maternal attachment for mothers of premature infants and to evaluate the effects in a neonatal intensive care unit (NICU). Methods: This program was developed through a literature review and validation of an expert group, and tested with 60 preterm infants (experimental group 30, control group 30) in a NICU in South Korea. Data were collected from December 2017 to March 2018 and analyzed using descriptive statistics, t-test, $x^2-test$ and Fisher's exact test with the SPSS/Win statistical program. Results: Maternal role confidence for the experimental group increased significantly compared to the control group (t=3.22, p=.002). Maternal attachment in the experimental group increased significantly compared to the control group (t=2.30, p=.025). Conclusion: The program developed in this study should be effective in promoting maternal role confidence and maternal attachment in mothers of premature infants.

• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.16-21
• /
• 1999

Background: This study is to suggest the optimal method as a treatment for the patent ductus arteriosus in the premature infants. Material and Method : Between April 1994 and April 1997, 45 premature infants with evidence of a hemodynamically significant patent ductus arteriosus associated with cardiopulmonary compromise underwent indomethacin therapy, surgical treatment, or both. Thirty-nine infants received indomethacin and twelve infants among them were surgically ligated because of indomethacin failure(5) or complications(7). Six infants, who weighed less than 1,500 gm at birth, were referred for primary surgical ligation because of contraindication to indomethacin therapy. Result: The failure rate of indomethacin therapy was 43%(17/39) and the complications(13/39, 33%) to the indomethacin were associated with a high morbidity and mortality. Among the infants who underwent ligation, there were no failures and complications related to the operation. This data suggests that in the premature neonate with a hemodynamically significant PDA, (1) indomethacin therapy is associated with a high failure rate and significant complications, (2) surgical duct closure is associated with minimal morbidity. Conclusion: Although the results of this study cannot suggest the optimal management for PDA in premature infants, primary surgical ligation may be considered. However, long-term studies will be needed to confirm this later.

• Child Health Nursing Research
• /
• v.24 no.1
• /
• pp.58-67
• /
• 2018

Purpose: This prospective study aimed to examine the development of premature infants at 12 and 24 months and to explore the factors related to their development. Methods: Of the 80 premature infants who were recruited, 52 participants at 12 months and 31 participants at 24 months were included in this study. The development of the infants was examined using the Korean Bayley scale of infant development-II. Postnatal depression, husband's support, social support, mother-infant attachment, and the home environment were assessed using self-report questionnaires completed by the mothers and through the researcher's observations. Results: There was significant difference between normal and delay group at psychomotor development at 12 months depending on social support at 6 months (t=2.03, p=.049). Mother-infant attachment at 6 months (r=.71, p<.001), 12 months (r=.37, p=.043), and 24 months (r=.40, p=.026), as well as social support (r=.38, p=.034) and the home environment (r=.41, p=.022) at 24 months, were correlated to mental development at 24 months. There was a significant positive correlation between mother-infant attachment at 6 months and psychomotor development at 24 months (r=.40, p=.046). Conclusion: To reduce the risk of developmental delay and to promote healthy development in premature infants, early nursing interventions targeting mother-infant attachment, the home environment, and the mother's social support structure are needed.