• Title/Summary/Keyword: neonatal unit

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Clinical Evaluation of Neonatal Pneumothorax (신생아 기흉의 임상적 고찰)

  • Lee, Seok-Gi;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1132-1138
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    • 1995
  • From 1991 to 1994, we experienced 24 cases of neonatal pneumothorax who were admitted to the Neonatal Intensive Care Unit[NICU , Chosun University Hospital. The Following results were obtained.1 The incidence of neonatal pneumothorax was 0.70%, and there were 8 spontaneous pneumothoraces and 16 secondary pneumothoraces. 2 The clinical manifestation of neonatal pneumothorax was as followed. Male infant was dominant[M:F=2:1 , the onset was within 24 hours in the majority[83% , and the right side[62% was more frequent than the left side. The gestation duration and birth weight show no correlation with underlying neonatal pneumothorax. The pulmonary diseases were meconium aspiration syndrome and hyaline membrane disease, and the incidence of those was 58%. Meconium aspiration syndrome occurred earlier than hyaline membrane disease. Symptoms and signs were tachypnea[46% , cyanosis[21% , irritability[13% , chest retraction[8% and apnea[8% .3 The treatments performed were oxygen therapy[17% , thoracentesis[4% and closed thoracostomy with underwater seal drainage[79% . The Mean duration of air leakage was 11.7 hours, and the mean drainage time was 4.35$\pm$1.3day. 4 The overall hospital mortality was 33%, and the rate of complication was 46%. The complications were metabolic acidosis, atelectasis, pleural effusion, pulmonary hemorrhage and pneumonia. We concluded that the prognosis was related to the underlying pulmonary disease.

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The Relation Between the Occupational Stress and Fatigue Level of Neonatal Nurses (신생아실 간호사의 직무 스트레스와 피로도와의 관계)

  • Park, Eun-A;Park, Jeong-Eon
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.261-269
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    • 2011
  • Purpose: The purpose of this study was to investigate occupational stress and fatigue level of neonatal nurses and to assess relationship between the two of them. Methods: Subjects were 109 neonatal nurses working at 2 university hospitals and 9 women's hospitals in D city, and the data were analyzed using descriptive statistics and binary logistic regression analysis by the SPSS/WIN 15.0. Results: The mean score of nurses' occupational stress level was 3.22, and the highest was 'night shift' among the 7 subcategories, and fatigue level was 62.0, and the highest was physical fatigue in configuration field. In logistic regression analyses, 'heavy workload' and 'inadequate physical environment' led to most occupational stress. Conclusion: In addition to significantly higher levels of occupational stress of neonatal nurses, the cumulative fatigue also resulted in decreased quality of nursing, job satisfaction and nursing productivity; therefore, appropriate number of nurses and improvement of work environment is necessary. Furthermore, to reduce the occupational stress and fatigue, we should try to develop adequate clinical guidelines and intervention strategies and apply them in neonatal care unit.

Are women with small endometriomas who undergo intracytoplasmic sperm injection at an elevated risk for adverse pregnancy, obstetric, and neonatal outcomes?

  • Verit, Fatma Ferda;Kucukakca, Ayse Seyma Ozsuer
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.1
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    • pp.80-84
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    • 2021
  • Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas. Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups. Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all). Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.

Calcium and phosphate metabolism and disorders in the newborn (신생아에서 칼슘 및 인 대사 평가와 질환)

  • Kim, Hae Soon
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.230-235
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    • 2007
  • In the early neonatal period, the neonate is challenged by the loss of the placental calcium transport and manifests a quick transition, from an environment in which PTHrP plays an important role to a PTH- and 1,25-dihydroxyvitamin D-controlled neonatal milieu. Disturbances in mineral homeostasis are common in the neonatal period, especially in premature infants and infants who are hospitalized in an intensive care unit. In many cases these disturbances are thought to be exaggerated responses to the normal physiological transition from the intrauterine environment to neonatal independence. Some disturbances in calcium and phosphate homeostasis are the result of genetic defects, which in many instances can now be identified at the molecular level. Although fetus develop remarkably normally in the presence of maternal calcium, PTH and vitamin D deficiency, the neonates demonstrate abnormalities that are consequences of the prior abnormal maternal calcium homeostasis. Evaluation and management of hypocalcemia and hypercalcemia in neonate requires specific knowledge of perinatal mineral physiology and the unique clinical and biochemical features of newborn mineral metabolism.

Correlations between the Status of the Umbilical Cord and Neonatal Health Status

  • Lee, Sun Min;Kim, Dong Yeon;Cho, Seongmin;Noh, Sun Mi;Park, Hye Ly;Lee, Gyungjoo
    • Child Health Nursing Research
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    • v.26 no.3
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    • pp.348-356
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    • 2020
  • Purpose: This study aimed to identify correlations between the status of the umbilical cord and neonatal health status. Methods: In total, 172 newborns were enrolled who were admitted to the newborn nursery with a gestational age of 35 weeks or older and a body weight of 2 kg or above. Data were collected on the basic personal information of the newborns, the diameter and soft tissue status of the umbilical cord, and neonatal health status after birth. Analyses were performed using t-test, analysis of variance, χ2 test, and Fisher exact test. Results: Umbilical cord diameter exhibited a statistically significant difference by sex (t=2.71, p=.007). A thin umbilical cord diameter was associated with a 1-minute Apgar score less than 8 points (t=2.47, p=.015) and with being transferred to the intensive care unit (t=2.45, p=.015). Poor soft tissue status of the umbilical cord was associated with a 1-minute Apgar score of less than 8 points (χ2=16.68, p<.001) and with oxygen being supplied (χ2=4.81, p=.028). Conclusion: Assessing the umbilical cord diameter and status in newborns is an important tool for evaluating neonatal health status after birth, and this point also underscores the importance of professionals' careful observations in the newborn nursery.

Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: a questionnaire survey for anticipated guidance in a neonatal follow-up clinic

  • Cho, Ji-Yun;Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Kim, So-Young;Sung, In-Kyung
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.272-279
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    • 2012
  • Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

A Survey on the Current Status of Neonatal Physical Therapy in South Korea

  • Kim, Sung Tae;Lee, Joon-Hee
    • The Journal of Korean Physical Therapy
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    • v.32 no.3
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    • pp.168-175
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    • 2020
  • Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.

Analysis of Characteristics of Peripheral Arterial Ischemia in Premature Babies and Effects of Nitroglycerin Patch Application

  • Kim, Jeongeun;Lee, Jin Won;Kim, Dong Yeon
    • Child Health Nursing Research
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    • v.26 no.4
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    • pp.434-444
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    • 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.