Non-invasive ventilation (NIV) is increasingly used in the supportive treatment of acute respiratory failure in children in the pediatric intensive care unit (PICU). However, finding an optimal fitting commercial available NIV face mask is one of the major challenges in daily practice, in particular for young children and those with specific facial features. Large air leaks and pressure-related skin injury due to suboptimal fit are important complications associated with NIV failure. Here, we describe a case of a 4-year old boy with cardiofaciocutaneous syndrome and rhinovirus-associated hypoxic acute respiratory failure who was successfully supported with NIV delivered by a simple anesthetic mask connected to a headgear by an in-house developed and 3D printed adaptor. This case is an example of the clinical challenge related to pediatric NIV masks in the PICU, but also shows the potential of alternative NIV interfaces e.g., by using a widely available and relatively cheap simple anesthetic mask. Further personalized strategies (e.g., by using 3D scanning and printing techniques) that optimize NIV mask fitting in children are warranted.
Parent participation in the nursing process significantly contributes to the overall wellbeing of a newborn and the whole family. It is important to ensure that nurses, who take care of newborns and collaborate with their family members, are well-acquainted with the influence that an infant's illness and critical condition as well as the stress have on the functioning of a family unit The Aim To compare parents' and nurses' perceptions of parents needs in Neonatal Intensive Care Unit.The study was conducted in Kaunas University Hospital NICU. The sample consisted of 181 parents and 37 nurses. The NICU Family Needs Inventory was used for data collection. The instrument included five following subscales of needs: proximity, information, assurance, support and comfort. Reliability of the scale was identified as 0.94 using Cronbach's a.The parents' needs perceived by both groups were compared within the subscales. Using Mann'o-Whitney rank test the significant differences between the parents' and nurses' assessments of individual statements were identified. The majority of statistically significant differences between parents and nurses have been found in case of assessment of proximity (75.0%) and informational (72.7%) needs related to the possibility for parents to be close to their newborn and to receive timely and adequate information about their newborn's health condition. Parents, if compared to nurses, assessed these needs as more important. The assessment of support needs showed the lowest number of differences (38.9%). There was a statistically significant difference in case of the decision making needs related to the newborn care that parents identified as being more important. Nurses perceived as being more important the needs related to parent-toparent support and possibility to share feelings.The comparison of parents and nurses perceptions of parents needs in NICU showed that there are statistically significant differences of individual statements assessment within the all five subscales. Background and aims Infants at the Neonatology Intensive Care Unit (NICU) of the Emma Children's Hospital/Academic Medical Centre Amsterdam are transferred to regional hospitals once they no longer need intensive care. Unfortunately, a number of these infants are re-admitted to the NICU. This study investigates the similarities between these hospitalised infants, in order to develop a way to limit the number of infants re-admitted to the NICU. Methods The first step in the process is to classify different diagnoses for re-admittance of infants to the NICU. By using these diagnoses, and adding parameters resulting from a search of literature, a set of risk parameters can be created. This set will be used to retrospectively analyse the nursing files of infants re-admitted to the NICU within 72 h after discharge. The exclusion criteria used were re-admittance for phototherapy, inserting an IV or planned surgical or treatment interventions. Results From July 2009 to July 2013, 44 infants were re-hospitalised at the NICU. ...
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