BackgroundNeonatal sepsis is the leading cause of mortality and morbidity in neonatal intensive care units. The volume of blood taken for culture remains one of the most important factors in isolating microorganisms.ObjectivesTo evaluate the impact of the intervention on the blood volume submitted for culture and to identify factors influencing the volume as determined by the phlebotomist.MethodsBlood culture volume was determined by weighing the culture bottle before and immediately after blood inoculation. A 3-month preintervention audit revealed that in 126/130 samples (96.9%), the volume of blood submitted was suboptimal. Multiple intervention measures were instituted, and volume was monitored over the next 9 months.Results637 blood culture samples were included in the study, 130 were in preintervention and 507 were in postintervention epochs. Following the intervention, suboptimal volume samples reduced from 96.9% (126/130 samples) to 25% (126/507 samples), p<0.0001 and the median (IQR) sample volume improved from 0.36 (0.23) ml to 0.9 (0.27) ml, p<0.0001. Poor blood flow was identified as the most common reason for an inadequate sample.ConclusionThe study underscores the role of educational intervention in improving the blood culture volume in newborn infants. Poor backflow from the cannula is an important cause of inadequate volume collection.
Aim To describe the characteristics and outcomes of neonates admitted to tertiary hospitals in New South Wales and Australian Capital Territory who have undergone surgical removal of a teratoma, as there is paucity of Australian data. Methods All neonates admitted to the neonatal intensive care unit with teratoma between 2007 and 2017 inclusive (as per neonatal intensive care units data collection) were included in this retrospective study. Results Forty-three neonates with a diagnosis of teratoma were included in the study. The most common tumors were sacrococcygeal teratomas, accounting for 79% (34) of all the cases. Twenty-four (56%) neonates were diagnosed with teratoma antenatally. Ninety-one percent (39) of the deliveries took place in the tertiary center. Median gestational age of the neonates was 37 weeks and the median weight was 3.39 kg. One or more additional anomalies apart from teratoma were detected in 16 neonates (37%), most common being congenital hydrocephalus and hydronephrosis. Overall survival was 93% at hospital discharge: the 3 neonates who died soon after birth did not undergo surgery and they all were premature with poor Apgar scores. Conclusions Sacrococcygeal teratoma was the most common type of teratoma with more than half of the cases determined antenatally. Overall survival of neonates after surgery for teratoma is high.
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