Special Considerations in Neonatal Mechanical Ventilation

Dalgleish, Stacey; Kostecky, Linda; Charania, Irina

doi:10.1016/j.cnc.2016.07.007

Cited by 4 publications

(5 citation statements)

References 75 publications

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“…Assisted ventilation of neonates has been a pivotal factor in neonatal medicine that has dramatically changed both mortality and morbidity of the neonatal population over the last 50 years . The initiation of ventilation is lifesaving; however, ventilator dependence (defined as a failure to wean from assisted ventilation) is problematic.…”

Section: Discussionmentioning

confidence: 99%

“…The initiation of ventilation is lifesaving; however, ventilator dependence (defined as a failure to wean from assisted ventilation) is problematic. Of the factors responsible for ventilator dependence, the two most important ones are ventilator‐associated pneumonia and ventilator‐associated lung disease . Strategies to distinguish these two factors have poor sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

“…Neonatal Bronchoscopy has both diagnostic and therapeutic uses and is a safe procedure in experienced hands . Specimen sampling of lung fluid via bronchoscopy has further improved accuracy of diagnosis of respiratory disease.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal bronchoscopy: Role in respiratory disease of the newborn—A 7 year experience

Mackanjee

Naidoo

Ramkaran

et al. 2019

Pediatric Pulmonology

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Background: Bronchoalveolar lavage (BAL) is a standardized method to obtain specimen samples from the airway lumen of the respiratory system. BAL is used to diagnose lung infection and infection markers in neonates. Objectives:The aim was to evaluate the utility of flexible fiberoptic bronchoscopy in term and preterm neonates and to evaluate the use of BAL obtained by bronchoscopy in neonatal lung disease. Methods: A retrospective analysis of Neonatal Intensive Care Unit (NICU) babies, during a 7-year period was conducted on 599 neonates who underwent the BAL procedure. Characteristics of the patients, indications, complications, and results of the procedure were recorded. Results: The main indications were nosocomial pneumonia (140) and unilateral lung disease (74). A normal finding was most prevalent (201), followed by tracheitis (65). Microbiology on BAL fluid was positive in 33% of bronchoscopies (195/599); most common organisms isolated were Acinetobacter, Klebsiella, and Pseudomonas. Conclusions: Neonatal bronchoscopy can serve as an important diagnostic and therapeutic tool in the management of neonatal lung disease, BAL specimen microbiology from bronchoscopy directs clinical decision making in the management of neonatal lung infection. Individual common markers of infection have poor correlation to BAL. A combination of the markers, however, improves correlation with

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neonatal bronchoscopy: Role in respiratory disease of the newborn—A 7 year experience

Mackanjee

Naidoo

Ramkaran

et al. 2019

Pediatric Pulmonology

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“…Mechanical ventilation has mostly been proven to be very important for the survival of extremely premature neonates and continues to play a major role in NICU ( 11 , 12 ). However, ventilator dependence is an important issue in these patients, and FB helps evaluate the airways and develop necessary interventions ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…This might be related to cough weakness, severe lung infection with hypersecretion, nervous system and/or muscle disease, muscle relaxants, sedatives, or the use of anesthesia after surgery or mechanical ventilation. Moreover, ventilator dependence may lead to ventilator-associated lung disease and ventilator-associated pneumonia ( 11 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

The clinical application of flexible bronchoscopy in a neonatal intensive care unit

Shi

Zhang

et al. 2022

Front. Pediatr.

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ObjectiveFlexible bronchoscopy is widely used in infants and it plays a crucial role. The aim of this study was to investigate the value and clinical safety of flexible bronchoscopy in a neonatal intensive care unit.MethodsA retrospective analysis was performed on the clinical data of 116 neonates who underwent flexible bronchoscopy and the outcomes of 147 procedures. A correlation analysis was performed on the relationship between flexible bronchoscopy findings, microscopic indications, and clinical disease.ResultsThe 147 procedures performed were due to the following reasons: problems related to artificial airways, 58 cases (39.45%); upper respiratory problems, 60 cases (40.81%) (recurrent dyspnea, 23 cases; upper airway obstruction, 17 cases; recurrent stridor, 14 cases; and hoarseness, six cases), lower respiratory problems, 51 cases (34.69%) (persistent pneumonia, 21 cases; suspicious airway anatomical disease, 21 cases; recurrent atelectasis, eight cases; and pneumorrhagia, one case), feeding difficulty three cases (2.04%). The 147 endoscopic examinations were performed for the following reasons: pathological changes, 141 cases (95.92%); laryngomalacia, 78 cases (53.06%); mucosal inflammation/secretions, 64 cases (43.54%); vocal cord paralysis, 29 cases (19.72%); trachea/bronchus stenosis, 17 cases (11.56%) [five cases of congenital annular constriction of the trachea, seven cases of left main tracheal stenosis, one case of the right middle bronchial stenosis, two cases of tracheal compression, and two cases of congenital tracheal stenosis]; subglottic lesions, 15 cases (10.20%) [eight cases of subglottic granulation tissue, six cases of subglottic stenosis, one cases of subglottic hemangioma]; tracheomalacia, 14 cases (9.52%); laryngeal edema, five cases (3.40%); tracheoesophageal fistula, four cases (2.72%); rhinostenosis, three cases (2.04%); tracheal bronchus, three cases (2.04%); glossoptosis, two cases (1.36%); laryngeal cyst, two cases (1.36%); laryngeal cleft, two cases (1.36%); tongue base cysts, one case (0.68%); and pneumorrhagia, one case (0.68%). Complications were rare and mild.ConclusionFlexible bronchoscopy is safe and effective for diagnosing and differentiating neonatal respiratory disorders in neonatal intensive care units.

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Exploring Research Topics and Trends in Nursing-related Communication in Intensive Care Units Using Social Network Analysis

Son

Lee

Nam

et al. 2018

CIN: Computers, Informatics, Nursing

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This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses." During the most recent phase, research topics included "critical care nursing," "patient handoff," and "quality improvement." The keywords of the top three groups among the 10 groups identified were related to "neonatal nursing and practice guideline," "infant or pediatric and terminal care," and "family, aged, and nurse-patient relations," respectively. This study can promote a systematic understanding of communication in intensive care units by identifying topic networks. Future studies are needed to conduct large prospective cohort studies and randomized controlled trials to verify the effects of patient-centered communication in intensive care units on patient outcomes, such as length of hospital stay and mortality.

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Special Considerations in Neonatal Mechanical Ventilation

Cited by 4 publications

References 75 publications

Neonatal bronchoscopy: Role in respiratory disease of the newborn—A 7 year experience

Neonatal bronchoscopy: Role in respiratory disease of the newborn—A 7 year experience

The clinical application of flexible bronchoscopy in a neonatal intensive care unit

Exploring Research Topics and Trends in Nursing-related Communication in Intensive Care Units Using Social Network Analysis

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