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  1. Article: The interfacility transport of critically ill newborns.

    Whyte, Hilary Ea / Jefferies, Ann L

    Paediatrics & child health

    2015  Volume 20, Issue 5, Page(s) 265–275

    Abstract: The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes ... ...

    Abstract The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns.
    Language French
    Publishing date 2015-06-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2106767-3
    ISSN 1918-1485 ; 1205-7088
    ISSN (online) 1918-1485
    ISSN 1205-7088
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Posthemorrhagic ventricular dilatation in preterm infants: When best to intervene?

    Leijser, Lara M / Miller, Steven P / van Wezel-Meijler, Gerda / Brouwer, Annemieke J / Traubici, Jeffrey / van Haastert, Ingrid C / Whyte, Hilary E / Groenendaal, Floris / Kulkarni, Abhaya V / Han, Kuo S / Woerdeman, Peter A / Church, Paige T / Kelly, Edmond N / van Straaten, Henrica L M / Ly, Linh G / de Vries, Linda S

    Neurology

    2018  Volume 90, Issue 8, Page(s) e698–e706

    Abstract: ... for posthemorrhagic ventricular dilatation (PHVD) managed with an "early approach" (EA), based on ventricular ... Observational cohort study of 127 preterm infants (gestation <30 weeks) with PHVD managed with EA (n = 78) or LA ... Results: Forty-nine of 78 (63%) EA and 24 of 49 (49%) LA infants received intervention. LA infants were ...

    Abstract Objective: To compare neurodevelopmental outcomes of preterm infants with and without intervention for posthemorrhagic ventricular dilatation (PHVD) managed with an "early approach" (EA), based on ventricular measurements exceeding normal (ventricular index [VI] <+2 SD/anterior horn width <6 mm) with initial temporizing procedures, followed, if needed, by permanent shunt placement, and a "late approach" (LA), based on signs of increased intracranial pressure with mostly immediate permanent intervention.
    Methods: Observational cohort study of 127 preterm infants (gestation <30 weeks) with PHVD managed with EA (n = 78) or LA (n = 49). Ventricular size was measured on cranial ultrasound. Outcome was assessed at 18-24 months.
    Results: Forty-nine of 78 (63%) EA and 24 of 49 (49%) LA infants received intervention. LA infants were slightly younger at birth, but did not differ from EA infants for other clinical measures. Initial intervention in the EA group occurred at younger age (29.4/33.1 week postmenstrual age;
    Conclusion: In preterm infants with PHVD, those with early intervention, even when eventually requiring a shunt, had outcomes indistinguishable from those without intervention, all being within the normal range. In contrast, in infants managed with LA, need for intervention predicted worse outcomes. Benefits of EA appear to outweigh potential risks.
    Classification of evidence: This study provides Class III evidence that for preterm infants with PHVD, an EA to management results in better neurodevelopmental outcomes than a LA.
    MeSH term(s) Cerebral Hemorrhage/complications ; Cerebral Hemorrhage/therapy ; Cerebral Ventricles/diagnostic imaging ; Cerebral Ventricles/pathology ; Cerebrospinal Fluid Shunts ; Child, Preschool ; Cohort Studies ; Dilatation, Pathologic/diagnostic imaging ; Dilatation, Pathologic/etiology ; Dilatation, Pathologic/pathology ; Dilatation, Pathologic/therapy ; Echoencephalography ; Humans ; Infant ; Infant, Premature/growth & development ; Organ Size ; Spinal Puncture ; Time-to-Treatment ; Treatment Outcome
    Language English
    Publishing date 2018-01-24
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000004984
    Database MEDical Literature Analysis and Retrieval System OnLINE

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