6 research outputs found
Light or Deep Pressure: Medical Staff Members Differ Extensively in Their Tactile Stimulation During Preterm Apnea
Background: Even though tactile stimulation is common practice to terminate preterm
apnea, the style and intensity of these interventions is not specified during theoretical or
practical training and has never been clinically evaluated.
Objective: The present study was designed to analyze the various modes of tactile
stimulation used to terminate preterm apnea and measure the pressure intensity and
frequency of these stimulations.
Methods: A model with the size and weight of an actual preterm infant was equipped
with sensor technology to measure stimulation pressure and frequency of tactile
stimulation. Additionally a camera system was used to record hand positions and
stimulation modes. Seventy medical staff members took part in the experiment.
Results: We found extreme between subjects differences in stimulation pressure that
could not be explained by professional experience but, to a degree, depended on apnea
intensity. Pressures ranged from 11.11 to 226.87 mbar during low intensity apnea and
from 9.89 to 428.15 mbar during high intensity apnea. The majority of participants
used rhythmic stimulation movements with a mean frequency of ∼1 Hz. Different modes
(rubbing, squeezing, tickling, and tapping) and finger positions were used.
Conclusion: Medical staff members intuitively adjust their tactile stimulation pressure
depending on the premature infants’ apnea intensity. However, mean pressure values
varied greatly between subjects, with similar pressure ranges for low and high intensity
apnea. The question remains which pressure intensities are necessary or sufficient for
the task. It is reasonable to assume that some stimulation types may be more effective
in rapidly terminating an apneic event
Charts and LMS Tables of Transfontanellar and Transvertical Ear-to-Ear Distances for Gestational Age
Introduction: To date cranial development has only been described by analyzing
occipitofrontal circumference (OFC). More precise methods of determining head
measurements have not been widely adopted. The use of additional measurements has
the potential to better account for the three-dimensional structure of the head. Our aim
was to put forward centile curves of such measurements for gestational age along with
a compound head volume index.
Methods: We created generalized additive models for location, scale, and shape of two
ear-to-ear distances (EED), transfontanellar (fEED) and transvertical (vEED), from birth
anthropometric data. Same was done for OFC, crown-heel length, and birth weight to
allow for comparison of our models with growth charts by Voigt et al. and Fenton and Kim.
Results: Growth charts and tables of LMS parameters for fEED and vEED were
derived from 6,610 patients admitted to our NICU and 625 healthy term newborns. With
increasing gestational age EEDs increase about half as fast compared to OFC in absolute
terms, their relative growths are fairly similar.
Discussion: Differences to the charts by Fenton and Kim are minute. Tape
measurements, such as fEED or vEED can be added to routine anthropometry at little
extra costs. These charts may be helpful for following and evaluating head sizes and
growth of preterm and term infants in three dimensions
Light or Deep Pressure: Medical Staff Members Differ Extensively in Their Tactile Stimulation During Preterm Apnea
Background: Even though tactile stimulation is common practice to terminate preterm
apnea, the style and intensity of these interventions is not specified during theoretical or
practical training and has never been clinically evaluated.
Objective: The present study was designed to analyze the various modes of tactile
stimulation used to terminate preterm apnea and measure the pressure intensity and
frequency of these stimulations.
Methods: A model with the size and weight of an actual preterm infant was equipped
with sensor technology to measure stimulation pressure and frequency of tactile
stimulation. Additionally a camera system was used to record hand positions and
stimulation modes. Seventy medical staff members took part in the experiment.
Results: We found extreme between subjects differences in stimulation pressure that
could not be explained by professional experience but, to a degree, depended on apnea
intensity. Pressures ranged from 11.11 to 226.87 mbar during low intensity apnea and
from 9.89 to 428.15 mbar during high intensity apnea. The majority of participants
used rhythmic stimulation movements with a mean frequency of ∼1 Hz. Different modes
(rubbing, squeezing, tickling, and tapping) and finger positions were used.
Conclusion: Medical staff members intuitively adjust their tactile stimulation pressure
depending on the premature infants’ apnea intensity. However, mean pressure values
varied greatly between subjects, with similar pressure ranges for low and high intensity
apnea. The question remains which pressure intensities are necessary or sufficient for
the task. It is reasonable to assume that some stimulation types may be more effective
in rapidly terminating an apneic event
Light or Deep Pressure: Medical Staff Members Differ Extensively in Their Tactile Stimulation During Preterm Apnea
Background: Even though tactile stimulation is common practice to terminate preterm
apnea, the style and intensity of these interventions is not specified during theoretical or
practical training and has never been clinically evaluated.
Objective: The present study was designed to analyze the various modes of tactile
stimulation used to terminate preterm apnea and measure the pressure intensity and
frequency of these stimulations.
Methods: A model with the size and weight of an actual preterm infant was equipped
with sensor technology to measure stimulation pressure and frequency of tactile
stimulation. Additionally a camera system was used to record hand positions and
stimulation modes. Seventy medical staff members took part in the experiment.
Results: We found extreme between subjects differences in stimulation pressure that
could not be explained by professional experience but, to a degree, depended on apnea
intensity. Pressures ranged from 11.11 to 226.87 mbar during low intensity apnea and
from 9.89 to 428.15 mbar during high intensity apnea. The majority of participants
used rhythmic stimulation movements with a mean frequency of ∼1 Hz. Different modes
(rubbing, squeezing, tickling, and tapping) and finger positions were used.
Conclusion: Medical staff members intuitively adjust their tactile stimulation pressure
depending on the premature infants’ apnea intensity. However, mean pressure values
varied greatly between subjects, with similar pressure ranges for low and high intensity
apnea. The question remains which pressure intensities are necessary or sufficient for
the task. It is reasonable to assume that some stimulation types may be more effective
in rapidly terminating an apneic event
Automated Complete Blood Cell Count Using Sysmex XN-9000® in the Diagnosis of Newborn Infection
The early identification of septically infected newborn infants is important for ensuring good outcomes. Blood cell differentiations are helpful, but they are often time consuming and inaccurate. In this study, we evaluated the use of automatic white blood cell differentiations by flow cytometry for the diagnosis of neonatal sepsis. Episodes of suspected infection in neonates were retrospectively classified into two groups, unlikely infection (UI, levels of Interleukin-6 < 400 pg/mL or CRP within 48 h < 10 mg/L), n = 101 and probable infection (PI, Interleukin-6 ≥ 400 pg/mL or CRP within 48 h ≥ 10 mg/L), n = 98. Complete blood cell counts were performed by Sysmex XN-9000® using flow cytometry. Relative and absolute proportions of immature granulocytes were evaluated. Unexpectedly, the absolute count of immature granulocytes was significantly lower in the group of PI compared to UI neonates. Similar results were found when analysing the relative proportion of immature granulocytes among all neutrophil granulocytes. On the other hand, manually counted immature to total (I/T) ratios of granulocytes were higher in PI than in UI infants. Therefore, we conclude that differentiations of granulocytes by Sysmex XN-9000® can be used to distinguish between infected and uninfected neonates if the results are interpreted according to our findings. A low count of immature granulocytes as determined by Sysmex XN-9000® may indicate neonatal infection
Automated Complete Blood Cell Count Using Sysmex XN-9000® in the Diagnosis of Newborn Infection
The early identification of septically infected newborn infants is important for ensuring good outcomes. Blood cell differentiations are helpful, but they are often time consuming and inaccurate. In this study, we evaluated the use of automatic white blood cell differentiations by flow cytometry for the diagnosis of neonatal sepsis. Episodes of suspected infection in neonates were retrospectively classified into two groups, unlikely infection (UI, levels of Interleukin-6 < 400 pg/mL or CRP within 48 h < 10 mg/L), n = 101 and probable infection (PI, Interleukin-6 ≥ 400 pg/mL or CRP within 48 h ≥ 10 mg/L), n = 98. Complete blood cell counts were performed by Sysmex XN-9000® using flow cytometry. Relative and absolute proportions of immature granulocytes were evaluated. Unexpectedly, the absolute count of immature granulocytes was significantly lower in the group of PI compared to UI neonates. Similar results were found when analysing the relative proportion of immature granulocytes among all neutrophil granulocytes. On the other hand, manually counted immature to total (I/T) ratios of granulocytes were higher in PI than in UI infants. Therefore, we conclude that differentiations of granulocytes by Sysmex XN-9000® can be used to distinguish between infected and uninfected neonates if the results are interpreted according to our findings. A low count of immature granulocytes as determined by Sysmex XN-9000® may indicate neonatal infection