Safety and efficacy of a home nasogastric monitoring program for premature infants

2021 ◽  
pp. 1-6
Author(s):  
B.D. Vergales ◽  
P.D. Murray ◽  
S.E. Miller ◽  
J.E. Vergales
Keyword(s):  
Premature Infants ◽  
Monitoring Program ◽  
Home Monitoring ◽  
Oral Feeding ◽  
Control Group ◽  
Telephone Contact ◽  
Home Group ◽  
Oral Skills ◽  
Control Study ◽  
At Home

BACKGROUND: A novel home monitoring program, in which premature infants are cared for at home with a nasogastric tube in place prior to achievement of full oral feeding, was evaluated. The program combines a digital, fully EMR-integrated, virtual daily rounding platform with direct provider video and telephone contact. METHODS: A case-control study was performed evaluating infants <  34 weeks’ gestation who were followed in our program. A historical control group, was created by matching 2 : 1 based on gestational age±6 days, retroactively. RESULT: 15 patients discharged in the program were compared with 30 controls. The home cohort gained an average of 30 g/day compared with the in-hospital group at 27g/day (p = 0.325). The home group required a mean of 5.9±2.9 days to full oral feeding once discharged, not different from the control group at 5.4±3.7 days (p = 0.606). The percentage of oral feeds for the home cohort, however, increased at a rate of 12.2%before discharge compared to rising 57%at home (p <  0.001). The control group spent an additional 8.1±3.9 days in the hospital after reaching criteria. There were no reported adverse events or readmissions. CONCLUSION: Premature infants can safely advance oral feeds using a home monitoring program. While at home, infants gained weight similarly to their inpatient controls inpatient, yet gained full oral skills at a significantly faster rate compared to when they were in the hospital.

Letters to the Editor

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1055-1055
Author(s):  
Dorothy Kelly ◽  
Daniel C. Shannon
Keyword(s):  
Social Worker ◽  
Monitoring Program ◽  
Home Monitoring ◽  
Medical Decision ◽  
Community Resources ◽  
Letters To The Editor ◽  
At Home

We have now supervised 230 families who have monitored an infant at home and have gradually developed our hospital and home monitoring program in response to our families' needs. The hospital program begins once a medical decision has been reached that the infant requires continuous surveillance. It consists of: (1) Evaluation of the family's strengths and weaknesses by the pediatrician and social worker. (2) Determination of family and community resources available to support weaknesses and to provide relief services.

A Home-Monitoring Program for Parents of Premature Infants

1989 ◽  
Vol 10 (2) ◽  
pp. 92???97 ◽  
Author(s):  
BARBARA J. LEONARD ◽  
SHERYL A. SCOTT ◽  
JANE SOOTSMAN
Keyword(s):  
Premature Infants ◽  
Monitoring Program ◽  
Home Monitoring

scholarly journals Risk factors of bronchopulmonary dysplasia in premature infants under 32 weeks of gestation: A retrospective case-control study

2020 ◽  
Author(s):  
Li Yue ◽  
Shu Dong Cui
Keyword(s):  
Risk Factors ◽  
Premature Infants ◽  
Gestational Age ◽  
Invasive Mechanical Ventilation ◽  
Calorie Intake ◽  
Control Group ◽  
Retrospective Case ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Control Study

Abstract Background: Bronchopulmonary dysplasia (BPD) in preterm infants is one of the most serious complications in neonatology, as it significantly affects the quality of life of preterm children. We retrospectively analyze the incidence and risk factors of BPD in premature infants under 32 weeks of gestation age.Methods: Clinical data of premature infants with gestational age ≤32 weeks admitted to the neonatal intensive care unit of the First Affiliated Hospital of Nanjing Medical University from 2015 to 2017 were selected for this retrospective case-control study. The patients were classified into the BPD and control groups based on the clinical diagnosis. We compared the general condition, treatments, complications, and clinical outcome of premature infants in both groups. Student’s t-test, non-parametric test, and binary logistic regression were used to analyze the occurrence of BPD and its potential risk factors.Results: A total of 213 premature infants aged ≤32 gestational weeks were included in the study; of these, 81 (38%) were diagnosed with BPD. The gestational age (29.14±1.88 weeks vs. 30.82±0.98 weeks, P<0.001) and weight (1240±314.87 g vs. 1584.77±318.18 g, P<0.001) in the BPD group were lower than those in the control group. The liquid quantity, urine volume, and calorie intake of preterm infants in the BPD group within one week after birth were significantly lower than those of infants in the control group. Logistic regression analysis showed that invasive mechanical ventilation (OR=5.065, 95% CI: 1.680–15.266); use of erythrocyte suspension (OR=10.146, 95% CI: 1.860–55.336); and PCO2 in early postnatal arterial blood gas (OR=1.122, 95% CI: 1.024–1.229) were risk factors for BPD. On the other hand, gestational age (OR=0.657, 95% CI: 0.460–0.937); calorie intake (OR=0.917, 95% CI: 0.874–0.963); PO2 (OR=0.925, 95% CI: 0.870–0.985); and pH in early postnatal arterial blood gas (OR<0.001, 95% CI: 0.000–0.156) were protective factors for BPD.Conclusion: The incidence of BPD in very low and extremely low birth weight infants is high. Maintaining early internal environment stability, increasing early calorie intake, shortening invasive mechanical ventilation time, reducing blood transfusion, and closing patent ductus arteriosus could likely reduce the incidence of BPD.

Emotional and Health Impact of Home Monitoring on Mothers: A Controlled Prospective Study

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 780-786
Author(s):  
Evelyn McElroy ◽  
Alfred Steinschneider ◽  
Steven Weinstein
Keyword(s):  
Health Hazard ◽  
Monitoring Program ◽  
Home Monitoring ◽  
Sudden Infant Death ◽  
Health Impact ◽  
Brief Symptom Inventory ◽  
Control Group ◽  
Sudden Infant ◽  
Sleep Study ◽  
Significant Group

The psychologic and health effects of home monitoring were evaluated in mothers, whose infants (epidemiologically not at high risk for sudden infant death syndrome) were placed on electronic surveillance because of results obtained from a laboratory sleep study conducted at 4 weeks of age. Mothers of these infants were studied prospectively at several periods following the infants' births: 6 weeks, 12 weeks, and 1 year. The initial sample consisted of 56 mothers. Evaluation procedures included the Neonatal Perception Inventories, Anxiety Inventory (State and Trait), Depression Inventory, Brief Symptom Inventory, and a Recent Life Changes Questionnaire. The results obtained from these women were compared with those of women who had delivered at about the same time but whose infants were not placed on a home monitoring program. A total of 57 women started in the control group. Very few statistically significant group differences were observed between the two subject groups: 2 weeks after initiating the home monitoring program, monitor mothers (when compared to nonmonitor mothers) perceived their infant's behavior differently (although not more bothersome) and had an increased degree of situational anxiety (although not to an abnormal degree). There were no statistically significant differences between the two groups 12 weeks or 1 year after giving birth. These results suggest that a home monitoring program, which includes an aggressive and readily available support system, does not impose a marked health hazard to mothers.

Case-Control Comparison of At-Home to Total Hospital Care for Autologous Stem-Cell Transplantation for Hematologic Malignancies

2006 ◽  
Vol 24 (30) ◽  
pp. 4855-4861 ◽  
Author(s):  
Francesc Fernández-Avilés ◽  
Enric Carreras ◽  
Alvaro Urbano-Ispizua ◽  
Montserrat Rovira ◽  
Carmen Martínez ◽  
...  
Keyword(s):  
Stem Cell ◽  
Febrile Neutropenia ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Hospital Readmission ◽  
Hematologic Malignancy ◽  
Control Group ◽  
Home Group ◽  
At Home

Purpose One of the most significant limitations of at-home autologous stem-cell transplantation (ASCT) is the necessity for hospital readmission. We developed an at-home ASCT program in which prophylactic ceftriaxone and treatment of febrile neutropenia with piperacillin and tazobactam was introduced to minimize the readmission rate. Patients and Methods Between November 2000 and February 2005, 178 consecutive patients underwent ASCT for a hematologic malignancy. Of these, 50 patients fulfilled the requirements for at-home ASCT. Results were compared with those observed in a control group of 50 patients individually matched to the group of patients treated at home for age, sex, diagnosis, stage of disease, conditioning, and source of stem cells. Results Febrile neutropenia occurred in fewer patients in the at-home group as compared with the hospitalized group (76% v 96%: P = .008), and duration of fever was also shorter in the at-home group (median, 2 and 6 days, respectively; range, 1 to 11 and 1 to 20 days, respectively; P = .00003). Hospital readmission in the at-home group was required in only four cases (8%). This resulted in a reduction of 18.6 days of hospitalization per patient. Likewise, total median charges were approximately half in the at-home group as compared with the in-hospital group (3,345 € v 6,250 €, respectively; P < .00001). Conclusion Results of at-home ASCT with prophylactic administration of ceftriaxone and domiciliary treatment of febrile neutropenia with piperacillin and tazobactam are highly satisfactory and significantly cheaper compared with those obtained with conventional in-hospital ASCT.

Biochemical markers in the assessment of protein-calorie malnutrition in premature neonates.

1986 ◽  
Vol 32 (7) ◽  
pp. 1269-1273 ◽  
Author(s):  
L Nadeau ◽  
J C Forest ◽  
M Masson ◽  
I Morrissette ◽  
F Larivière ◽  
...  
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Biochemical Markers ◽  
Interindividual Variability ◽  
Oral Feeding ◽  
Control Group ◽  
Total Proteins ◽  
Premature Neonates ◽  
Clinical Problems

Abstract We studied 135 premature newborns of 26 to 36 weeks gestation, divided into three groups: the control group, 66 premature infants with uncomplicated course; 51 premature neonates with appropriate birth weight for gestational age (AGA), who suffered from clinical problems that delayed oral feeding; and 18 premature infants with small birth weight for gestational age (SGA). When neonates of the same postnatal age were compared, prealbumin concentrations were the lowest in the SGA group at the third and fourth postnatal week. Although the AGA group had the most infants with serious illnesses and the lowest protein-calorie intakes, their prealbumin concentrations did not differ significantly from those of the control group. But when the infants of each group were subdivided on the basis of intakes and weight gain regardless of postnatal age, those with greater intakes showed significantly higher prealbumin values; however, in all groups, the infants with higher intakes were also significantly older. Total proteins and albumin showed similar changes in all groups. Prealbumin concentrations showed great interindividual variability in infants of the same postnatal age. We conclude that prealbumin, albumin, and serum total proteins are not sufficiently sensitive biochemical markers to assess alterations of the nutritional status of premature infants.

scholarly journals Premature: growth and its relation to oral skills

CoDAS ◽  
2015 ◽  
Vol 27 (4) ◽  
pp. 378-383
Author(s):  
Camila Lehnhart Vargas ◽  
Luana Cristina Berwig ◽  
Eduardo Matias dos Santos Steidl ◽  
Leila Sauer Prade ◽  
Geovana Bolzan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Tube Feeding ◽  
Oral Feeding ◽  
Feeding Performance ◽  
Time Of Feeding ◽  
Oral Skills

OBJECTIVE: To evaluate the influence of oral motor skills of premature infants on their oral feeding performance and growth, during neonatal hospitalization.METHODS: Fifty-one newborns hospitalized in the neonatal intensive care unit of a hospital in Southern Brazil, between July 2012 and March 2013, were evaluated. The evaluation of oral feeding skills, according to Lau and Smith, was applied after prescription for starting oral feeding. The oral feeding performance was analyzed using the following variables: days taken to start independent oral feeding and hospital discharge. Growth was measured by weight, length, and head circumference, using the curves of Fenton, at birth, first and independent oral feeding, and hospital discharge.RESULTS: At birth, 71% preterm infants were proper for gestational age, most of them were males (53%), with average of 33.6 (±1.5) weeks of gestational age. The gestational age in the assessment did not influence the oral feeding performance of the premature infant and did not differ between levels. Time of transition from tube feeding to oral feeding and hospital stay was shorter when the oral skills were higher. At birth, there was a tendency of low weight and low oral feeding performance. Level IV premature infants in the release of oral feeding presented higher weights.CONCLUSION: The level of oral skills of the premature infant interfered positively on time of feeding transition from tube to independent oral feeding and hospital stay. Growth, represented by weight gain, was not affected by the level of oral skill.

Impact of Yoga on Blood Pressure and Quality of Life in Patients with Hypertension

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
J. Vasantha Priya ◽  
C. Kanniammal ◽  
Jaideep Mahendra ◽  
G. Valli
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Medical Treatment ◽  
Control Group ◽  
Pressure Therapy ◽  
Home Group ◽  
Yoga Class ◽  
Study Results ◽  
At Home

Background: Medical treatment of hypertension is not always sufficient to achieve blood pressure control. Despite this, previous studies on supplementary therapies, such as yoga, are relatively few. The investigator evaluated the effects of yoga intervention on blood pressure and quality of life in patients in selected hospital diagnosed with hypertension. Methods: Adult patients (age 20–80 years) with diagnosed hypertension were identified at OPD of Meenakshi Medical College and Hospital. In total, 83 subjects with blood pressure values of 120–179/≤109 mmHg at baseline were enrolled. At baseline, the patients underwent standardized blood pressure measurement at the health care center and they completed a questionnaire on self-rated quality of life (WHOQOL). There were three groups: 1) Yoga class with investigator (n = 28); 2) Yoga at home (n = 28); and 3) a control group (n = 27). The participants were matched at the group level for systolic blood pressure. After 12 weeks of intervention, the assessments were performed again. At baseline a majority of the patients (92%) were on antihypertensive medication, and the patients were requested not to change their medication during the study. Results: The yoga class group showed improvement in blood pressure or self-rated quality of life, while in the yoga at home group there was a decline in diastolic blood pressure of 4.4 mmHg (p less tha 0.05) compared to the control group. Moreover, the yoga at home group showed significant improvement in self-rated quality of life compared to the control group (p less than 0.05). Conclusions: A short yoga program for the patient to practice at hospital seems to have an antihypertensive effect, as well as a positive effect on self-rated quality of life compared to controls. This implies that simple yoga exercises may be useful as a supplementary blood pressure therapy in addition to medical treatment.

Rorschach Characteristics in Adolescents with Systemic Lupus Erythematosus

2006 ◽  
Vol 28 (1) ◽  
pp. 100-118 ◽  
Author(s):  
J. Santoantonio ◽  
L. Yazigi ◽  
E. I. Sato
Keyword(s):  
Lupus Erythematosus ◽  
Case Control Study ◽  
Activity Index ◽  
Disease Activity Index ◽  
Female Adolescents ◽  
Control Group ◽  
Intelligence Scale ◽  
The Mean ◽  
Experimental Group ◽  
Control Study

The purpose of this study was to investigate the personality characteristics in adolescents with SLE. The research design is a case-control study by means of the Rorschach Method and the Wechsler Intelligence Scale. Study group: 30 female adolescents with lupus, 12–17 years of age. The SLE Disease Activity Index was administered during the period of psychological evaluation. Control group: 32 nonpatient adolescents were matched for age, sex, and socioeconomic level. In the Wechsler Intelligence Scale the mean IQ of the experimental group was significantly lower than that of the control group (77 and 98, respectively, p < .001). In the Rorschach, the lupus patients showed greater difficulty in interpersonal interactions, although they displayed the resources to process affect and to cope with stressful situations. A positive moderate correlation (p = .069) between the activity index of the disease and the affect constriction proportion of the Rorschach was observed: the higher the SLEDAI score, the lower the capacity to process affect. There is a negative correlation between the activity index of the disease and the IQ (p = .001): with a higher activity index of the disease, less intellectual resources are available.

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