Neonatal network : NN
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Neonatal network : NN · Aug 2002
ReviewManaging our first breaths: a reflection on the past several decades of neonatal pulmonary therapy.
Lung disease has been a leading cause of significant morbidity and mortality since neonates first drew breath. Over the past few decades, many treatment options have evolved to aid us in our ability to support neonatal breathing. ⋯ Understanding traditional therapeutic options and knowing what may be on the horizon can help caregivers to better match treatment plans with individual infants. This article reviews advances in mechanical ventilation, adjuvant therapies, and respiratory drugs through the past few decades and speculates on future directions in this field.
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Neonatal network : NN · Aug 2002
ReviewSome pain, some gain: reflections on the past two decades of neonatal pain research and treatment.
This review reflects back on the progress that has been made in infant pain research over the past 20 years and how the research has influenced (or has failed to influence) the attitudes and practices of health professionals about infant pain. Progress in understanding of infant pain neurobiology, treatment, and measurement are discussed, and new directions for future research are proposed.
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A newborn lies wide-awake, about to be intubated. The infant is able to feel everything, to hear everything--but cannot do anything to change the situation. Big people hold down the newborn and place a laryngoscope blade into the mouth, then a large endotracheal tube into the trachea. ⋯ Use of these medications optimizes intubating conditions and helps to minimize the adverse physiologic effects of intubation. Neonatology has yet to embrace this trend, however. This article addresses the issue of sedation for intubation in the neonatal population.
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Oxygen is one of the most commonly administered drugs in the neonatal intensive care unit. A variety of techniques exists to deliver oxygen to infants who are not on a ventilator or who are not receiving positive pressure. These techniques include oxygen hood, nasal cannula, face mask delivery or "free flow," and "flooding" the incubator with oxygen. ⋯ Recent advances in incubator technology have improved the delivery of supplcmental oxygen by incubator flooding. This technique is generally underutilized, but it has some advantages over thc other modalities in certain clinical scenarios. The neonatal nurse needs to be aware of the characteristics of the various oxygen delivery technologies and the tools needed to optimally care for infants who are dependent on supplemental oxygen.