Pediatrics
-
Multicenter Study
Influenza virus infection and the risk of serious bacterial infections in young febrile infants.
We aimed to determine the risk of SBIs in febrile infants with influenza virus infections and compare this risk with that of febrile infants without influenza infections. ⋯ Febrile infants
-
Multicenter Study
Impact of electronic health record-based alerts on influenza vaccination for children with asthma.
The goal was to assess the impact of influenza vaccine clinical alerts on missed opportunities for vaccination and on overall influenza immunization rates for children and adolescents with asthma. ⋯ Clinical alerts were associated with only modest improvements in influenza vaccination rates.
-
Multicenter Study
Conflicts about end-of-life decisions in NICUs in the Netherlands.
To determine the frequency and background of conflicts about neonatal end-of-life (EoL) decisions. ⋯ The parents were involved in all EoL decision-making processes, and consensus was ultimately reached in all cases. Conflicts within the team occurred in 4% of the cases and between the team and the parents in 12% of the cases. The conflicts were resolved by postponing the EoL decision until consensus was achieved.
-
Multicenter Study
Early nasal continuous positive airway pressure and necrotizing enterocolitis in preterm infants.
The use of early nasal continuous positive airway pressure (ENCPAP) as the mode of initial respiratory support for very low birth weight (VLBW) infants has been increasing. The impact of CPAP and oxygen on gut mucosa and perfusion in premature infants is not known. The relation between ENCPAP and necrotizing enterocolitis (NEC) has not been adequately addressed. ⋯ Data on 343 premature infants were collected for this study. Mean birth weight was 999 +/- 289 g and gestational age was 28 +/- 2.6 weeks. The majority of patients were managed with ENCPAP, with only 13% of patients intubated in the delivery room. The overall incidence of NEC was 7% (n = 24). The exposure to ENCPAP did not increase the risk for NEC compared with the use of a ventilator. CONCLUSIONS. The risk of NEC in VLBW premature infants was not increased by the use of ENCPAP. Initial respiratory support with ENCPAP seems to be a safe alternative to routine intubation and mechanical ventilation in premature infants.