Facilitated tucking during early neonatologist‐performed echocardiography in very preterm neonates

Gautheyrou, Laurène; Durand, Sabine; Jourdes, Emilie; Jonckheere, Julien De; Combes, Clémentine; Cambonie, Gilles

doi:10.1111/apa.14555

Cited by 15 publications

(13 citation statements)

References 29 publications

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“…54 Another advantage is that it is effective for extremely or very premature infants without requiring any other abilities, such as mature sucking ability. 55 Moreover, it can be used when newborns are unable to be transferred from the incubator or bed. 26 SSC, also known as KC, refers to the way the mother holds a diaper-clad infant upright on her breast at approximately 60°, providing maximum skin-to-skin contact between the baby and mother.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…One advantage of FT is that parents or health professionals can easily learn and perform it because of its minimal technical challenges 54. Another advantage is that it is effective for extremely or very premature infants without requiring any other abilities, such as mature sucking ability 55. Moreover, it can be used when newborns are unable to be transferred from the incubator or bed 26…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

et al. 2022

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ObjectivesTo synthesise current evidence from systematic reviews (SRs) regarding the efficacy and safety of non-pharmacological interventions to prevent and treat pain in newborn infants.DesignOverview of SRs.Data sourcesWe searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Database, Chinese Science and Technology Periodical Database (VIP) and Google Scholar to identify all relevant SRs published in the last 5 years.Eligibility criteria for selecting studiesWe included SRs that evaluated the efficacy and safety of non-pharmacological interventions for neonatal pain.Data extraction and synthesisTwo reviewers independently extracted the data, assessed the methodological quality using a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 and graded the evidence quality with the Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsA total of 29 SRs were included in this overview, of which 28 focused on procedural pain and only 1 focused on postoperative pain. Based on AMSTAR 2, seven reviews were found to be of ‘high quality‘, eight of ‘moderate quality’, five of ‘low quality’ and nine of ‘critically low quality’. The GRADE results suggested that facilitated tucking, kangaroo care, sweet solutions, familiar odour or combined non-pharmacological interventions, such as a combination of sucrose and non-nutritive sucking, were effective and safe in reducing pain from medical procedures in neonates. However, sucrose alone was less effective than local anaesthesia or a combination of the two during circumcision.ConclusionsFacilitated tucking, small volumes of sweet solutions, kangaroo care and familiar odour were recommended. Scientific implementation strategies should be developed to promote the clinical use of these effective non-pharmacological interventions. Meanwhile, further rigorous trials and SRs are needed to identify the best non-pharmacological approaches for pain from common surgery and illnesses in neonates.PROSPERO registration numberCRD42021292583.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

et al. 2022

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“…Another source of ventilation perfusion mismatch, clearly demonstrated in our patient, was the alterations in vascular tone, leading to PH, an increase in pulmonary vascular resistance, and ductal right-left shunting. Based on our experience, a peak tricuspid regurgitant jet velocity reaching 3 m/s was clearly high for this patient, corresponding to approximately double the velocity we usually record in premature infants [ 46 ]. Using a relevant M-mode echocardiography index to assess pulmonary haemodynamics, a study in stable low birthweight neonates suggested increased pulmonary vascular resistance during the infusion of 0.6 g/kg of a pure soybean oil emulsion over 2 h [ 47 ].…”

Section: Discussionmentioning

confidence: 80%

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

et al. 2021

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Background Tenfold or more overdose of a drug or preparation is a dreadful adverse event in neonatology, often due to an error in programming the infusion pump flow rate. Lipid overdose is exceptional in this context and has never been reported during the administration of a composite intravenous lipid emulsion (ILE). Case presentation Twenty-four hours after birth, a 30 weeks’ gestation infant with a birthweight of 930 g inadvertently received 28 ml of a composite ILE over 4 h. The ILE contained 50% medium-chain triglycerides and 50% soybean oil, corresponding to 6 g/kg of lipids (25 mg/kg/min). The patient developed acute respiratory distress with echocardiographic markers of pulmonary hypertension and was treated with inhaled nitric oxide and high-frequency oscillatory ventilation. Serum triglyceride level peaked at 51.4 g/L, 17 h after the lipid overload. Triple-volume exchange transfusion was performed twice, decreasing the triglyceride concentration to < 10 g/L. The infant’s condition remained critical, with persistent bleeding and shock despite supportive treatment and peritoneal dialysis. Death occurred 69 h after the overdose in a context of refractory lactic acidosis. Conclusions Massive ILE overdose is life-threatening in the early neonatal period, particularly in premature and hypotrophic infants. This case highlights the vigilance required when ILEs are administered separately from other parenteral intakes. Exchange transfusion should be considered at the first signs of clinical or biological worsening to avoid progression to multiple organ failure.

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“…The infant is held in a flexed foetal‐type position with its limbs close to the midline of the torso. In this issue of Acta Paediatrica, Gautheyrou et al report the findings of their randomised controlled trial of the use of facilitated tucking in very preterm neonates below 30 weeks of gestation during early NPE. The primary outcome was the effect that facilitated tucking had on echocardiographic indexes of pulmonary haemodynamics.…”

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confidence: 99%

Neonatologist Performed Echocardiography offers haemodynamic assessments that go beyond clinical signs and biochemical tests

Nestaas

2018

Acta Paediatrica

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Facilitated tucking during early neonatologist‐performed echocardiography in very preterm neonates

Abstract: Echocardiography performed soon after birth in very premature neonates may generate mild discomfort. FT during echocardiography is associated with lower pulmonary artery pressures and improves infant's comfort during this examination.

Cited by 15 publications

References 29 publications

Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report

Neonatologist Performed Echocardiography offers haemodynamic assessments that go beyond clinical signs and biochemical tests

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