Kittredge Lecture: Airway Safety in Neonatal and Pediatrics

Volsko, Teresa A

doi:10.4187/respcare.10017

Cited by 6 publications

(3 citation statements)

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“…Furthermore, a high blood flow is presumed to lower the need to exert pressure on the incision site, such as by squeezing, thereby minimizing the risk of hemolysis 11,12. Hemolysis, resulting from inappropriate or incorrect handling of procedures during blood collection, is the breakdown of red blood cells and is recognized as a major preanalytical problem because a range of biochemical tests are unmeasurable in this situation 12–14. The hemolysis index aids in evaluating sample integrity as an indicator of the number of destroyed red blood cells present in a sample 13,15.…”

Section: Background and Significancementioning

confidence: 99%

“…11,12 Hemolysis, resulting from inappropriate or incorrect handling of procedures during blood collection, is the breakdown of red blood cells and is recognized as a major preanalytical problem because a range of biochemical tests are unmeasurable in this situation. [12][13][14] The hemolysis index aids in evaluating sample integrity as an indicator of the number of destroyed red blood cells present in a sample. 13,15 Warming of the incision site before heel stick may be beneficial for collecting pH and blood gas specimens as well, 16,17 and studies also found that warming the heel may reduce the infant's pain.…”

Section: Background and Significancementioning

confidence: 99%

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Warming Prior to Heel Stick

Toennesen,

Kierkegaard,

Kofoed

et al. 2023

Advances in Neonatal Care

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Background: Capillary blood sampling (heel stick) in infants is commonly performed in neonatal care units. Before the procedure, warming the infant's heel is often a customary practice, but no consensus exists on the most effective heel-warming method. Purpose: To compare the effects of routinely used warming methods (glove, gel pack, or blanket) applied prior to heel stick on blood sample quality and infant's comfort. Methods: This prospective, double-blind, randomized controlled trial conducted in the neonatal intensive care unit included infants (postmenstrual age of ≥28 + 0 weeks and ≤43 + 6 weeks) who were computer-randomized to 1 of 3 warming methods. The primary outcome was blood flow velocity at sampling. Secondary outcomes were hemolysis index, infant COMFORTneo score, and frequency of postprocedure skin injuries. In addition, irrespective of the warming method used, the correlation between heel skin temperature and postprocedure heel skin injury was analyzed. Results: A total of 176 heel warmings were successfully randomized, and 173 were analyzed. Despite a significant difference in obtained heel skin temperature after warming between the 3 warming methods (P = .001), no difference in blood flow velocity (P = .91), hemolysis index (P = .99), or COMFORTneo score (P = .76) was found. Baseline skin temperatures above 37.0°C were associated with higher incidences of skin injury, and skin temperatures after warming were significantly higher in skin-injured heels (P = .038). Implications for Practice and Research: All 3 warming methods had similar effects on blood sample quality and infant's comfort. However, excessive warming of the heel should be avoided to prevent skin injuries.

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Section: Background and Significancementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

Warming Prior to Heel Stick

Toennesen,

Kierkegaard,

Kofoed

et al. 2023

Advances in Neonatal Care

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“…Dentro del contexto del estudio la dificultad respiratoria pediátrica es una queja común que genera a que los pacientes pediátricos fueran consultados en las unidades de emergencias pediátricas, las causas comunes de dificultad respiratoria pediátrica incluyen bronquiolitis viral, neumonía, enfermedad reactiva de las vías respiratorias/asma y CRUP (Volsko, Teresa A.;& Barnhart, Sherry, 2019). Ante ello, las prescripciones de CNAF en la población pediátrica se han triplicado en la última década, esto como alternativa al régimen de tratamiento convencional por CPAP (Haley-Fishman, et al 2023).…”

Section: Introductionunclassified

Uso de cánula nasal de alto flujo CNAF en emergencia pediatría del Hospital de Lima Este-Vitarte, 2024-Perú

Huaraca Carhuaricra,

Lorena Li Parra,

Arias Ochoa

et al. 2023

rcli

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La CNAF es una terapia no invasiva efectiva y con mínimos efectos adversos para enfermedades respiratorias. Objetivo. Determinar la incidencia del uso de cánula nasal de alto flujo CNAF en el Departamento de emergencia, del área pediátrica del Hospital de Lima Este - Vitarte, 2024. El estudio es descriptivo y prospectivo con cohorte de usuarios pediátricos, los datos recolectados fueron llenados en el registro de incidencias por las enfermeras de turno en los tópicos de shock trauma tópico y observación de pediatría, para la búsqueda y recolección de información se utilizaron: Scopus, WoS, Medline, Scielo, LILACS, Global Healt, Embase, y Google académico. Por la naturaleza del estudio, se considera a 38 pacientes. Se observó que la mayoría eran varones 58%, con crisis asmática 74%. Los resultados mostraron mejoras en la frecuencia cardíaca y respiratoria, así como en la puntuación de Wood-Downes-Férres. Algunos pacientes requirieron derivación a cuidados intensivos 24%. Se destacó la menor incidencia de complicaciones como lesiones de mucosa nasal 5%. La CNAF se considera una terapia segura y eficaz en el manejo de enfermedades respiratorias pediátricas en entornos de emergencia y cuidados críticos.

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