Tracheostomy on infants born in the periviable period: Outcomes at discharge from the neonatal intensive care unit (NICU)

Pereira, Kevin D.; Teplitzky, Taylor B.; Zur, Karen B.; Preciado, Diego; Briddell, Jenna W.; El-Metwally, Dina; Isaiah, Amal

doi:10.1016/j.ijporl.2021.110746

“…After mastering these skills, the families can make sensory perception intervention on infants, which can not only improve the infants' excitatory-inhibitory function and enhance the brain regulatory effect but also raise their environmental adaptability, thus allowing infants to have better neuromotor and intellectual development [ 21 ]. Previous evidence found that the family participatory management mode can significantly increase the 18-month MDI and PDI scores of premature infants, with a similar effect on the growth and development of premature infants of different gestational ages [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families’ Psychological Status

Liu

¹

,

Xu²,

Li³

2022

Contrast Media & Molecular Imaging

1

0

1

View full text Add to dashboard Cite

The purpose of this study was to explore the effects of family participatory nursing on the clinical outcomes of premature infants in the neonatal intensive care unit (NICU) and their families’ psychological status. Total of 150 premature infants were admitted to the NICU of our hospital from December 2019 to December 2021, and their families were selected by convenience sampling method and divided into control group (n = 78, from December 2019 to December 2020) and observation group (n = 72, from January 2020 to December 2021) according to the admission time. The infants in the control group were given routine nursing, while those in the observation group received family participatory nursing. In the observation group, the length of stay and duration of oxygen therapy were shorter, the weight gain speed was higher, and the incidence rate of nosocomial infection was lower than those in control groups P < 0.05 . The time of reaching full gastrointestinal feeding was earlier, the daily milk intake and exclusive breastfeeding rate were higher, and the feeding intolerance rate was lower in observation group than those in control group P < 0.05 . Observation group exhibited significantly higher body weight, Z-value of body weight, NBNA score at 7 d after hospitalization, 15-month mental development index (MDI), and psychomotor development index (PDI) scores than control group P < 0.05 . In addition, the families’ somatization, depression and anxiety factor scores, and total score of SCL-90 in the observation group were lower than those in the control group, while each dimension score and total score of MPOC-20 were higher than those in control groups P < 0.05 . Family participatory nursing is of great significance in ameliorating the clinical outcomes of premature infants in the NICU, which can shorten the length of stay, improve feeding conditions, facilitate infant growth and development, and enhance their families’ psychological status and nursing satisfaction.

show abstract

“…Prolonged mechanical ventilation in post-prematurity infants with severe bronchopulmonary dysplasia (BPD) is now the most common indication for tracheostomy in infants ( 5 , 6 ). As advanced technology in neonatal intensive care units (NICUs) becomes more routine, the survival of extremely premature infants has also increased the need for long-term mechanical ventilation ( 7 ), specifically for those infants born at the threshold of viability (≤24 weeks' gestation), who have greater odds of developing severe BPD ( 8 , 9 ). Other reasons for performing tracheostomy in infants include congenital anomalies of the airway, neurological and complex cardiac anomalies, and genetic diseases with either short- or long-term survival outcome ( 7 , 8 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Tracheostomy in infants with severe bronchopulmonary dysplasia: A review

Akangire

¹

,

Manimtim

²

2023

View full text Add to dashboard Cite

In recent years, with increased survival of infants with severe bronchopulmonary dysplasia (BPD), long term ventilation due to severe BPD has increased and become the most common indication for tracheostomy in infants less than one year of age. Evidence shows that tracheostomy in severe BPD may improve short- and long-term respiratory and neurodevelopmental outcomes. However, there is significant variation among centers in the indication, timing, intensive care management, and follow-up care after hospital discharge of infants with severe BPD who received tracheostomy for chronic ventilation. The timing of liberation from the ventilator, odds of decannulation, rate of rehospitalization, growth, and neurodevelopment are all clinically important outcomes that can guide both clinicians and parents to make a well-informed decision when choosing tracheostomy and long-term assisted ventilation for infants with severe BPD. This review summarizes the current literature regarding the indications and timing of tracheostomy placement in infants with severe BPD, highlights center variability in both intensive care and outpatient follow-up settings, and describes outcomes of infants with severe BPD who received tracheostomy.

show abstract

“…While recent retrospective cohort studies have examined the outcomes of infants with tracheostomies, to our knowledge, this is a unique cohort in the Canadian context. 9,10,[15][16][17][18][19][20][21][22][23] Canada has a singlepayer, provincially administered, publicly funded healthcare system. Alberta, Canada also has a comprehensive, publicly funded home care system for technology-dependent children.…”

Section: Discussionmentioning

confidence: 99%

“…While recent retrospective cohort studies have examined the outcomes of infants with tracheostomies, to our knowledge, this is a unique cohort in the Canadian context 9,10,15–23 . Canada has a single‐payer, provincially administered, publicly funded healthcare system.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tracheostomies in term and preterm infants: A single‐center Canadian retrospective cohort

Wong

¹

,

Harris

²

,

Hicks

³

et al. 2022

Pediatric Pulmonology

0

View full text Add to dashboard Cite

Main outcome measures: Hospital course, discharge, and 3-year post-tracheostomy outcomes were compared between preterm infants <29 weeks gestation and infants with congenital anomalies.Results: Forty-three infants were identified; seven were lost to follow-up and excluded. Of the 36 analyzed, 86% survived to discharge. At discharge, 13% were decannulated, 36% required no mechanical ventilation, and 52% required mechanical ventilation. Median hospitalization was 295 days. At 3 years post-tracheostomy, 97% were alive. Proportions of infants with tracheostomy in situ was 80%, 73%, and 60% at 1, 2, and 3 years post tracheostomy. Tracheostomy incidence was 2.7% for preterm infants <29 weeks gestational age with 55% for subglottic stenosis. All preterm infants received postnatal steroids. Preterm infants underwent tracheostomy at later chronological age (123 vs. 81 days, p < 0.001), but similar corrected gestational age (42 + 5 vs. 51 + 2 weeks, p = 0.095). Preterm infants had more intubation attempts (17 vs. 4, p < 0.001), total extubations (8 vs. 2, p < 0.001), and days on ventilation before tracheostomy (100 vs. 78, p < 0.001).Conclusions: Infants who underwent tracheostomy in a Canadian public healthcare setting demonstrated decreasing tracheostomy dependence and high survival post tracheostomy, despite prolonged hospitalization. Preterm infants had more intubation and extubation events which may have contributed to airway injury.

show abstract

Tracheostomy on infants born in the periviable period: Outcomes at discharge from the neonatal intensive care unit (NICU)

Cited by 15 publications

References 20 publications

Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families’ Psychological Status

Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families’ Psychological Status

Tracheostomy in infants with severe bronchopulmonary dysplasia: A review

Tracheostomies in term and preterm infants: A single‐center Canadian retrospective cohort

Contact Info

Product

Resources

About