Table of contents
(Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 24, 2018 Category: Perinatology & Neonatology Source Type: research
Neuromonitoring in the neonatal ECMO patient
Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to advances in medical and surgical management, overall mortality has decreased. However, short and long-term neurological morbidity has remained high. Therefore, increasing attention has been focused on multimodal neuromonitoring to track and optimally, minimize or prevent intracranial injury. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 2, 2018 Category: Perinatology & Neonatology Authors: Nan Lin, John Flibotte, Daniel J. Licht Source Type: research
Maternal sepsis
This article will provide the reader with rational steps to aid in the recovery of such a patient. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Authors: Arthur Jason Vaught Source Type: research
Trauma in pregnancy
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6 –8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize tha t even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients ...
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Authors: Christopher Kevin Huls, Corey Detlefs Source Type: research
Managing congenital heart disease in the obstetric patient
Objective: Cardiovascular disease is the major cause of pregnancy-related maternal mortality in the United States, and congenital heart disease (CHD) is the most common form of structural heart disease affecting women of childbearing age. Most females born with CHD will reach childbearing age and consider pregnancy. Adult CHD and maternal-fetal medicine (MFM) specialists managing women with CHD should provide preconception counseling, cardiovascular risk assessment prior to pregnancy that estimates maternal and fetal risk, management during pregnancy, and in the peripartum period and also know the potential complications a...
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Authors: Heidi M. Connolly Source Type: research
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(Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Source Type: research
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(Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Source Type: research
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(Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Source Type: research
Table of contents
(Source: Seminars in Perinatology)
Source: Seminars in Perinatology - February 1, 2018 Category: Perinatology & Neonatology Source Type: research
Extracorporeal membrane oxygenation in infants with congenital diaphragmatic hernia
Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly which impairs normal pulmonary development leading to acute and chronic respiratory failure, pulmonary hypoplasia, pulmonary hypertension, and mortality. CDH is the most common non-cardiac indication for neonatal ECMO. Prenatal and postnatal predictors of CDH severity aid in patient selection. Centers vary in preferred mode of ECMO and timing of CDH repair. Survivors of severe CDH with ECMO are at risk for long-term sequelae including neurodevelopmental delays. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 12, 2018 Category: Perinatology & Neonatology Authors: Theresa R. Grover, Natalie E. Rintoul, Holly L. Hedrick Source Type: research
An overview of medical ECMO for neonates
Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 11, 2018 Category: Perinatology & Neonatology Authors: Kathryn Fletcher, Rachel Chapman, Sarah Keene Source Type: research
Anticoagulation in neonatal ECMO
Despite advances made in technology and neonatal intensive care, the rate of hemorrhagic and thrombotic complications remains unacceptably high in patients undergoing extracorporeal membrane oxygenation (ECMO) and these complications negatively impact morbidity and mortality. Management of anticoagulation in neonates who have a developing hemostatic system is vastly different from adults and poses unique challenges. Variation in practice among ECMO centers regarding anticoagulation monitoring and titration reflects the lack of high-quality evidence. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 11, 2018 Category: Perinatology & Neonatology Authors: Aditi Kamdar, Natalie Rintoul, Leslie Raffini Source Type: research
Education for ECMO providers: Using education science to bridge the gap between clinical and educational expertise
A well-organized educational curriculum for the training of both novice and experienced ECMO providers is critical for the continued function of an institutional ECMO program. ELSO provides guidance for the education for ECMO specialists, physicians and staff, which incorporates “traditional” instructor-centered educational methods, such as didactic lectures and technical skill training. Novel research suggests utilization of strategies that align with principles of adult learning to promote active learner involvement and reflection on how the material can be applied to understand existing and new constructs may be mor...
Source: Seminars in Perinatology - January 11, 2018 Category: Perinatology & Neonatology Authors: Lindsay Johnston, Susan B. Williams, Anne Ades Source Type: research
Ethical and end of life considerations for neonates requiring ECMO support
ECMO has proven to be a life-saving intervention for a variety of disease entities with a high rate of survival in the neonatal population. However, ECMO requires clinical teams to engage in many ethical considerations. Even with ongoing improvements in technology and expertise, some patients will not survive a course of ECMO. An unsuccessful course of ECMO can be difficult to accept and cause a great deal of angst. These questions can result in real conflict both within the care team, and between the care team and the family. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - January 10, 2018 Category: Perinatology & Neonatology Authors: Roxanne Kirsch, David Munson Source Type: research
Multidisciplinary obstetric critical care delivery: The concept of the “virtual” intensive care unit
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the “virtual” intensive care unit. We challenge the traditional association of the word “unit” to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric cri tical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, ...
Source: Seminars in Perinatology - January 5, 2018 Category: Perinatology & Neonatology Authors: Michael P. Leovic, Hailey N. Robbins, Roman S. Starikov, Michael R. Foley Source Type: research
