Navegando por Palavras-chave "Terapia intensiva neonatal"
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- ItemAcesso aberto (Open Access)Cost estimate of hospital stays for premature newborns of adolescent mothers in a Brazilian public hospital(Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2014-04-01) Mwamakamba, Lutufyo Witson [UNIFESP]; Zucchi, Paola; Universidade Federal de São Paulo (UNIFESP)Objective: To estimate the direct costs of hospital stay for premature newborns of adolescent mothers, in a public hospital. Method: A cost estimate study conducted between 2009 and 2011, in which direct hospital costs were estimated for premature newborns of adolescent mothers, with 22 to 36 6/7 gestational weeks, and treated at the neonatal unit of the hospital. Result: In 2006, there were 5,180 deliveries at this hospital, and 17.8% (922) were newborns of adolescent mothers, of which 19.63% (181) were admitted to the neonatal unit. Out of the 181 neonates, 58% (105) were premature and 80% (84) of them were included in this study. These 84 neonates had a total of 1,633 days in-patient hospital care at a total cost of US$195,609.00. Approximately 72% of this total cost (US$141,323.00) accounted for hospital services. The mean daily costs ranged from US$97.00 to US$157.00. Conclusion: This study demonstrated that the average cost of premature newborns from adolescent mothers was US$2,328.00 and varied according to birth weight. For those weighing <1,000g at birth, the mean direct cost was US$8,930.00 per stay as opposed to a cost of US$642.00 for those with birth weight >2,000g. The overall estimated direct cost for the 84 neonates in the study totaled US$195,609.00.
- ItemSomente MetadadadosDor no recém-nascido prematuro intubado e ventilado: avaliação multidimensional e resposta à analgesia com fentanyl(Universidade Federal de São Paulo (UNIFESP), 1993) Guinsburg, Ruth [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]
- ItemAcesso aberto (Open Access)Fatores perinatais associados a anormalidades no traçado do eletroencefalograma de amplitude integrada em prematuros no primeiro dia de vida(Universidade Federal de São Paulo (UNIFESP), 2016-10-20) Castro, Junia Sampel de [UNIFESP]; Guinsburg, Ruth [UNIFESP]; http://lattes.cnpq.br/6286661930160341; http://lattes.cnpq.br/8186489658827033; Universidade Federal de São Paulo (UNIFESP)Introduction: Given the growing concern about the neurological morbidities that premature infants are subject, to monitoring of brain electrical activity has gained ground in clinical practice; however, there are still gaps in knowledge about the factors that can influence brain function of preterm newborn infants on the first day of life. Objective: To evaluate the association between perinatal factors and abnormalities on electroencephalography amplitude-integrated (aEEG) in preterm newborn infants on the first day of life. Methods: Cross-sectional study with prospective data collection of 60 preterm infants with gestational age between 230/7-326/7 weeks, without malformations. The preterm infants were monitored by aEEG (Olympic CFM 6000, Natus®) for 3-24 hours on the first day of life with biparietal hydrogel electrodes applied in P3-P4 position. The tracings were recorded and analyzed in each record column for the presence of burst-suppression pattern, sleep-wake cycle and amplitude of the lower margin <3mV or <5mV. The association of perinatal factors (maternal complications, mode of delivery, neonatal demographic characteristics, resuscitation procedures, hypothermia on admission and SNAPPE II score) with modifications in aEEG was assessed by multiple logistic regression,using the independent variables which in the univariate analysis show p <0.20, excluded one by one if p> 0.05. At each stage, the model adjustment was assessed by the Hosmer-Lemeshow test. For the dependent variables "presence burst suppression pattern" and "presence of lower margin <3mV" noted the existence of collinearity between the variables "need for positive pressure ventilation in the delivery room" and "intubation in the delivery room" and it was decided to create two distinct models for each collinear independent variables. The results were described as odds ratio (OR) and its 95% confidence interval (95% CI). SPSS 19.0 software was used. Results: 60 preterm infants were studied with mean gestational age of 28.5±2.4 weeks, birth weight 1045 ± 369g, 55% male sex. The aEEG was installed on average 12 hours of life. Preterm infants were monitored for an average of 21 hours and 85% of this period there were appropriate tracing that allowed the analysis of the characteristics of brain neurological activity. The discontinuous pattern occurred in 65% of preterm infants and the continuous pattern in 23%. The burst-suppression pattern was associated with vaginal delivery (OR 7,6; 95%CI 1,1-53,1; p=0,041) and clinical severity of preterm infants detected by SNAPPE II ?40 (OR 13,1; 95%CI 1,8-95,1; p=0,011). The lower margin of the aEEG<3mV was also associated with the clinical severity of the newborn (OR 10,6; 95%CI 2,3-49,2; p=0,003), while its value <5mV was associated with lower gestational age (OR 0,51; 95%CI 0,34-0,761; p=0,001) and male sex (OR 4,03; 95%CI 0,96-16,04; p=0,057). There was no association between perinatal variables and absence of sleep-wake cycle in aEEG on the first day of life. Conclusion: Biological variables of preterm infants and their clinical severity are associated with electroencephalographic tracings characteristics on the first day of life and should be considered in clinical practice when aEEG is monitored.
- ItemAcesso aberto (Open Access)Nível de ruído em unidade de terapia intensiva neonatal(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2007-12-01) Kakehashi, Tereza Yoshiko; Pinheiro, Eliana Moreira [UNIFESP]; Pizzarro, Gilberto [UNIFESP]; Guilherme, Arnaldo [UNIFESP]; Universidade São Marcos; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: Determine noise levels in the Neonatal Intensive Care Unit and identify the sources of these noises. METHODS: Quantitative, descriptive and exploratory study, carried out in São Paulo. Data was collected in April and May of 2005. A dosimeter was used to record a total of 96 hours of measurements. Nine hours of observation were also conducted to identify sources of noise. RESULTS: Leq noise levels ranged from of 61.3 to 66.6 dBA and were higher on the weekends. Peak values ranged from 90.8 to 123.4 dBC and the highest values were recorded at night. The sources of the noise were: beeping noises from ventilators and heart rate monitors, conversations between health professional and others. CONCLUSION: The deleterious effects of high levels of noise on newborns and health professionals show the need for interventions in routines and professionals and families' conduct.
- ItemSomente MetadadadosAs representações maternas acerca do bebê que nasce com doenças orgânicas graves(Universidade Federal de São Paulo (UNIFESP), 2003) Battikha, Ethel Cukierkorn [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]O objetivo deste trabalho de pesquisa e a circunscricao e analise das representacoes psiquicas maternas acerca do nascimento de bebes com doencas organicas graves. Pesquisa qualitativa, fundamentada no campo teorico-psicanalitico, baseada no material coletado em 11 entrevistas semi-estruturadas com maes de bebes, no periodo de sua internacao na unidade de terapia intensiva neonatal. Refere que o anuncio da doenca provoca nas maes questoes fundamentais que, ressalvadas as singularidades pessoais, sao comuns a todas. Analisa as implicacoes de um nascimento marcado pelo luto do filho imaginado e pela emergencia na mae de uma profunda ferida narcisica, e problematiza as marcas fundantes da subjetividade desse bebe, sustentadas nesse vinculo inicial mae-bebe. Constata que as entrevistas realizadas a proposito da pesquisa tiveram um efeito terapeutico, e enfatiza a necessidade de um espaco constituido de escuta analitica dessa mae, enquanto permanecer o bebe na instituicao hospitalar. Conclui tambem que a humanizacao da UTIN perpassa trabalhos interdisciplinares que possam contemplar questoes como a comunicacao do diagnostico do bebe aos pais, bem como a necessidade de um espaco de interlocucao para os profissionais, onde suas proprias questoes e angustias, mobilizadas nesse atendimento, possam ser trabalhadas. Considera que a historia dessa crianca esta se constituindo, e que muitos podem ser os seus desdobramentos a partir do reposicionamento subjetivo dos pais, alem do posicionamento dos profissionais envolvidos no seu atendimento durante o tempo em que estiverem sob os seus cuidados
- ItemAcesso aberto (Open Access)O ruído da unidade de terapia intensiva neonatal após a implementação de programa educativo(Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem, 2012-12-01) Tsunemi, Miriam Harumi; Kakehashi, Tereza Yoshiko; Pinheiro, Eliana Moreira [UNIFESP]; Universidade Estadual Paulista (UNESP); Escola de Terapias Orientais de São Paulo; Universidade Federal de São Paulo (UNIFESP)The present study verified the sound pressure levels inside incubators and at the Neonatal Intensive Care Unit, six months after the implementation of an educational program. Quantitative and descriptive study carried out at the Neonatal Intensive Care Unit and inside the incubators of a hospital. It was registered 151 hours and 30 minutes of sound pressure levels at the Neonatal Intensive Care Unit and inside the incubators, in January 2009 and 2010. The highest and lowest mean Leq before the educational program at the Neonatal Intensive Care Unit were 71.0 dBA and 59.0 dBA, respectively. After the intervention, it was registered at the Neonatal Intensive Care Unit the mean Leq between 80.4 and 52.6 dBA. Inside the incubators, values varied from 79.2 and 40.0 dBA to 79.1 and 45.4dBA post intervention, remaining above the recommended values. It was verified that there was no reduction of sound pressure level after the intervention. Some strategies are suggested to sensitize the staff, preparation of a guideline, architectural changes, renovation and/or preventive maintenance of equipments.