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The Team Members’ Perspective on Teamwork During Neonatal Resuscitation
Author(s) -
Mia McLanders,
Penelope Sanderson,
Helen Liley
Publication year - 2017
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13494_193
Subject(s) - medicine , teamwork , perspective (graphical) , neonatal resuscitation , resuscitation , medical emergency , intensive care medicine , medical education , nursing , emergency medicine , management , artificial intelligence , computer science , economics
University, the Waikato District Health Board, the Univeristy of Auckland, the University of Auckland, Liggins Institute On behalf of the CHYLD Study Team. Background: Higher and unstable glucose concentrations in the first 48 hours in neonates at risk of hypoglycaemia have been associated with neurosensory impairment. It is unclear what defines and contributes to instability. Methods: Prospective study of term and late preterm babies (N = 139) born at risk of neonatal hypoglycaemia with interstitial glucose (IG) monitoring and > =1 hypoglycaemic episode <48 hours after birth. Masked IG parameters were analyzed for 6-hour epochs after each episode (blood glucose concentration <2.6 mmol/l) and related to treatment and neurodevelopmental outcome at 2 and 4.5y. Results: Glycaemic instability in the first 48 hours was related to instability after hypoglycaemia. IG parameters were not related to risk factors for hypoglycaemia. Treatment with intravenous dextrose was associated with higher IG maximum and range, and lower minimum compared to treatment with dextrose gel plus breast milk, breast milk alone or formula alone. The risk of neurosensory impairment was increased with both long and short time to reach IG maximum (middle vs upper tertile OR = 3.33, 95%CI 1.44-7.70 and lower tertile OR = 2.94, 95%CI 1.31-6.59). Conclusion: Glycaemic response to hypoglycaemia contributes to overall glycaemic instability in newborns and is influenced by treatment. Slow or rapid recovery from hypoglycaemia is associated with neurosensory impairment.