• Clinical and Experimental Pediatrics
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• 제57권3호
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• pp.101-109
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• 2014

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

• Clinical and Experimental Pediatrics
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• 제45권11호
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• pp.1426-1429
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• 2002

저자들은 재태연령 35주 2일, 출생 체중 2.19 kg으로 출생시 낮은 Apgar score(1/2)와 흉부 촬영상 우측 횡격막 거상을 보였던 환아에서 복부 초음파 검사와 컴퓨터 단층촬영을 시행하여 간 우엽에 생긴 단발성 농양을 발견하였으며 초음파를 이용한 경피적 천자 흡인물 배양 검사에서 포도상 구균이 검출된 선천성 간농양 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Child Health Nursing Research
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• 제13권4호
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• pp.436-443
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• 2007

Purpose: An exploratory study was done to examine the validity of the new Ballard scale with extended scoring system(eNBS) in estimating gestational age(AG) in full-term newborns. Method: The eNBS scoring system was extended to include all numbers of total score of NBS and GA to allow a 3-days variation in GA estimatio compared to the original scale which has a 2-week variation due to the application of a 5-score interval for the total NBS score and only even numbers for GA. GA by eNBS(GA-eNBS) was compared with GA by LMP(GA-LMP) and GA by standard NBS(GA-sNBS) in 133 full-term newborns. Difference between GA-LMP and GA-eNBS was analyzed for each GA. Results: Positive correlations were observed in GA-sNBS and GA-eNBS with GA-LMP. There was no difference between GA-LMP and GA-eNBS at 39GA and 40GA. At 37GA and 38GA, GA-eNBS overestimated GA-LMP up to 1 week, while underestimating up to 1 week at 41GA. Conclusions: The accuracy of eNBS was validated within 3 days of variation in GA estimation at 39-40GA. Overestimation by eNBS suggests the possible acceleration of fetal maturity in premature newborns, while underestimation, of the deceleration of fetal maturity in postterm newborns.

• 대한간호학회지
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• 제35권7호
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• 대한간호학회지
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• 제49권2호
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• pp.126-136
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• 2019

Purpose: This study was conducted to evaluate the effect of breast milk olfactory stimulation on physiological responses, oral feeding progression, and body weight in preterm infants. Methods: A repeated measures design with nonequivalent control group was used. The participants were healthy, preterm infants born at a gestational age of 28~32 weeks; 12 in the experimental group and 16 in the control group. Data were collected prospectively in the experimental group, and retrospectively in the control group, by the same methods. Breast milk olfactory stimulation was provided 12 times over 15 days. The data were analyzed using the chi-square test, Mann-Whitney U test, Wilcoxon signed rank test and linear mixed models using SPSS 19. Results: The gastric residual volume (GRV) of the experimental group was significantly less than that of the control group. The heart rate, oxygen saturation, respiration rate, transition time to oral feeding, and body weight were not significantly different between the two groups. Conclusion: These findings indicate that breast milk olfactory stimulation reduces GRV and improves digestive function in preterm infants without inducing distress.

• Clinical and Experimental Pediatrics
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• 제62권3호
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• pp.79-84
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• 2019

Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and care sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.

• Child Health Nursing Research
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• 제27권1호
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• pp.34-42
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• 2021

Purpose: The purpose of this study was to identify the supportive care needs of parents of preterm children in South Korea using text data from a portal site. Methods: In total, 628 online newspaper articles and 1,966 social network service posts published between January 1 and December 31, 2019 were analyzed. The procedures in this study were conducted in the following order: keyword selection, data collection, morpheme analysis, keyword analysis, and topic modeling. Results: The term "yirundung-yi", which is a native Korean word referring to premature infants, was confirmed to be a useful term for parents. The following four topics were identified as the supportive care needs of parents of preterm children: 1) a vague fear of caring for a baby upon imminent neonatal intensive care unit discharge, 2) real-world difficulties encountered while caring for preterm children, 3) concerns about growth and development problems, and 4) anxiety about possible complications. Conclusion: Supportive care interventions for parents of preterm children should include general parenting methods for babies. A team composed of multidisciplinary experts must support the individual growth and development of preterm children and manage the complications of prematurity using highly accessible media.

• Child Health Nursing Research
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• 제28권1호
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• pp.70-81
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• 2022

Purpose: This study aimed to develop and evaluate the effectiveness of an educational program on developmental positioning (EPDP) for nurses in neonatal intensive care units (NICUs). Methods: The study utilized a non-equivalent control group pretest-posttest design. Sixty NICU nurses were recruited from two university hospitals in Daejeon, South Korea. The EPDP consisted of a 7-week program: 3 weeks of education and practice, followed by 4 weeks of encouragement messages using social networking services. Developmental positioning (DP) posters and DP aids were also provided during the intervention period. The intervention group (n=30) received the EPDP, but not the control group. The data were analyzed using the 𝜒² test, the Fisher exact test, the independent t-test, and repeated-measures analysis of variance. Results: Participants' knowledge (t=7.49, p<.001), attitudes (t=1.99, p=.001), self-efficacy (t=2.99, p=.004), performance of DP (t=2.98, p=.004) and Infant Positioning Assessment Tool (IPAT) scores (F=29.50, p<.001) were significantly higher in the intervention group than in the control group. Conclusion: The EPDP can be an effective and useful program for improving the performance of DP among NICU nurses by increasing their knowledge, attitudes, and self-efficacy of DP. However, further research involving various NICU settings is needed to gather more empirical evidence.

• Child Health Nursing Research
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• 제28권2호
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• pp.112-123
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• 2022

Purpose: This study aimed to develop and evaluate a mobile application focusing on developmental support care for infants born prematurely. Methods: An application was developed using the analysis, design, development, implementation, and evaluation model. In the analysis phase, previous research was evaluated through big data text-mining and a literature review. In the design phase, the preliminary content of the application was designed, and the content validity and comprehension were verified. A hybrid application was developed and used by eight experts and ten users, who evaluated the layout of the mobile application and their satisfaction with it. Results: The content of the designed application comprised a diary, customized information, developmental play, and community. The mean scores for layout were 3.73±0.47 and 3.43±0.68 out of 4 points among the experts and users, respectively. Users' mean satisfaction score was 3.70±0.70 out of 5 points. Conclusion: The information provided by the mobile application was evaluated as consistent and systematic. The application was also found to be satisfactory by infants' parents. The mobile application developed through this study is expected to be effective in supporting the development of children born prematurely.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.281-285
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• 2023

Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.