Neonatal Network
September/October 2004
Vol. 23, No. 5

ABSTRACTS

Jarcho-Levin Syndrome: A Case Study
A CEU Offering
Peggy Ables, RN, BSN

Jarcho-Levin syndrome is a rare genetic disorder characterized by multiple vertebral and rib anomalies. There are two types of Jarcho-Levin syndrome, spondylothoracic dysplasia and spondylocostal dysostosis. Spondylothoracic dysplasia has a grimmer prognosis than spondylocostal dysostosis. Many of the infants born with this disorder succumb to respiratory failure. With new advances in medical care, even the more severely affected children have an improved chance of survival. This is a case presentation of one child with spondylothoracic dysplasia and a brief history of the disease process.


NRP 2006: How Revised Guidelines Develop
Jeanette Zaichkin, RNC, MN
Wendy Marie Simon, MA

Revised materials for the Neonatal Resuscitation Program (NRP) will be released in spring 2006. These revisions are the result of a carefully synchronized process carried out by members of the International Liaison Committee on Resuscitation (ILCOR) Neonatal Delegation, which includes the American Academy of Pediatrics Neonatal Resuscitation Program Steering Committee and the American Heart Association. ILCOR provides a consistent international framework for identifying and reviewing research on various aspects of resuscitation, a forum for debating issues and reaching consensus, and a mechanism for publishing findings in medical journals. NRP 2006 materials will be the result of carefully coordinated efforts and international collaboration on resuscitation science.

Comfort Care of Neonates at the End of Life
Marilyn Stringer, PhD, CRNP
Valerie D. Shaw, MSN
Rashmin C. Savani, MBChB

Most neonatal intensive care units have approaches to manage patients at the end of their lives. Published guidelines to help direct practitioners are lacking, and these management approaches, commonly referred to as comfort care, are often based on tradition. Recently, our neonatal staff experienced a unique situation that involved giving comfort care to a previable neonate who lived much longer than anticipated. Our staff identified the need for an evidence-based practice guideline to focus on four key care issues: provision of warmth, close physical contact, nutritional support, and sedation and pain management. The purpose of this article is to supply health care providers with evidence-based comfort care guidelines for neonates at the end of life who either are previable or have had life support withdrawn. The process used for developing the guidelines is included.

Kangaroo Care: Is It for Everyone?
Madalynn Neu, RN, PhD

Purpose: In spite of the benefits reported for kangaroo holding, many mothers of preterm infants requiring intensive care do not choose to hold kangaroo style. The purpose of this study is to describe factors that influence mothers of healthy preterm infants to choose kangaroo holding compared to the standard care method of blanket holding.

Sample: Twenty-four primiparous mothers of healthy infants born at 30-34 weeks gestational age.

Design: In this naturalistic inquiry, mothers were interviewed twice: once while the infant was hospitalized and again after the infant was discharged home.

Results: Mothers' holding practices divided them into three groups: (1) kangaroo holding in hospital and home, (2) blanket holding in hospital and home, and (3) holding practice switched from hospital to home. Three themes emerged from the interview data: (1) emotional state, (2) holding environment, and (3) benefits of close contact with the infant.