Clinical effect of maternal voice stimulation in alleviating procedural pain in hospitalized neonates / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of maternal voice stimulation in alleviating procedural pain in neonates during heel blood collection.@*METHODS@#A total of 72 neonates who were admitted to the neonate intensive care unit were randomly divided into an intervention group (n=35) and a control group (n=37). Heel blood collection was performed by the routine method in the control group. The intervention group listened to their mothers' voice from 1 minute before heel blood collection to the end of the procedure. Pain score, incidence of crying, and vital signs were recorded before and after heel blood collection.@*RESULTS@#Compared with the control group, the heart rate was significantly reduced, the blood oxygen saturation significantly increased, the incidence of crying and the pain score were significantly reduced in the intervention group during the procedure of heel blood collection (P<0.05).@*CONCLUSIONS@#Maternal voice stimulation helps to reduce procedural pain and maintain stable vital signs in neonates.

Effect of placement of peripherally inserted central catheter via the upper versus lower extremity veins: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To investigate the effect of placement of peripherally inserted central catheter (PICC) via the upper versus lower extremity veins in neonates through a Meta analysis.@*METHODS@#CNKI, Wanfang Data, VIP Data, CBMdisc, PubMed, Web of Knowledge, Embase, Medline, Cochrane Library and Google Scholar were searched for control studies on the effect of PICC placement via the upper versus lower extremity veins in neonates. RevMan 5.3 was used to perform a Meta analysis of the studies which met the inclusion criteria.@*RESULTS@#A total of 18 studies were included, among which there were 8 randomized controlled trials and 10 cohort studies, with 4 890 subjects in total. Compared with those undergoing PICC placement via the upper extremity veins, the neonates undergoing PICC placement via the lower extremity veins had significantly lower incidence rates of complications (RR=0.83, 95%CI: 0.75-0.92, P<0.05), catheter-related infections (RR=0.77, 95%CI: 0.60-0.99, P<0.05), catheter malposition (RR=0.28, 95%CI: 0.18-0.42, P<0.05), extravasation of the infusate (RR=0.52, 95%CI: 0.40-0.70, P<0.05), and unplanned extubation (RR=0.82, 95%CI: 0.69-0.98, P<0.05). They also had a significantly higher first-attempt success rate of puncture (RR=1.17, 95%CI: 1.05-1.30, P<0.05) and a significantly shorter PICC indwelling time (MD=-0.93, 95%CI: -1.26-0.60, P<0.05).@*CONCLUSIONS@#The above evidence shows that PICC placement via the lower extremity veins has a better effect than PICC placement via the upper extremity veins in neonates.

Cornelia de Lange syndrome: report of a case and the review of literature on 17 cases / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristics of Cornelia de Lange Syndrome (CdLS) and to review the latest clinical research reports.</p><p><b>METHOD</b>Clinical and laboratory data of one case of neonatal CdLS are reported, and literature on 17 cases of CdLS in China and the international reports of the clinical and molecular biological research on this disease were reviewed.</p><p><b>RESULT</b>(1) The patient was an infant with intrauterine growth retardation and born as a term small for gestational age infant with specific facial features, bone abnormality of extremities, and patent ductus arteriosus (PDA). She also had severe feeding difficulty and slow weight gain. She was followed up till 4 months of age and showed severe developmental retardation. (2) The total number of past reported case of CdLS in China was 17 with a male to female ratio of 6:12. The average age of diagnosis was 17 months. The following specific facial features could be observed: synophrys, long and curved eyelashes, hirsutism, microcephalus, low hairline, broad depressed nasal bridge, long prominent philtrum, and high palate. Most of the patients were complicated with mental retardation, recurrent vomiting or feeding difficulty, abnormal muscle tone, cutis marmorata, hypophalangism, and genitalia anomaly. Clinical manifestations of Chinese patients were similar to those of the overseas reports. The karyotype of 15 cases was investigated and was normal. The etiology of CdLS is unknown. There is no specific treatment. The commonest causes of death are lung diseases caused by gastroesophageal reflex/aspirate related pneumonia.</p><p><b>CONCLUSION</b>Typical clinical manifestations of CdLS are specific facial features (mainly synophrys, long and curved eyelashes, long prominent philtrum), complications of multi-system malformations (mainly growth and developmental retardation, esophagogastric reflex, hypophalangism), related gene mutations occurred in NIPBL, SMC1A, and SMC3 gene.</p>

Umbilical venous catheterization related infection in the neonatal intensive care unit / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the incidence and pathogens of umbilical venous catheterization (UVC) related infection in the neonatal intensive care unit (NICU).</p><p><b>METHODS</b>A total of 112 neonates (birth weight 1,500 g) who received UVC within 24 hrs after birth were included. Blood culture was performed right after UVC. At 24 hrs and 1 week after UVC, umbilical skin scrub cultures were performed. Skin redness and swelling for more than 24 h, or severe abdominal distension, or poor general condition for unknown reason after UVC, or positive blood culture results, were the criteria for catheterization related infection.</p><p><b>RESULTS</b>The incidence rate for UVC related infection was 8.9%. Total culture positive rate was 9.4%. At 24 hrs and 1 week after UVC, the umbilical skin scrub culture positive rate was 7.1% and 16.2%, respectively. Rate of Gram positive and Gram negative pathogens was 55.2% and 44.8%, respectively. Group B Streptococcus was main Gram positive pathogen. Klebsiella and E.coli were the main Gram negative pathogens.</p><p><b>CONCLUSIONS</b>UVC is, to some extent, related to nosocomial infection in the NICU. Among UVC related infection, Gram positive and Gram negative pathogens take almost the chance.</p>