Guidelines for preventing catheter infection: assessment of knowledge and practice among paediatric and neonatal intensive care healthcare workers.

We analysed knowledge of and adherence to guidelines for the prevention of catheter-related infection (CRI) among Spanish healthcare workers (HCWs) from paediatric and neonatal intensive care units by distributing 357 questionnaires to 31 Spanish hospitals. The overall mean scores for individual knowledge and daily practice were 5.61 and 5.78, respectively. Our results reveal room for improvement in Spanish HCWs' knowledge of prevention of CRI. Continuing education programmes and implementation of care bundles must be introduced to improve prevention and management of CRI.

[SEN1500: design and implementation of a registry of infants weighing less than 1,500 g at birth in Spain]. / SEN1500: diseño y desarrollo del registro de niños de menos de 1.500 g al nacer en España.

OBJECTIVE: To design and implement a registry of infants weighing less than 1,500 g at birth in Spain. MATERIAL AND METHODS: Prospective, cohort, multicenter study. All live born infants weighing less than 1,500 g in several voluntarily participating neonatal units in public and private hospitals were included. RESULTS: In the first 4 years of the registry (2002 to 2005), 9,638 very-low-birth-weight infants were born in the 65 neonatal units that have so far joined the program. CONCLUSIONS: The goal of very-low-birth-weight infant databases is to try to improve the quality and safety of the medical care given to these newborns and their families. This type of program helps to coordinate and promote several areas, including those of health education, training of medical staff, research and development, surveillance and quality improvement.

SEN1500: diseño y desarrollo del registro de niños de menos de 1.500 g al nacer en España / SEN1500: Design and implementation of a registry of infants weighing less than 1.500 g at birth in Spain

Objetivo: Diseño y desarrollo de un registro de niños de menos de 1.500 g al nacer en España. Material y métodos: Estudio de cohortes prospectivo multicéntrico. Se incluyen todos los recién nacidos vivos de peso inferior a 1.500 g al nacer en las unidades neonatales (UN) que voluntariamente se integren en el proyecto. Resultados: En los primeros 4 años de funcionamiento del registro han participado en el estudio 65 UN diferentes. El total de niños seleccionados entre 2002 y 2005 es de 9.637. Conclusiones: La misión de las bases de datos de los niños de muy bajo peso al nacer es intentar mejorar la calidad y la seguridad de los cuidados médicos que se proporcionan a los recién nacidos y a su familia. Su desarrollo posibilita la coordinación de programas de educación sanitaria y formación de profesionales médicos y de enfermería, de líneas de investigación y de proyectos de mejora (AU)

Objective: To design and implement a registry of infants weighing less than 1,500 g at birth in Spain. Material and methods: Prospective, cohort, multicenter study. All live born infants weighing less than 1,500 g in several voluntarily participating neonatal units in public and private hospitals were included. Results: In the first 4 years of the registry (2002 to 2005), 9,638 very-low-birth-weight infants were born in the 65 neonatal units that have so far joined the program. Conclusions: The goal of very-low-birth-weight infant databases is to try to improve the quality and safety of the medical care given to these newborns and their families. This type of program helps to coordinate and promote several areas, including those of health education, training of medical staff, research and development, surveillance and quality improvement (AU)

[Obstetric trauma. A current problem?]. / Traumatismos obstétricos. Un problema actual?

Advances in obstetric practice have decreased birth traumas in the last years, although they are still an important chapter in neonatal age. Between 1993-1998 a total of 21,375 stillborns were registered with a total of 309 birth injuries in 303 neonates (1.44%). The diagnoses were: 2 liver subcapsular hematomas, 105 cephalohematomas, 16 parietal fractures, 11 subdural hemorrhages, 107 clavicular fractures, 10 miscellaneous fractures, 8 soft tissue injuries, 25 facial nerve injuries and 25 braquial palsy. About relation between type of labor and birth trauma was found that clavicular fracture and cephalic vaginal delivery were associated in 50% of the cases, cephalohematoma and forceps in 51%, braquial palsy and vaginal delivery in 44% and forceps in 36%. High weight at birth was another risk factor for entities such as clavicular fracture and braquial palsy. We conclude that birth trauma is a pathology with a relevant incidence and their epidemiology factor had to be known.

[Extracorporeal membrane oxygenation, ECMO. Experience with the first 22 cases]. / Oxigenación por membrana extracorpórea, ECMO. Experiencia de los primeros 22 casos.

OBJECTIVE: Extracorporal membrane oxygenation (ECMO) is an alternative to cases of respiratory or cardiopulmonary insufficiency when conventional therapy has failed. We present the first 22 patients treated with ECMO at the neonatology unit of the "Gregorio Marañon" Hospital. PATIENTS AND METHODS: From October 1997 until September 1999, 22 patients were treated with ECMO. In 8 of them ECMO was necessary because of respiratory insufficiency without response to conventional treatment (r-ECMO) and a veno-venous tidal flow system was used. In 14 patients, cardiac ECMO was necessary in the veno-arterial modality because of ventricular failure after extracorporal circulatory assistance during cardiovascular surgery. RESULTS: The 8 patients of the respiratory ECMO group had a mean previous oxygenation index of 89 +/- 36.6 (50-150). The mean duration of ECMO was 7.8 +/- 6.5 (1-16) days and the age at the beginning of ECMO ranged between 1 and 151 days. The most frequent indications in this group were congenital diaphragmatic hernia in three cases, meconium aspiration syndrome in 2 cases and 1 case each of septic shock, idiopathic pulmonary hypertension and air leak. The cannula was removed in 5/8 patients due to recovery and 5/8 survived. The 14 patients of the cardiac ECMO group needed veno-arterial ECMO because of severe ventricular failure. Eight out of fourteen were decannulated after improvement. In 5/14 there was multiorgan failure or bad neurological prognosis resulting in death while on ECMO. In 1 out of 14 patients removal of the cannula was impossible because of cardiac insufficiency. The mean age at the beginning of ECMO was 54 (3-178) days. The mean weight at ECMO was 3209 +/- 739 (2700-5000) gr and the mean duration of ECMO was 6 (1-15) days. CONCLUSIONS: ECMO is an effective treatment in rescuing critical patients when conventional treatment fails. Meconium aspiration syndrome is the pathology with the best prognosis on ECMO. Cardiac ECMO represents a complex group of patients in which ECMO is the only treatment and which may result in recovery in 40% of the patients.

[Interorbital distance in the skull of the newborn infant]. / La distancia interorbital en el cráneo del recién nacido.

Authors have measured interorbital radiological distance in 45 newborns (26 males and 19 females), with a gestational age of 37.644 +/- 3.682 weeks (mean +/- SD), with a range of 25 to 42 weeks. The values obtained were 15.538 +/- 2.437 millimeters (mean +/- SD) for males and 15.894 +/- 1.943 mm (mean +/- SD) for females. The interorbital distance has a positive correlation with gestational age, weight, bizygomatic distance and minimal frontal width. Interorbital distance is closely correlated to the minimal frontal width in males.