Abstract:
:Based on the authors' review of the literature on pediatric postoperative pain assessment with special attention to groups of vulnerable infants, this article (1) reports on type of surgery and its relationship to postoperative pain intensity; (2) reviews the characteristics of existing postoperative pain instruments for neonates, infants, and toddlers; (3) discusses timing, duration, and who should assess postoperative pain; (4) reviews the specific literature on pain assessment in critically ill infants, including the extremely low birth weight and the cognitively and/or neurologically impaired infant, and (5) discusses the role of parents in postoperative pain assessment. Postoperative pain instruments are useful for specific groups of vulnerable infants, but it is important that in addition to the valuable scoring of pain, common sense is used and factors such as developmental stage, temperament and personality, number of previous painful experiences, anxiety, and environmental factors are taken into account.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
van Dijk M,Peters JW,Bouwmeester NJ,Tibboel Ddoi
10.1016/s0095-5108(02)00015-5subject
Has Abstractpub_date
2002-09-01 00:00:00pages
469-91, xissue
3eissn
0095-5108issn
1557-9840pii
S0095-5108(02)00015-5journal_volume
29pub_type
杂志文章,评审abstract::Advances in fetal echocardiography are providing highly accurate diagnoses of congenital heart disease prior to delivery, making it possible to plan the delivery-room management of these newborns. Knowledge of the expected transitional circulation occurring with birth and the pathophysiologic implications of congenita...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2005.09.014
更新日期:2005-12-01 00:00:00
abstract::HFV is a mode of therapy that allows gas exchange with pressure fluctuations much lower than that required for conventional ventilation, and may consequently decrease the incidence of barotrauma and chronic lung disease. At present the National Institute of Health is sponsoring the first large controlled trial to test...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-09-01 00:00:00
abstract::The specific pathologic processes preceding the onset of irreversible cerebral injury seem to be a combination of several complex mechanisms due to the severity and duration of the insult to the biochemical modifications in the brain. An early diagnosis of the newborn at high risk for brain damage is relevant for prev...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2004.03.008
更新日期:2004-03-01 00:00:00
abstract::The currently available interventional cardiac procedures in neonates and infants are at various stages of development. We currently dilate neonates and infants with critical valvular pulmonary and aortic stenosis and postoperative aortic obstruction. We do not routinely dilate native coarctation of the aorta because ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Prevention of harm from medication errors has become a national priority. Medication errors in the neonatal intensive care unit are common, and most can be avoided. This article reviews the prevalence and types of medication errors affecting the care of the neonate and summarizes approaches that have been used to redu...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2007.11.010
更新日期:2008-03-01 00:00:00
abstract::In summary, the in utero diagnosis of nonimmune hydrops is associated with a grave prognosis. Antenatal evaluation will determine the cause in many cases, allowing appropriate decisions to be made regarding the management of the pregnancy. To date, no specific in utero therapy exists for most causes of nonimmune hydro...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-12-01 00:00:00
abstract::Most pharmacokinetic and biologic attributes of digitalis are age dependent. They are determined in great measure by the chemical structure of the specific cardiac glycoside being used. These effects differ in the intact normal circulation and in heart failure because of the altered autonomic nervous system and hormon...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Discussed in this article are the effects of pregnancy-induced hypertension on the renin-angiotensin-aldosterone system; the possible role of prostanoids, deoxycorticosterone, and deoxycorticosterone sulfate in blood pressure control; and the effect of pregnancy-induced hypertension upon the endocrinology of the mater...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1983-10-01 00:00:00
abstract::Although therapies in addition to whole-body cooling are being developed to treat the neonate at risk for hypoxic-ischemic encephalopathy, we have no quickly measured serum inflammatory or neuronal biomarkers to acutely and accurately identify brain injury or to follow the efficacy of therapy. This review covers infla...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2016.04.008
更新日期:2016-09-01 00:00:00
abstract::Diagnostic and invasive procedures in premature infants may require general anesthesia. General anesthetics interfere with the development of the immature animal brain. Accelerated apoptosis, disturbed synaptogenesis, and cytoarchitecture are among the mechanisms suspected to underlie this phenomenon. The implications...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.08.002
更新日期:2019-12-01 00:00:00
abstract::Neurologically impaired infants have immature, damaged, or abnormally developed nervous systems that may cause abnormalities of sucking and swallowing, among other problems. Sucking abnormalities usually present as absence of the sucking response, weakness or incoordination of sucking and swallowing, or some combinati...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-03-01 00:00:00
abstract::The development of the flow-directed pulmonary artery catheter in the early 1970s moved invasive monitoring from the laboratory to the patient's bedside. Its current use in obstetrics is directed toward definition of certain pathophysiologic states unique to pregnancy and toward diagnosis and management of critically ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract::The nutritional support of gastrointestinal growth and function is an important consideration in the clinical care of neonatal infants. In most health infants, the provision of either breast milk or formula seems to support normal intestinal mucosal growth, but the most significant advantages of breast milk may be for...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00065-4
更新日期:2002-03-01 00:00:00
abstract::Infants in the Neonatal Oxygenation Prospective Meta-analysis trials were randomized to SpO2 targets of 85% to 89% or 91% to 95%. Group allocation was masked. Different outcomes are likely partially attributable to differences in achieved SpO2. Infants randomized to the lower range had higher than intended readings. S...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.05.011
更新日期:2019-09-01 00:00:00
abstract::The fetal environment is thus well suited for normal growth and development with oxygen availability exceeding oxidative needs. With impairments in blood gas exchange this excess oxygen acts as a "margin of safety," providing for the maintenance of oxidative metabolism through increases in fractional O2 extraction, al...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::Total parenteral nutrition permits normal growth and development of the infant during the adaptive phase of the short bowel syndrome. Skilled nutritional support combined with a variety of medical and surgical manipulations facilitates survival of infants with as little as 15 to 20 cm of intestinal length. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-03-01 00:00:00
abstract::The percentage of United States cesarean births increased from 20.7% in 1996 to 31.1% in 2006. Cesarean rates increased for women of all ages, race/ethnic groups, and gestational ages and in all states. Both primary and repeat cesareans have increased. Increases in primary cesareans in cases of "no indicated risk" hav...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.03.007
更新日期:2008-06-01 00:00:00
abstract::Congenital lung lesions (CLLs) comprise a heterogeneous group of developmental and histologic entities often diagnosed on screening prenatal ultrasound. Most fetuses with CLL are asymptomatic at birth; however, the risk of malignancy and infection drives the decision to prophylactically resect these lesions. The autho...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2017.08.003
更新日期:2017-12-01 00:00:00
abstract::The incidence of neonatal abstinence syndrome owing to prenatal opioid exposure has grown rapidly in recent decades and it disproportionately affects rural, non-white, and public insurance-dependent populations. Treatment consists of pharmacologic and nonpharmacologic interventions with wide variability in approaches ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.08.012
更新日期:2019-12-01 00:00:00
abstract::Decision-making for extremely immature preterm infants at the margins of viability is ethically, professionally, and emotionally complicated. A standard for prenatal consultation should be developed incorporating assessment of parental decision-making preferences and styles, a communication process involving a recipro...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/j.clp.2011.06.004
更新日期:2011-09-01 00:00:00
abstract::Necrotizing enterocolitis (NEC) is a multifactorial disorder that primarily affects premature infants. Human milk compared with formula reduces the incidence of NEC. Feeding practices do not increase the incidence of NEC in preterm infants. There is no evidence supporting continuous versus intermittent tube feedings i...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2012.12.001
更新日期:2013-03-01 00:00:00
abstract::Cesarean delivery as a result of maternal request is increasingly popular, leading to important ethical questions. One of the challenging issues is balancing respect for the autonomy of a pregnant woman with concerns of beneficence and nonmaleficence for her and the fetus. The perceived benefit of cesarean section is ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.03.011
更新日期:2008-06-01 00:00:00
abstract::For adults and pediatric age patients, high-dose intravenous epinephrine was recommended if standard-dose epinephrine failed to achieve return of spontaneous circulation. More recent trials suggest that high-dose epinephrine is not beneficial and may result in increased harm. There are no randomized clinical studies o...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2005.11.016
更新日期:2006-03-01 00:00:00
abstract::Pulse oximetry, a noninvasive technique of measuring oxygen saturation continuously, is being used increasingly in the intensive care setting. This article provides information regarding physiologic basis and practical aspects of clinical usage of pulse oximetry in the neonate, both in medical and surgical units. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::This chapter describes the utility of event-related potential recordings in the assessment of auditory and visual system integrity in the newborn infant. A battery of electrophysiologic tests is described that permits the evaluation of sequential levels of processing within these sensory system. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::It is now recognized that pregnancy is associated with significant changes in maternal thyroid function that are largely mediated by the placenta. The author summarizes the understanding of these changes during pregnancy and follows with a discussion of fetal thyroid system ontogenesis. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1983-10-01 00:00:00
abstract::Complex biochemical consequences are the result of a series of secondary biochemical changes caused by oxygen depletion. Hypoxia in the fetus and neonate results in decreased GI blood flow, especially to the GI mucosa. Although severe O2 deprivation cannot be entirely compensated for, an increase in tissue O2 extracti...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1986-03-01 00:00:00
abstract::Neonatal stress responses have been investigated only in recent years. Term neonates mount substantial hormonal and metabolic responses, which are distinct from those of adult patients. These responses can be altered significantly by the effects of prematurity, the effects of graded surgical stress, and the anesthetic...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::A regionalized system of perinatal care, which draws on the strengths of individual hospitals and corrects any weaknesses, can enhance the level of performance of the community hospital. Although the care of high risk infants takes priority in this system, concern is expressed that routine perinatal care should also r...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Outcomes of neonatal intensive care unit (NICU) graduates have been categorized by rates of neurodevelopmental impairment at 2 years old. Although useful as metrics for research, these early childhood assessments may underestimate or overestimate later functional capabilities. Often overlooked are less severe but more...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.05.008
更新日期:2018-09-01 00:00:00