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Thrombosis in Children
Published in Hau C. Kwaan, Meyer M. Samama, Clinical Thrombosis, 2019
Eric F. Grabowski, Margaret W. Hilgartner
Increasing need for venous access brought about the introduction of catheters buried under the skin for 1 to 2 in. before introduction and threading into deep vessels and into the right atrium. This has usually been done in the chest wall with threading into the right atrium, or through the vena cava when the larger double-lumen catheters are needed. The rationale behind this innovation was a desire to decrease introduction of surface contaminants into the bloodstream by the superficial tunneling of the catheters. The original Broviac catheter for adults was modified in size by Broviac for babies and children, and more recently the single lumen has been increased to a double lumen for additional lines that are not connecting.48 Hickman varieties have a thicker wall and larger lumen, and are better suited for adults.49
Habilitation of very preterm infants at a Post Acute Care Inpatient Rehabilitation (PACIR) center after neonatal intensive care unit (NICU) discharge
Published in Developmental Neurorehabilitation, 2019
Meenakshi Singh, Boriana Parvez, Agnes Banquet, Jordan S Kase
NTISS scores range from 0 to 100, derived from 62 items, with an assigned weight of 1–4 points for each. The total score depends upon the complexity of interventions required for each organ system. As the level of therapeutic intensity and complexity increases, so does the scoring. Certain items are mutually exclusive, and only the most heavily weighted items are used in the computation. As an example, if a baby was treated with high-frequency ventilation then extubated to nasal cannula, the NTISS for this item will be 4, for the highest level of respiratory support. To ensure consistency in the scoring for our study population, certain assumptions were made. For example, the following surgeries were classified as minor: patent arteriosus ductus (PDA) ligation, gastrostomy tube (G-tube) without fundoplication, Broviac catheter placement, Omaya reservoir, Penrose drain placement, or hernia repair. However, G-tube with fundoplication, tracheostomy, bowel resection, and ventriculoperitoneal (VP) shunt placement were considered as major surgeries. Cardiopulmonary resuscitation in the delivery room was defined if the Apgar score was ≤5 at 5 min after birth and/or the requirement of chest compressions and/or epinephrine administration.