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Antiseptic use in the neonatal intensive care unit-a dilemma in clinical practice: An evidence based review

World Journal of Clinical Pediatrics 2016年第2期5卷 159-171页

作者： Sundar Sathiyamurthy jayanta banerjee Sunit V Godambe Children’s Directorate Department of Neonatal Medicine Imperial College Healthcare NHS Trust

Infants in the neonatal intensive care unit are highly susceptible to healthcare associated infections(HAI), with a substantial impact on mortality, morbidity and healthcare costs. Effective skin disinfection with topical antiseptic agents is an important intervention in the prevention or reduction of HAI. A wide array of antiseptic preparations in varying concentrations and combinations has been used in neonatal units worldwide. In this article we have reviewed the current evidence of a preferred antiseptic of choice over other agents for topical skin disinfection in neonates. Chlorhexidine(CHG) appears to be a promising antiseptic agent; however there exists a significant concern regarding the safety of all agents used including CHG especially in preterm and very low birth weight infants. There is substantial evidence to support the use of CHG for umbilical cord cleansing and some evidence to support the use of topical emollients in reducing the mortality in infants born in developing countries. Well-designed large multicentre randomized clinical trials are urgently needed to guide us on the most appropriate and safe antiseptic to use in neonates undergoing intensive care, especially preterm infants.

关键词： Antiseptics Disinfectants Topical Neonate Preterm Very low birth weight infant Chlorhexidine Povidone-iodine Alcohol

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Resuscitation of extremely preterm infants- controversies and current evidence

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World Journal of Clinical Pediatrics 2016年第2期5卷 151-158页

作者： Pooja N Patel jayanta banerjee Sunit V Godambe Department of Neonatology Imperial College Healthcare NHS Trust

Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitation and stabilisation of extremely preterm infants but there is a lack of evidence in the periviable(gestational age 23-25 wk) preterm subgroup. Presence of an experienced team during the delivery of extremely preterm infant to improve outcome is reviewed. Adaptation from foetal to neonatal cardiorespiratory haemodynamics is dependent on establishing an optimal functional residual capacity in the extremely preterm infants, thus enabling adequate gas exchange. There is sufficient evidence for a gentle approach to stabilisation of these fragile infants in the delivery room. Evidence for antenatal steroids especially in the periviable infants, delayed cord clamping, strategies to establish optimal functional residual capacity, importance of temperature control and oxygenation in delivery room in extremely premature infants is reviewed in this article.

关键词： Extremely preterm infants Resuscitation Antenatal steroids Delayed cord clamping Ventilator support Oxygenation in delivery room Temperature stability

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10-Minute Consultation ＂My baby keeps bringing up his feeds!＂

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英国医学杂志中文版 2010年第4期13卷 254-254页

作者： jayanta banerjee Mita M Roy Sheetal Bhojani Naina Emcy

A 6 week old baby boy,first child of young white parents,presents with recurrent episodes of vomiting from age 3 *** was born at term after an uneventful pregnancy.

关键词：孕妇保健知识个人卫生呕吐

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