Widely used in ATM, Kiosk and other self-service machines etc. Its exact etiology is not fully elucidated and felt to be multifactorial. Facility Design and Construction. Your Guide to 16, Gaming Industry Suppliers. There were total patients identified for retrospective analysis:
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When there was a lack of adequate information, the research team either determined an infant that met criteria for moderate-to-severe HIE based on other findings in the medical record such as multiple abnormal lab values or even death or decided to exclude the infant from the study if insufficient evidence was wbfh.
Previous studies demonstrate conflicting results.
The authors of the study plan to complete a larger multicenter randomized controlled trial evaluating the use of therapeutic hypothermia to decrease the amount of GI ischemic injury and surgical intervention required for NEC. We estimate that fewer infants with HIE were referred to our tertiary care institution prior to use of WBTH due to the lack of therapeutic options, further limiting the number of patients available for analysis. Future implications for study may include use of therapeutic hypothermia for other causes of gastrointestinal ischemia-reperfusion injury such as NEC.
We then performed the log-rank test to compare survival curves between the two groups. Decreased perfusion to the GI tract [ 5 ] and decreased motility leading to feeding intolerance [ 6 ] may follow perinatal asphyxia.
It should be noted that a requirement for GT placement or gavage feeds at discharge or the number of days to reach full oral feeds could all be reflections of oral skills. There is no current standardized practice for initiating feeds in late-preterm and term infants with HIE at our institution. These outcomes were chosen as objective measures of GI morbidity and feeding tolerance that could be easily determined from the electronic medical documentation.
Patients who did not reach full oral feeds due to death, GT placement, or discharge with gavage feeds were also treated as censored data. Our results show that the majority of subjects had elevated liver enzymes and elevated coagulation parameters, expected sequelae of HIE [ 1516 ]. There were some indications of hepatic dysfunction and feeding disturbances seen in subjects involved in a few of the major studies for therapeutic hypothermia, but none of those studies focused specifically on the effects to the GI system as a primary outcome.
The feeding protocols are primarily used for the initiation and advancement of feeds in preterm infants. However, we expected to see a difference in practice for initiation of feeds over the twelve-year timeframe of our study, believing that many providers would feel more comfortable starting feeds sooner in the group of infants treated with WBTH.
Secondary outcomes included never started enteral feeds, never reached full enteral feeds, never reached full oral feeds, death, GT, combined death and GT, discharge with gavage feeds, combined death and discharge with gavage feeds, NEC, use of extracorporeal membrane oxygenation ECMOelevated liver enzymes, wbt coagulation parameters, and days to hospital wbht or death.
Casino City Press A leading publisher and distributor of casino and gaming business data and market research reports. Advertising, Marketing and Sales. NEC is a unique form of gastrointestinal ischemia that occurs most often in preterm infants.
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There were total patients identified for retrospective analysis: Interestingly, there was no difference in the DOL feeds initiated between groups in either analysis. This was the reason for dividing the groups into strict and general criteria based on the level of documentation available. Applied in Kiosk, car-parking system, subway and highway applications. If patients had indirect evidence of moderate-to-severe HIE wvth lab values, abnormal neuroimaging, death, etc.
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However, advancement of enteral feeds is a wbtb specific measure of GI motility and the decreased number of days to reach full enteral feeds alone suggests a nonneural benefit to WBTH. InHall et al. Compact size and high performance.
Primary and secondary outcome variables for general criteria group. However, the lower mortality combined with more significant results seen in the groups of infants with clear evidence of moderate-to-severe HIE by a more strict definition wwbth the strict use of cooling criteria used by our institution.
Patients with adequate documentation were included in the study as dbth controls and defined as the non-WBTH strict criteria group. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
There was no statistical significance between groups for primary outcomes, mortality, or GI morbidity measures. Survival analyses demonstrated that the WBTH group reached full enteral feeds median time: A historical cohort study was performed because therapeutic hypothermia has been accepted as the standard of care for infants with moderate-to-severe HIE; a prospective analysis or randomized controlled trial is not an ethical option to evaluate the effects of WBTH on GI morbidity and feeding wtbh a perinatal hypoxic event.
This retrospective study covered a wide time frame during which many changes occurred in medical practice, including the standard use of WBTH for moderate-to-severe HIE and the use of standardized feeding protocols. All analyses were performed using SAS 9.
Its exact etiology is not fully elucidated and felt to be multifactorial.