ADVANCES IN NEONATAL CARE 对其发表的原创研究和临床实践文章采取了独特而动态的方法。解决每天面临的实践挑战——每年在二级和三级新生儿重症监护病房照顾 40,000 多名低出生体重婴儿——该杂志促进循证护理并改善最小患者及其家人的结果。同行评审的社论包括独特而详细的视觉和教学辅助工具，例如家庭教学工具箱、从研究到实践、培养临床专业知识和在线功能。每期都提供印刷和在线格式的继续教育 (CE) 文章。

Advances in Neonatal Care takes a unique and dynamic approach to publishing original research and clinical practice articles. The journal addresses the daily practical challenges faced in neonatal intensive care units, caring for over 40,000 low birth weight infants each year. By promoting evidence-based care, it aims to improve outcomes for these vulnerable patients and their families. Peer-reviewed editorials include unique and detailed visual and educational aids, such as family teaching toolkits, translation from research to practice, development of clinical expertise, and online features. Each issue provides continuing education (CE) articles in both print and online formats.

《Advances in Neonatal Care》采用独特而动态的方法，发表原创研究和临床实践文章。该杂志专注于解决新生儿重症监护病房中每天面临的实践挑战，每年照顾超过40,000名低出生体重婴儿。通过促进循证护理，该杂志致力于改善这些脆弱患者及其家庭的结果。同行评审的社论中包含独特而详细的视觉和教学辅助工具，例如家庭教学工具箱、从研究到实践的转化、临床专业知识的培养以及在线功能。每期杂志还提供印刷和在线格式的继续教育（CE）文章。

Advances in Neonatal Care

Moniaci, Valerie K. APRN, NNP-BC; Bellflower, Bobby DNSc, NNP-BC, FAANP Author Information

Valerie K. Moniaci

Bobby Bellflower

NANN's Thermoregulation in the Care of Infants Guideline for Practice Executive Summary

NANN 婴儿护理中的体温调节指南执行摘要

Hemophagocytic lymphohistiocytosis (HLH) is a rare disease resulting from an abnormal proliferation of histiocytes within the body's tissues leading to an ineffective immune response. Typically, HLH is characterized by fever, hepatosplenomegaly, cytopenia, hypertriglyceridemia, hypofibrinogenemia, and hemophagocytosis. However, the premature infant with HLH may present differently making diagnosis of the disease cumbersome. If an infant is born with ascites, cytopenias, hypofibrinogenemia, and hepatosplenomegaly, a diagnosis of HLH cannot be ruled out. In addition, premature infants oftentimes will not present with fever because they are kept normothermic from ambient sources. Reports of premature infants with HLH in the literature are rare. This is a case presentation of a 27-week-gestation female with a family history of HLH.

Amanda G. Woods

Christopher W. Woods

Hemophagocytic Lymphohistiocytosis in the Premature Neonate

早产儿中的噬血细胞性淋巴组织细胞增多症

Familial hemophagocytic lymphohistiocytosis is a rare and inherited disease that affects both males and females equally and is most often fatal if not treated. Diagnosis is challenging because it mimics severe sepsis by demonstrating hepatomegaly, splenomegaly, persistent fever, central nervous system involvement, and cytopenias. The etiologies of hemophagocytic lymphohistiocytosis have been well established through the identification of 3 causative genetic mutations. Therapies for hemophagocytic lymphohistiocytosis focus on restoring health by diminishing the disease sequelae with a goal of hematopoietic stem cell transplant, the only known curative therapy for hemophagocytic lymphohistiocytosis. Current research is being conducted to identify other causative genetic mutations and newer, more effective treatment modalities.

Brian F. Whaley

Familial Hemophagocytic Lymphohistiocytosis in the Neonate

新生儿家族性噬血细胞性淋巴组织细胞增生症

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare disease that can be triggered by cytomegalovirus, a relatively common infectious exposure to neonates. The clinical presentation is common to many acute illnesses seen in extreme premature infants; however, there are key clinical and laboratory findings that can lead to the diagnosis. Purpose: We present a case of an extreme premature infant of 25 weeks' gestation who developed cytomegalovirus-induced HLH. Using the current published protocols that are used in pediatric cancer can be adapted for use in a premature infant, which led to remission of HLH and eventual discharge from the neonatal intensive care unit. Implications for Practice: There are published treatment protocols used in pediatric oncology that when initiated early can lead to favorable outcomes and remission in even the most fragile neonates. Implications for Research: Additional studies are needed on the pharmacokinetics, dosing, and side effects on medications used for treatment of HLH in preterm infants. Additional research is needed to improve the clinician's ability to reach the diagnosis as well as define treatment strategies that provide optimal outcomes.

Matthew Halliday

Julie Ross

W. Michael Southgate

Cytomegalovirus-Induced Hemophagocytic Lymphohistiocytosis in an Extreme Preterm Infant

极早产儿中由巨细胞病毒诱发的噬血细胞性淋巴组织细胞增生症

Background: The challenging transition to parenthood affects both mothers and fathers; yet, the strain intensifies with a premature birth in the neonatal intensive care unit (NICU), underscoring the importance of acknowledging and addressing potential differences in parental roles. Purpose: This paper aimed to investigate how parental role conflicts among mothers and fathers of preterm-born infants hospitalized in German NICUs manifest and investigated potential parental resources. Methods: Twenty-four participants, 17 mothers, and seven fathers of very low birth-weight infants were interviewed. A thematic content analysis was performed at a semantic level. Results: Fathers feel pressured to fulfill the role expectations, often leading to the suppression of paternal feelings and needs. For mothers, deviating from societal expectations regarding their expressive roles can be distressing, as they worry that such deviation might hinder their infants from having a successful start in life. Consulting with healthcare professionals shows to ease challenges for both parental roles. Implications for Practice and Research: Maternal and paternal challenges are often rooted in expectations placed on their societal roles. Highlighting these challenges can be essential for increasing awareness and effectively addressing them. Tailored nursing practices may have the potential to facilitate individuals’ navigation of uncertainties and fulfillment of caregiving roles.

Alinda Reimer

Jan Hoffmann

Laura Mause

Carolin Heinen

Till Dresbach

Nadine Scholten

“I Was Broken and Still Had to Stay Strong. I Cannot Be Weak”

“我曾破碎却仍需坚强。我不能软弱”

Background: Preterm infants face challenges to feed orally, which may lead to failure to thrive. Oral feeding skill development requires intact neurobehaviors. Early life stress results in DNA methylation of NR3C1 and HSD11B2 , which may disrupt neurobehaviors. Yet, the extent to which early life stress impairs oral feeding skill development and the biomechanism whereby this occurs remains unknown. Our team is conducting an NIH funded study (K23NR019847, 2022-2024) to address this knowledge gap. Purpose: To describe an ongoing study protocol to determine the extent to which early life stress, reflected by DNA methylation of NR3C1 and HSD11B2 promoter regions, compromises oral feeding skill development. Methods: This protocol employs a longitudinal prospective cohort study. Preterm infants born between 26 and 34 weeks gestational age have been enrolled. We evaluate early life stress, DNA methylation, cortisol reactivity, neurobehaviors, and oral feeding skill development during neonatal intensive care unit hospitalization and at 2-week post-discharge. Results: To date, we have enrolled 70 infants. We have completed the data collection. Currently, we are in the data analysis phase of the study, and expect to disseminate the findings in 2025. Implications for Practice and Research: The findings from this study will serve as a foundation for future clinical and scientific inquiries that support oral feeding and nutrition, reduce post-discharge feeding difficulties and lifelong risk of maladaptive feeding behaviors and poor health outcomes. Findings from this study will also provide further support for the implementation of interventions to minimize stress in the vulnerable preterm infant population.

Thao Griffith

Rosemary White-Traut

Dina Tell

Stefan J. Green

Linda Janusek

Epigenetics Embedding of Oral Feeding Skill Development in Preterm Infants

早产儿口腔喂养技能发展的表观遗传嵌入

Background: The COVID-19 pandemic affected the maternal-infant dyad, especially due to visitation restrictions in neonatal units. These changes may impact the psychological, physical, and developmental health of mothers and newborns. Purpose: This systematic review evaluates the impact of enforced separation and restrictive visitation policies in neonatal units during the pandemic, focusing on the maternal-infant dyad. Data Sources: Data sources include CINAHL, MEDLINE, Web of Science, APA PsycINFO, Academic Search Ultimate, and Embase, covering studies published between 2020 and 2024. Study Selection: A detailed search was conducted using terms related to COVID-19, maternal and neonatal health, and visitation restrictions in neonatal units. Articles were included if they were peer-reviewed, written in English, and focused on the impact of visitation restrictions on maternal and neonatal health. Data Extraction: The data extraction process began with 789 references. After removing duplicates, we screened titles and abstracts. We then conducted a full-text assessment of the remaining studies, selecting 14 that met the inclusion criteria. Results: The analysis showed significant emotional, psychological, and developmental impacts on mothers and newborns due to pandemic-induced separation and inconsistent policies. It highlighted depressive symptoms, stress, bonding disruptions, and the effectiveness of virtual bonding. Implications for Practice and Research: The review emphasizes the need for family-centered care, coping strategies, and virtual bonding in neonatal units. It calls for culturally sensitive policies to support mothers and infants during crises. The review also highlights the importance of studying the long-term effects of pandemic-induced separations and improving support for future health emergencies.

Victoria J. Kain

Sasitorn Phumdoung

Siriporn Vetcho

Piyada Chaisri

The Impact of Pandemic-Induced Separation and Visitation Restrictions on the Maternal-Infant Dyad in Neonatal Units

大流行引发的分离和探视限制对新生儿病房母婴关系的影响

Background: Point-of-care ultrasound (POCUS) in the neonatal intensive care unit (NICU) is becoming increasingly utilized, with the focus of training aimed at physicians. However, the role of neonatal nurse practitioners (NNPs) in the development of POCUS programs is not well described. Purpose: To describe the NNP role in the implementation of a NICU POCUS program and exemplify the potential to expand the professional scope and educational advancement of NNPs. Methods: In 2018, a multidisciplinary team assembled to develop a POCUS program in the NICU at Lucile Packard Children’s Hospital (LPCH). Three NNPs received formal POCUS training in order to provide onsite training, perform and supervise POCUS imaging, and participate in quality assurance sessions. NNPs also assisted with the development of a REDCap database and imaging protocols. Results: The LPCH POCUS NNP providers contributed to the advancement of the profession by practicing to the full scope of their role, providing leadership in program development, research, and education. Incorporating NNPs into the programmatic structure of a POCUS program can be a model for others. With advancing skill set, NNPs can be positioned to be national leaders and educators. Implications for practice and research: NICUs developing POCUS programs can benefit from the integration of NNPs to serve as consistent content experts to expand the number of trained providers while assuring the quality of image capture. POCUS is becoming increasingly essential to the care of newborns. NNPs can play a central role in performing POCUS, participating in quality improvement and research, and educating other NICU providers.

Jacklin H. Tong

Christine Manipon

Shelby Vallandingham-Lee

Reedhi Dasani

Alexis S. Davis

Shazia Bhombal

The Role of Neonatal Nurse Practitioners in the Implementation of a Bedside Point-of-Care Ultrasound Program

新生儿执业护士在床旁即时超声项目实施中的作用

Background: Rates of severe retinopathy of prematurity (ROP) continue to rise globally despite advances in healthcare. Differences in practices related to optimizing oxygenation is among key factors that increase the risk of severe ROP. A recent increase in severe ROP rates at 2 local neonatal intensive care units (NICUs) prompted further investigation into potential preventative practices. Purpose: The project team’s goal was to reduce rates of severe ROP by 20% in the 2 participating units. Methods: A level IV and level III NICU were targeted, including 255 infants at risk for ROP. Interventions included staff education, implementation of new established oxygen guidelines, as well as use of order sets, and alarm limits. Compliance rates and severe ROP rates before and after new guideline implementation were assessed. Results: After implementing the new guidelines, average alarm limit compliance met project goals of 90% at both sites. Severe ROP rates declined from 10% to 7% in the level IV NICU site and from 6% to 0% in the level III NICU site during the 24-month study period from 2022 to 2023. Implications for practice and research: Education and increased understanding regarding risk factors for ROP patients are crucial to successfully implementing and sustaining standardized oxygenation guidelines. Including the entire healthcare team and patient families is key to successful QI initiatives and improving patient outcomes. Further research is needed for optimal standardized oxygen alarm limits for this patient population. Video Abstract: One of the leading causes of childhood blindness is retinopathy of prematurity (ROP). 1 ROP is a disease of the retina that affects premature infants, with the highest risk to very low birthweight (VLBW) infants born with a gestational age of less than 30 to 32 weeks or infants weighing less than 1500 grams. 2 There are 5 stages of ROP. Stages 1 and 2 are considered mild and resolve on their own. Stage 3 is considered moderate-severe and sometimes resolves independently, with many cases requiring treatment. Stages 4 and 5 ROP are deemed severe and require treatment.

短名	Adv. Neonatal. Care.
Journal Impact	1.65
国际分区	NURSING(Q2)
期刊索引	SCI Q3中科院 4 区

ISSN	1536-0903, 1536-0911
h-index	52
国内分区	医学(4区)医学护理(3区)

涉及主题	医学生物政治学法学儿科心理学化学精神科生物化学重症监护医学护理部内科学梅德林新生儿重症监护室遗传学病理外科
出版信息	出版商: Lippincott Williams and Wilkins Ltd.，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2002，原创研究文献占比: 85.39%，自引率:12.50%， Gold OA占比: 5.47%

Advances in Neonatal Care

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NANN's Thermoregulation in the Care of Infants Guideline for Practice Executive Summary

Hemophagocytic Lymphohistiocytosis in the Premature Neonate

Familial Hemophagocytic Lymphohistiocytosis in the Neonate

Cytomegalovirus-Induced Hemophagocytic Lymphohistiocytosis in an Extreme Preterm Infant

“I Was Broken and Still Had to Stay Strong. I Cannot Be Weak”

“I Was Broken and Still Had to Stay Strong. I Cannot Be Weak”

Epigenetics Embedding of Oral Feeding Skill Development in Preterm Infants

The Impact of Pandemic-Induced Separation and Visitation Restrictions on the Maternal-Infant Dyad in Neonatal Units

The Role of Neonatal Nurse Practitioners in the Implementation of a Bedside Point-of-Care Ultrasound Program

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