1 40 5 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource February 2022 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month February 2022 List URL Address <a href="http://doi.org/10.1016/j.semperi.2021.151549" target="_blank" rel="noreferrer noopener">http://doi.org/​10.1016/j.semperi.2021.151549</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Whom are we seeking to protect? Extremely preterm babies and moral distress Publisher An entity responsible for making the resource available Seminars in Perinatology Date A point or period of time associated with an event in the lifecycle of the resource 2021 Subject The topic of the resource End-of-life care; Decision-making; Neonatal intensive care; Moral distress; Ethical confrontation; Prematurity Creator An entity primarily responsible for making the resource Prentice TM; Gillam L; Davis PG; Janvier A Description An account of the resource Advances in perinatal care bring with them ethical challenges and difficult questions. When should we provide life-sustaining interventions, and who should decide? Particularly at the edges of viability, some clinicians may feel required to provide a level of care that they believe is not in the patient's interests, resulting in moral distress. This article will discuss the complex nature of moral distress arising during the care of extremely preterm babies. It will describe the challenges and cognitive biases present when contemplating potential harms to the baby and recognize the possible costs to both healthcare provider and baby when moral distress arises. Both clinicians caring for extremely preterm babies and the families themselves can experience moral distress. This article argues that for clinicians, recognizing the range of possible sources of moral distress is vital in order to appropriately address moral distress. Moral distress may arise from a desire to protect the baby, but also from an impulse to protect oneself from the emotional burdens of care. Addressing moral distress requires reflection on the factual beliefs, experiences and personal values which lie behind the distress, both within one self in and in discussion with colleagues. Moral distress indicates that a situation is ethically challenging, but it does not necessarily mean that a wrong decision has been made. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1016/j.semperi.2021.151549" target="_blank" rel="noreferrer noopener">10.1016/j.semperi.2021.151549</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). 2021 Davis PG Decision-making End-of-life Care ethical confrontation February 2022 List Gillam L Janvier A Moral Distress neonatal intensive care Prematurity Prentice TM Seminars in Perinatology Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource January 2021 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month January 2021 List URL Address <a href="http://doi.org/10.1002/14651858.CD002271.pub3" target="_blank" rel="noreferrer noopener">http://doi.org/​10.1002/14651858.CD002271.pub3</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants Publisher An entity responsible for making the resource available Cochrane Database of Systematic Reviews Date A point or period of time associated with an event in the lifecycle of the resource 2020 Subject The topic of the resource Humans; Infant Newborn; Treatment Failure; Infant Premature; Randomized Controlled Trials as Topic; Selection Bias; Infant Low Birth Weight; Pneumothorax/etiology; Outcome Assessment Health Care; Bronchopulmonary Dysplasia/etiology; Continuous Positive Airway Pressure/adverse effects/methods; Intermittent Positive-Pressure Ventilation/adverse effects; Pulmonary Surfactants/therapeutic use; Respiratory Insufficiency/prevention & control; Respiratory Distress Syndrome Newborn/mortality/therapy Creator An entity primarily responsible for making the resource Ho JJ; Subramaniam P; Davis PG Description An account of the resource BACKGROUND: Respiratory distress, particularly respiratory distress syndrome (RDS), is the single most important cause of morbidity and mortality in preterm infants. In infants with progressive respiratory insufficiency, intermittent positive pressure ventilation (IPPV) with surfactant has been the usual treatment, but it is invasive, potentially resulting in airway and lung injury. Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of respiratory distress, as well as for the prevention of apnoea, and in weaning from IPPV. Its use in the treatment of RDS might reduce the need for IPPV and its sequelae. OBJECTIVES: To determine the effect of continuous distending pressure in the form of CPAP on the need for IPPV and associated morbidity in spontaneously breathing preterm infants with respiratory distress. SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search CENTRAL (2020, Issue 6); Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions; and CINAHL on 30 June 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: All randomised or quasi-randomised trials of preterm infants with respiratory distress were eligible. Interventions were CPAP by mask, nasal prong, nasopharyngeal tube or endotracheal tube, compared with spontaneous breathing with supplemental oxygen as necessary. DATA COLLECTION AND ANALYSIS: We used standard methods of Cochrane and its Neonatal Review Group, including independent assessment of risk of bias and extraction of data by two review authors. We used the GRADE approach to assess the certainty of evidence. Subgroup analyses were planned on the basis of birth weight (greater than or less than 1000 g or 1500 g), gestational age (groups divided at about 28 weeks and 32 weeks), timing of application (early versus late in the course of respiratory distress), pressure applied (high versus low) and trial setting (tertiary compared with non-tertiary hospitals; high income compared with low income) MAIN RESULTS: We included five studies involving 322 infants; two studies used face mask CPAP, two studies used nasal CPAP and one study used endotracheal CPAP and continuing negative pressure for a small number of less ill babies. For this update, we included one new trial. CPAP was associated with lower risk of treatment failure (death or use of assisted ventilation) (typical risk ratio (RR) 0.64, 95% confidence interval (CI) 0.50 to 0.82; typical risk difference (RD) -0.19, 95% CI -0.28 to -0.09; number needed to treat for an additional beneficial outcome (NNTB) 6, 95% CI 4 to 11; I(2) = 50%; 5 studies, 322 infants; very low-certainty evidence), lower use of ventilatory assistance (typical RR 0.72, 95% CI 0.54 to 0.96; typical RD -0.13, 95% CI -0.25 to -0.02; NNTB 8, 95% CI 4 to 50; I(2) = 55%; very low-certainty evidence) and lower overall mortality (typical RR 0.53, 95% CI 0.34 to 0.83; typical RD -0.11, 95% CI -0.18 to -0.04; NNTB 9, 95% CI 2 to 13; I(2) = 0%; 5 studies, 322 infants; moderate-certainty evidence). CPAP was associated with increased risk of pneumothorax (typical RR 2.48, 95% CI 1.16 to 5.30; typical RD 0.09, 95% CI 0.02 to 0.16; number needed to treat for an additional harmful outcome (NNTH) 11, 95% CI 7 to 50; I(2) = 0%; 4 studies, 274 infants; low-certainty evidence). There was no evidence of a difference in bronchopulmonary dysplasia, defined as oxygen dependency at 28 days (RR 1.04, 95% CI 0.35 to 3.13; I(2) = 0%; 2 studies, 209 infants; very low-certainty evidence). The trials did not report use of surfactant, intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis and neurodevelopment outcomes in childhood. AUTHORS' CONCLUSIONS: In preterm infants with respiratory distress, the application of CPAP is associated with reduced respiratory failure, use of mechanical ventilation and mortality and an increased rate of pneumothorax compared to spontaneous breathing with supplemental oxygen as necessary. Three out of five of these trials were conducted in the 1970s. Therefore, the applicability of these results to current practice is unclear. Further studies in resource-poor settings should be considered and research to determine the most appropriate pressure level needs to be considered. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1002/14651858.CD002271.pub3" target="_blank" rel="noreferrer noopener">10.1002/14651858.CD002271.pub3</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). 2020 Bronchopulmonary Dysplasia/etiology Cochrane Database of Systematic Reviews Continuous Positive Airway Pressure/adverse effects/methods Davis PG Ho JJ Humans Infant Low Birth Weight Infant Newborn Infant Premature Intermittent Positive-Pressure Ventilation/adverse effects January 2021 List Outcome Assessment Health Care Pneumothorax/etiology Pulmonary Surfactants/therapeutic use Randomized Controlled Trials as Topic Respiratory Distress Syndrome Newborn/mortality/therapy Respiratory Insufficiency/prevention & control Selection Bias Subramaniam P Treatment Failure Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource September 2018 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month October 2018 List URL Address <a href="http://doi.org/10.1136/archdischild-2017-313539" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/archdischild-2017-313539</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Always a burden? Healthcare providers' perspectives on moral distress Publisher An entity responsible for making the resource available Archives of Disease in Childhood Fetal & Neonatal Edition Date A point or period of time associated with an event in the lifecycle of the resource 2018 Subject The topic of the resource Humans; Intensive Care Units; Stress; Attitude of Health Personnel; Female; Male; Adult; Qualitative Research; Intensive Care; Terminal Care/es [Ethics]; Terminal Care/px [Psychology]; Morals; Job Satisfaction; Psychological; Neonatal; Burnout; Terminal Care; Health Personnel/px [Psychology]; Professional/px [Psychology]; Neonatal/sn [Statistics & Numerical Data]; Neonatal/es [Ethics]; Burnout; Intensive Care; Stress; Neonatal/px [Psychology]; Professional; Professional/et [Etiology]; Professional/pc [Prevention & Control]; Psychological/et [Etiology]; Psychological/pc [Prevention & Control] Creator An entity primarily responsible for making the resource Prentice TM; Gillam L; Davis PG; Janvier A Description An account of the resource BACKGROUND: Current conceptualisations of moral distress largely portray a negative phenomenon that leads to burnout, reduced job satisfaction and poor patient care. OBJECTIVE: To explore clinical experiences, perspectives and perceptions of moral distress in neonatology. DESIGN: An anonymous questionnaire was distributed to medical and nursing providers within two tertiary level neonatal intensive care units (NICUs)-one surgical and one perinatal-seeking their understanding of the term and their experience of it. Open-ended questions were analysed using qualitative methodology. RESULTS: A total of 345 healthcare providers from two NICUs participated (80% response rate): 286 nurses and 59 medical providers. Moral distress was correctly identified as constrained moral judgement resulting in distress by 93% of participants. However, in practice the term moral distress was also used as an umbrella term to articulate different forms of distress. Moral distress was experienced by 72% of providers at least once a month. Yet despite the negative sequelae of moral distress, few (8% medical, 21% nursing providers) thought that moral distress should be eliminated from the NICU. Open-ended responses revealed that while interventions were desired to decrease the negative impacts of moral distress, moral distress was also viewed as an essential component of the caring profession that prompts robust discussion and acts as an impetus for medical decision-making. CONCLUSIONS: Moral distress remains prevalent within NICUs. While the harmful aspects of moral distress need to be mitigated, moral distress may have a positive role in advocating for and promoting the interests of the neonatal population. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1136/archdischild-2017-313539" target="_blank" rel="noreferrer noopener">10.1136/archdischild-2017-313539</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. 2018 Adult Archives of Disease in Childhood Fetal & Neonatal Edition Attitude Of Health Personnel Burnout Davis PG Female Gillam L Health Personnel/px [psychology] Humans Intensive Care Intensive Care Units Janvier A Job Satisfaction Male Morals Neonatal Neonatal/es [Ethics] Neonatal/px [Psychology] Neonatal/sn [Statistics & Numerical Data] October 2018 List Prentice TM Professional Professional/et [Etiology] Professional/pc [Prevention & Control] Professional/px [Psychology] Psychological Psychological/et [etiology] Psychological/pc [Prevention & Control] Qualitative Research September 2018 List Stress Terminal Care Terminal Care/es [ethics] Terminal Care/px [psychology] Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month Backlog URL Address <a href="http://doi.org/10.1136/archdischild-2015-309410" target="_blank" rel="noreferrer">http://doi.org/10.1136/archdischild-2015-309410</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Moral distress within neonatal and paediatric intensive care units: a systematic review Publisher An entity responsible for making the resource available Archives Of Disease In Childhood Date A point or period of time associated with an event in the lifecycle of the resource 2016 Subject The topic of the resource Palliative Care; Intensive Care; Ethics; decision making; moral distress Creator An entity primarily responsible for making the resource Prentice T; Janvier A; Gillam L; Davis PG Description An account of the resource OBJECTIVE: To review the literature on moral distress experienced by nursing and medical professionals within neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs). DESIGN: Pubmed, EBSCO (Academic Search Complete, CINAHL and Medline) and Scopus were searched using the terms neonat*, infant*, pediatric*, prematur* or preterm AND (moral distress OR moral responsibility OR moral dilemma OR conscience OR ethical confrontation) AND intensive care. RESULTS: 13 studies on moral distress published between January 1985 and March 2015 met our inclusion criteria. Fewer than half of those studies (6) were multidisciplinary, with a predominance of nursing staff responses across all studies. The most common themes identified were overly 'burdensome' and disproportionate use of technology perceived not to be in a patient's best interest, and powerlessness to act. Concepts of moral distress are expressed differently within nursing and medical literature. In nursing literature, nurses are often portrayed as victims, with physicians seen as the perpetrators instigating 'aggressive care'. Within medical literature moral distress is described in terms of dilemmas or ethical confrontations. CONCLUSIONS: Moral distress affects the care of patients in the NICU and PICU. Empirical data on multidisciplinary populations remain sparse, with inconsistent definitions and predominantly small sample sizes limiting generalisability of studies. Longitudinal data reflecting the views of all stakeholders, including parents, are required. 2016-08 Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1136/archdischild-2015-309410" target="_blank" rel="noreferrer">10.1136/archdischild-2015-309410</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). Type The nature or genre of the resource Journal Article 2016 Archives of Disease in Childhood Backlog Davis PG Decision Making Ethics Gillam L Intensive Care Janvier A Journal Article Moral Distress Palliative Care Prentice T Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month Backlog URL Address <a href="http://doi.org/10.1001/jama.2011.2024" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.2011.2024</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity Publisher An entity responsible for making the resource available Jama Date A point or period of time associated with an event in the lifecycle of the resource 2012 Subject The topic of the resource Child; Female; Humans; infant; Male; Follow-Up Studies; Treatment Outcome; Survival Analysis; Odds Ratio; Child Development; Incidence; Preschool; infant; Newborn; Premature; Apnea/drug therapy; Blindness/epidemiology/etiology/prevention & control; Caffeine/adverse effects/therapeutic use; Central Nervous System Stimulants/adverse effects/therapeutic use; Cerebral Palsy/epidemiology; Cognition Disorders/epidemiology/etiology/prevention & control; Deafness/epidemiology/etiology/prevention & control; Developmental Disabilities/epidemiology/etiology/prevention & control; N2N; Very Low Birth Weight Creator An entity primarily responsible for making the resource Schmidt B; Anderson PJ; Doyle LW; Dewey D; Grunau RE; Asztalos EV; Davis PG; Tin W; Moddemann D; Solimano A; Ohlsson A; Barrington KJ; Roberts RS; Trial Investigators Caffeine for Apnea of Prematurity (CAP) Description An account of the resource CONTEXT: Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. OBJECTIVE: To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age. DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up from 2005 to 2011 in 31 of 35 academic hospitals in Canada, Australia, Europe, and Israel, where 1932 of 2006 participants (96.3%) had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between 1999 and 2004. A total of 1640 children (84.9%) with birth weights of 500 to 1250 g had adequate data for the main outcome at 5 years. MAIN OUTCOME MEASURES: Combined outcome of death or survival to 5 years with 1 or more of motor impairment (defined as a Gross Motor Function Classification System level of 3 to 5), cognitive impairment (defined as a Full Scale IQ<70), behavior problems, poor general health, deafness, and blindness. RESULTS: The combined outcome of death or disability was not significantly different for the 833 children assigned to caffeine from that for the 807 children assigned to placebo (21.1% vs 24.8%; odds ratio adjusted for center, 0.82; 95% CI, 0.65-1.03; P = .09). The rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness did not differ significantly between the 2 groups. The incidence of cognitive impairment was lower at 5 years than at 18 months and similar in the 2 groups (4.9% vs 5.1%; odds ratio adjusted for center, 0.97; 95% CI, 0.61-1.55; P = .89). CONCLUSION: Neonatal caffeine therapy was no longer associated with a significantly improved rate of survival without disability in children with very low birth weights who were assessed at 5 years. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1001/jama.2011.2024" target="_blank" rel="noreferrer">10.1001/jama.2011.2024</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). Type The nature or genre of the resource Journal Article 2012 Anderson PJ Apnea/drug therapy Asztalos EV Backlog Barrington KJ Blindness/epidemiology/etiology/prevention & control Caffeine/adverse effects/therapeutic use Central Nervous System Stimulants/adverse effects/therapeutic use Cerebral Palsy/epidemiology Child Child Development Cognition Disorders/epidemiology/etiology/prevention & control Davis PG Deafness/epidemiology/etiology/prevention & control Developmental Disabilities/epidemiology/etiology/prevention & control Dewey D Doyle LW Female Follow-up Studies Grunau RE Humans Incidence Infant JAMA Journal Article Male Moddemann D N2N Newborn Odds Ratio Ohlsson A Premature Preschool Roberts RS Schmidt B Solimano A Survival Analysis Tin W Treatment Outcome Trial Investigators Caffeine for Apnea of Prematurity (CAP) Very Low Birth Weight