On-ward observations in neonatal intensive care: Towards safer supplemental oxygen & IV therapy

On-ward observations in neonatal intensive care: Towards safer supplemental oxygen & IV therapy

Van der Eijk, A.C.

Dankelman, J. (promotor)
Simonsz, H.J. (promotor)

Mechanical, Maritime and Materials Engineering

BioMechanical Engineering

2012-09-24

The focus of this thesis is on supplemental oxygen therapy and intrave nous (IV) therapy in neonatal intensive care. Both therapies are essential, but potentially dangerous for (preterm) newborn infants. Supplemental oxygen therapy refers to the therapy where a gas mixture with >21% of oxy gen is supplied to the patient via (mechanical) ventilation to reach and maintain adequate tissue oxygenation. Unfortunately the accurate manual control of the oxygenation in newborn infants is difficult and time consuming.  In IV therapy various types of nutrition, drugs, and/or fluids are administered directly into the veins of the patient. Although it is expected that the IV substances are supplied to the patient with the pre-programmed flow-rate, the actual volume delivery varies over time. Particularly in newborn infants, these sudden changes in delivered volume can have severe consequences. The objective of the research was to determine the limitations of supplemental oxygen therapy and IV therapy in current neonatal intensive care and to identify areas for improvements. To meet the objective, several studies were performed including on-ward observations. The overall conclusion is that in both therapies (unregistered) variations in clinical practice are present. It is to be expected that these unnoticed differences in care lead to differences in outcome of patients. To achieve a more standardised approach and to improve the safety of both supplemental oxygen therapy and IV therapy, in this thesis several recommendations are provided.

Neonatal Intensive Care
Oxygen
Preterm infants
Pulse oximetry
Alarm management
Intravenous therapy

http://resolver.tudelft.nl/uuid:d6781373-17d2-42ec-859e-a506021e3d1a

2014-02-01

9789461913555

Institutional Repository

doctoral thesis

(c) 2012 Van der Eijk, A.C.