Shelley Reid - Academia.edu (original) (raw)
Papers by Shelley Reid
Neonatal Paediatric and Child Health Nursing, Jul 1, 2011
BMC Pediatrics, 2015
The optimal strategy for weaning very preterm infants from nasal continuous positive airway press... more The optimal strategy for weaning very preterm infants from nasal continuous positive airway pressure (NCPAP) is unclear. Reported strategies include weaning NCPAP to a predefined pressure then trialling stopping completely (abrupt wean); alternate periods of increased time off NCPAP whilst reducing time on until the infant is completely weaned (gradual wean); and using high flow nasal cannula (HFNC) to assist the weaning process. The aim of this study was to determine the optimal weaning from NCPAP strategy for very preterm infants. A pilot single centre, factorial design, 4-arm randomised controlled trial. Sixty infants born <30 weeks gestation meeting stability criteria on NCPAP were randomly allocated to one of four groups. Group 1: abrupt wean with HFNC; Group 2: abrupt wean without HFNC; Group 3: gradual wean with HFNC; Group 4: gradual wean without HFNC. The primary outcomes were duration of respiratory support, chronic lung disease, length of hospital stay and time to full suck feeds. The primary outcome measures were not significantly different between groups. Group 1 had a significant reduction in duration of NCPAP (group 1: median 1 day; group 2: 24 days; group 3: 15 days; group 4: 24 days; p = 0.002) and earlier corrected gestational age off NCPAP. There was a significant difference in rate of parental withdrawal from the study, with group 2 having the highest rate. Group 3 had a significantly increased duration on HFNC compared to group 1. Use of high flow nasal cannula may be effective at weaning infants from NCPAP but did not reduce duration of respiratory support or time to full suck feeds. Abrupt wean without the use of HFNC was associated with an increased rate of withdrawal by parent request. This study is registered at the Australian New Zealand Clinical Trials Registry ( www.anzctr.org.au/). (Registration Number = ACTRN12610001003066).
Journal for Specialists in Pediatric Nursing
PEDIATRICS, 2000
To determine whether use of the click test, a rapid bedside test of surfactant function, results ... more To determine whether use of the click test, a rapid bedside test of surfactant function, results in earlier and more appropriate surfactant administration in ventilated preterm infants than does usual early rescue treatment. Ventilated preterm infants (n = 126) with inspired oxygen >/=25% and mean airway pressure >/=7 cm H(2)O were randomized in gestational strata (<28 weeks and 28-36 weeks) to have surfactant therapy determined by the click test or by usual clinical and chest radiograph criteria. The treatment group had the click test performed on a tracheal aspirate as soon as possible after intubation and, if negative or equivocal (surfactant deficient), surfactant was given. The control group had surfactant given as soon as possible based on clinical and chest radiograph diagnoses of respiratory distress syndrome. In infants of <28 weeks' gestation, use of the click test resulted in significantly earlier surfactant therapy (median time: 50 vs 159 minutes) and a reduction in the number of infants receiving surfactant (48% vs 79%). In infants of 28 to 36 weeks' gestation, there was no difference in time to surfactant (median time: 300 vs 268 minutes) or in the number of infants receiving surfactant. Neonatal morbidity and mortality were similar in click test and control groups. Use of the click test in ventilated, extremely premature infants results in significantly earlier and more appropriately targeted administration of surfactant than does early rescue therapy based on clinical and radiograph criteria. A randomized trial of targeted early rescue surfactant therapy versus prophylactic surfactant therapy in infants of <28 weeks' gestation is warranted. The click test has the potential to improve clinical outcomes and reduce costs.
Journal of Paediatrics and Child Health, 2006
There is international recognition that health personnel involved in deliveries should be adequat... more There is international recognition that health personnel involved in deliveries should be adequately trained in neonatal resuscitation. A survey was carried out in New South Wales (NSW) and the Australian Capital Territory (ACT) to ascertain the type, frequency and availability of training in neonatal resuscitation to staff who may need to resuscitate an infant at birth. The survey included a self-perception rating of confidence and competence in neonatal resuscitation. Questionnaires were sent to 117 hospitals carrying out deliveries in NSW and ACT. Questionnaires were distributed to staff members who may be present at a delivery in a designated 24-h period. In total, 1457 questionnaires from 101 hospitals were returned and analysed. Overall response rate was 86.3% with 96.1% able to be assigned to tertiary, urban non-tertiary or rural areas. Eighty-five per cent of tertiary respondents had a training programme available to them compared with 59% of urban non-tertiary staff and 31% of rural practitioners. Approximately one-third of respondents in rural and urban non-tertiary units had either never been trained or had training more than 2 years before the survey. In rural areas more than 25% staff were not confident in their resuscitation skills and only 9% felt very competent. Three-quarters of all births in NSW and ACT take place in rural or urban non-tertiary hospitals where one-third of health personnel are inadequately trained in neonatal resuscitation and many do not feel confident in their skills. Effective neonatal resuscitation training for these areas is urgently required.
Journal of Advanced Nursing, 2005
This paper reports an audit of the effect on admission temperatures of using occlusive polyethyle... more This paper reports an audit of the effect on admission temperatures of using occlusive polyethylene wrap applied immediately after the birth of extremely premature infants. Use of occlusive polyethylene wrap during the early postnatal management of the premature infant reduces evaporative and convective heat loss. Retrospective pre-intervention audit was carried out, followed by the introduction of occlusive polyethylene wrap for thermal management during resuscitation and early stabilization. Prospective post-intervention audit was then performed. The pre-intervention (control) group infants were immediately dried with prewarmed towels and resuscitated under radiant heat. Infants in the intervention group were managed under radiant heat, were not dried but were immediately enclosed in an occlusive polyethylene wrap. The demographic characteristics of the two groups were comparable. Use of occlusive polyethylene wrap resulted in higher admission temperatures for infants less than 27 weeks gestation (z=108.50, P<0.01). There was no statistically significant improvement in admission temperatures for 27-29 week infants. The rate of hypothermia on admission (<35.6 degrees C per axilla) was lower in the intervention group (chi(2)=5.12, d.f.=1, P=0.02), but more infants recorded temperatures exceeding 37.2 degrees C during the first 12 hours (chi(2)=23.45, d.f.=1, P<0.01). There were no other adverse effects noted. Use of occlusive polyethylene wrap improved admission temperatures for infants less than 27 weeks gestation. This intervention is easy to implement and does not interfere with resuscitation. However, removal of the wrap should be considered following admission to a closed care system in the neonatal intensive care unit because, in the intervention group, hyperthermia in the first 12 hours was a potential side effect.
Journal for Specialists in Pediatric Nursing, 2008
Journal of Paediatrics and Child Health, 2014
This article compares the severity of illness scoring systems clinical risk index for babies (CRI... more This article compares the severity of illness scoring systems clinical risk index for babies (CRIB)-II and score for neonatal acute physiology with perinatal extension (SNAPPE)-II for discriminatory ability and goodness of fit in the same cohort of babies of less than 32 weeks gestation and aims to provide validation in the Australian population. CRIB-II and SNAPPE-II scores were collected on the same cohort of preterm infants born within a 2-year period, 2003 and 2004. The discriminatory ability of each score was assessed by the area under the receiver operator characteristic curve, and goodness of fit was assessed by the Hosmer-Lemeshow (HL) test. The outcome measure was in-hospital mortality. A multivariate logistic regression model was tested for perinatal variables that might add to the risk of in-hospital mortality. Data for both scores were available for 1607 infants. Both scores had good discriminatory ability (CRIB-II area under the curve 0.913, standard error (SE) 0.014; SNAPPE-II area under the curve 0.907, SE 0.012) and adequate goodness of fit (HL χ(2) = 11.384, 8 degrees of freedom, P = 0.183 for CRIB-II; HL χ(2) = 4.319, 7 degrees of freedom, P = 0.742 for SNAPPE-II). The multivariate model did not reveal other significant variables. Both severity of illness scores are ascertained during the first 12 h of life and perform similarly. Both can facilitate risk-adjusted comparisons of mortality and quality of care after the first post-natal 12 h. CRIB-II scores have the advantage of being simpler to collect and calculate.
Neonatal Paediatric and Child Health Nursing, Jul 1, 2011
BMC Pediatrics, 2015
The optimal strategy for weaning very preterm infants from nasal continuous positive airway press... more The optimal strategy for weaning very preterm infants from nasal continuous positive airway pressure (NCPAP) is unclear. Reported strategies include weaning NCPAP to a predefined pressure then trialling stopping completely (abrupt wean); alternate periods of increased time off NCPAP whilst reducing time on until the infant is completely weaned (gradual wean); and using high flow nasal cannula (HFNC) to assist the weaning process. The aim of this study was to determine the optimal weaning from NCPAP strategy for very preterm infants. A pilot single centre, factorial design, 4-arm randomised controlled trial. Sixty infants born <30 weeks gestation meeting stability criteria on NCPAP were randomly allocated to one of four groups. Group 1: abrupt wean with HFNC; Group 2: abrupt wean without HFNC; Group 3: gradual wean with HFNC; Group 4: gradual wean without HFNC. The primary outcomes were duration of respiratory support, chronic lung disease, length of hospital stay and time to full suck feeds. The primary outcome measures were not significantly different between groups. Group 1 had a significant reduction in duration of NCPAP (group 1: median 1 day; group 2: 24 days; group 3: 15 days; group 4: 24 days; p = 0.002) and earlier corrected gestational age off NCPAP. There was a significant difference in rate of parental withdrawal from the study, with group 2 having the highest rate. Group 3 had a significantly increased duration on HFNC compared to group 1. Use of high flow nasal cannula may be effective at weaning infants from NCPAP but did not reduce duration of respiratory support or time to full suck feeds. Abrupt wean without the use of HFNC was associated with an increased rate of withdrawal by parent request. This study is registered at the Australian New Zealand Clinical Trials Registry ( www.anzctr.org.au/). (Registration Number = ACTRN12610001003066).
Journal for Specialists in Pediatric Nursing
PEDIATRICS, 2000
To determine whether use of the click test, a rapid bedside test of surfactant function, results ... more To determine whether use of the click test, a rapid bedside test of surfactant function, results in earlier and more appropriate surfactant administration in ventilated preterm infants than does usual early rescue treatment. Ventilated preterm infants (n = 126) with inspired oxygen >/=25% and mean airway pressure >/=7 cm H(2)O were randomized in gestational strata (<28 weeks and 28-36 weeks) to have surfactant therapy determined by the click test or by usual clinical and chest radiograph criteria. The treatment group had the click test performed on a tracheal aspirate as soon as possible after intubation and, if negative or equivocal (surfactant deficient), surfactant was given. The control group had surfactant given as soon as possible based on clinical and chest radiograph diagnoses of respiratory distress syndrome. In infants of <28 weeks' gestation, use of the click test resulted in significantly earlier surfactant therapy (median time: 50 vs 159 minutes) and a reduction in the number of infants receiving surfactant (48% vs 79%). In infants of 28 to 36 weeks' gestation, there was no difference in time to surfactant (median time: 300 vs 268 minutes) or in the number of infants receiving surfactant. Neonatal morbidity and mortality were similar in click test and control groups. Use of the click test in ventilated, extremely premature infants results in significantly earlier and more appropriately targeted administration of surfactant than does early rescue therapy based on clinical and radiograph criteria. A randomized trial of targeted early rescue surfactant therapy versus prophylactic surfactant therapy in infants of <28 weeks' gestation is warranted. The click test has the potential to improve clinical outcomes and reduce costs.
Journal of Paediatrics and Child Health, 2006
There is international recognition that health personnel involved in deliveries should be adequat... more There is international recognition that health personnel involved in deliveries should be adequately trained in neonatal resuscitation. A survey was carried out in New South Wales (NSW) and the Australian Capital Territory (ACT) to ascertain the type, frequency and availability of training in neonatal resuscitation to staff who may need to resuscitate an infant at birth. The survey included a self-perception rating of confidence and competence in neonatal resuscitation. Questionnaires were sent to 117 hospitals carrying out deliveries in NSW and ACT. Questionnaires were distributed to staff members who may be present at a delivery in a designated 24-h period. In total, 1457 questionnaires from 101 hospitals were returned and analysed. Overall response rate was 86.3% with 96.1% able to be assigned to tertiary, urban non-tertiary or rural areas. Eighty-five per cent of tertiary respondents had a training programme available to them compared with 59% of urban non-tertiary staff and 31% of rural practitioners. Approximately one-third of respondents in rural and urban non-tertiary units had either never been trained or had training more than 2 years before the survey. In rural areas more than 25% staff were not confident in their resuscitation skills and only 9% felt very competent. Three-quarters of all births in NSW and ACT take place in rural or urban non-tertiary hospitals where one-third of health personnel are inadequately trained in neonatal resuscitation and many do not feel confident in their skills. Effective neonatal resuscitation training for these areas is urgently required.
Journal of Advanced Nursing, 2005
This paper reports an audit of the effect on admission temperatures of using occlusive polyethyle... more This paper reports an audit of the effect on admission temperatures of using occlusive polyethylene wrap applied immediately after the birth of extremely premature infants. Use of occlusive polyethylene wrap during the early postnatal management of the premature infant reduces evaporative and convective heat loss. Retrospective pre-intervention audit was carried out, followed by the introduction of occlusive polyethylene wrap for thermal management during resuscitation and early stabilization. Prospective post-intervention audit was then performed. The pre-intervention (control) group infants were immediately dried with prewarmed towels and resuscitated under radiant heat. Infants in the intervention group were managed under radiant heat, were not dried but were immediately enclosed in an occlusive polyethylene wrap. The demographic characteristics of the two groups were comparable. Use of occlusive polyethylene wrap resulted in higher admission temperatures for infants less than 27 weeks gestation (z=108.50, P<0.01). There was no statistically significant improvement in admission temperatures for 27-29 week infants. The rate of hypothermia on admission (<35.6 degrees C per axilla) was lower in the intervention group (chi(2)=5.12, d.f.=1, P=0.02), but more infants recorded temperatures exceeding 37.2 degrees C during the first 12 hours (chi(2)=23.45, d.f.=1, P<0.01). There were no other adverse effects noted. Use of occlusive polyethylene wrap improved admission temperatures for infants less than 27 weeks gestation. This intervention is easy to implement and does not interfere with resuscitation. However, removal of the wrap should be considered following admission to a closed care system in the neonatal intensive care unit because, in the intervention group, hyperthermia in the first 12 hours was a potential side effect.
Journal for Specialists in Pediatric Nursing, 2008
Journal of Paediatrics and Child Health, 2014
This article compares the severity of illness scoring systems clinical risk index for babies (CRI... more This article compares the severity of illness scoring systems clinical risk index for babies (CRIB)-II and score for neonatal acute physiology with perinatal extension (SNAPPE)-II for discriminatory ability and goodness of fit in the same cohort of babies of less than 32 weeks gestation and aims to provide validation in the Australian population. CRIB-II and SNAPPE-II scores were collected on the same cohort of preterm infants born within a 2-year period, 2003 and 2004. The discriminatory ability of each score was assessed by the area under the receiver operator characteristic curve, and goodness of fit was assessed by the Hosmer-Lemeshow (HL) test. The outcome measure was in-hospital mortality. A multivariate logistic regression model was tested for perinatal variables that might add to the risk of in-hospital mortality. Data for both scores were available for 1607 infants. Both scores had good discriminatory ability (CRIB-II area under the curve 0.913, standard error (SE) 0.014; SNAPPE-II area under the curve 0.907, SE 0.012) and adequate goodness of fit (HL χ(2) = 11.384, 8 degrees of freedom, P = 0.183 for CRIB-II; HL χ(2) = 4.319, 7 degrees of freedom, P = 0.742 for SNAPPE-II). The multivariate model did not reveal other significant variables. Both severity of illness scores are ascertained during the first 12 h of life and perform similarly. Both can facilitate risk-adjusted comparisons of mortality and quality of care after the first post-natal 12 h. CRIB-II scores have the advantage of being simpler to collect and calculate.