Biomedical subjects

E Cignacco

Publications and source records attributed to E Cignacco.

4 recordsLinked to original sources

PubMed2004

[Recommendations for the palliative care of dying neonates].

Neonates and infants have the highest mortality rate in the pediatric patient population, but there is a paucity of data about their palliative care. Most neonate deaths occur during the first week of life so it is mostly the staff of NICUS's and obstetrical wards who are confronted with the palliative care of dying neonates. Clinical experience shows that many aspects of care in palliative situations are not well known to the health care providers. This is especially true for pain assessment and pain treatment during the dying process. A search of the literature on this subject resulted in only a few publications; hence, this article basically describes clinical experience in the palliative care of neonates. In this article some recommendations for decision-making and standardization of palliative care for dying neonates are presented.

Analgesics, Opioid↗

PubMed2001

[Pain assessment in newborn infants--a review of the literature].

While adults and children can express pain verbally it is not possible to appreciate pain immediately in neonates owing to their lack of language. Pain in the newborn must therefore be assessed indirectly and thus involves the use of physiological, behavioural and biochemical parameters. The present review of the literature describes the difficulties accompanying an objective appreciation of pain among the newborn, in particular in the case of premature babies. Most of the existing scales of pain have been developed for the purposes of research and their practical application in a regular clinical context has never been tested. Nurses and doctors are therefore still faced with the problem of having to use a small number of substantiated tools which, however, have hardly been tested in practice. This is all the more questionable since according to the literature the short and long-term consequences of continuous pain in neonates can include intraventricular haemorrhages, changes in feeding and sleeping patterns and damages to the delicate relationship between the infant and its parents.

Humans↗

PubMed1998

[Pre-eclampsia and its psychosocial sequelae].

In the present work some psychosomatic conditions in the setting of preeclampsia are described. The important psychosocial consequences for women suffering from this disease and the drawback for their partners will be elucidated. Preeclampsia as a disease including hypertension, proteinuria and generalized edema is often associted with generalized seizures occuring most commonly at the end of the second trimenon of pregnancy. The disease bears a heavy risk for the mothers as well as for her unborn child. Until now the exact pathophysiological basis of the disease has not been entirely elucidated. For the pregnant woman and her psychosocial surrounding the outbreak of the disease is in most cases unexpected. During development of the disease she has to face a role change from a so far normal pregnancy to a high-risk situation. This may change also the attitude to the unborn child by herself and her partner. The preterm delivery induced therapeutically, together with the succeeding problems for the newborn complete the high psychosocial stress related to the entire situation. Therefore it is useful and important to offer psychosocial support to the mother as well as to her parter during the illness and the time after delivery.

Adaptation, Psychological↗

PubMedDate not supplied

[Measures for the assessment of pain in neonates as well as a comparison between the Bernese Pain Scale for Neonates (BPSN) with the Premature Infant Pain Profile (PIPP)].

BACKGROUND: Neonate's expression of pain lacks the ability to report pain. Several pain measures exist to assess acute pain in term and preterm neonates. The aim of the present study is to compare them with respect to their validity and reliability. METHOD: Review of the literature and a description of the measures most often cited. Additionally, the validity of the Bernese Pain Scale for Neonates (BPSN) was assessed in a department of neonatology of a university hospital. PATIENTS: Assessments of pain (n = 48) in term and preterm neonates with and without respiratory support. RESULTS: Existing pain measures are using behavioural indicators of pain (eg, facial expression, body posture, movements, and vigilance) as well as physiological indicators of pain (eg, changes in heart rate, respiratory rate, blood pressure, oxygen saturation). The used measures and their feasibility in everyday practice, the study population and the method of validation were presented. The BPSN differentiates pain from nonpain (F = 41.27, p < 0.0001) and the interrater- as well as the intrarater-reliability was high (r = 0.87 - 0.98 and r = 0.98 - 0.99, respectively). CONCLUSIONS: Assessment of acute pain in neonates should take into account the way of validation that has been performed especially with respect to the study population. The BSN is a pain measure with good validity and reliability for the assessment of pain in term and preterm neonates.

Arousal↗