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1. Survey of neonatal respiratory support use in very preterm infants in Italy

Author

Gagliardi, L, Tagliabue, P, Bellù, R, Corchia, C, Mosca, F, Zanini, R, Network Neonatale Italiano, Prandi, Giovanna, Tandoi, Francesco, Gagliardi, L, Tagliabue, P, Bellù, R, Corchia, C, Mosca, F, Zanini, R, Corsello, G, and Giuffre, M

Subjects
Respiratory Therapy, medicine.medical_specialty, medicine.medical_treatment, Continuous positive airway pressure, Ventilation, continuous positive airway pressure, variation, preterm infant, respiratory management, Variation, macromolecular substances, Pediatrics, Cohort Studies, Settore MED/38 - Pediatria Generale E Specialistica, Humans, Medicine, Intensive care medicine, Premature, Ventilation, continuous positive airway pressure, variation, preterm infant, respiratory management, business.industry, Infant, Newborn, Infant, Obstetrics and Gynecology, Perinatology and Child Health, Newborn, Respiratory support, Very preterm, Italy, Preterm infant, Pediatrics, Perinatology and Child Health, Respiratory management, Breathing, Premature Birth, Infant, Premature, preterm neonates, respiratory distress syndrome, respiratory support, business
Abstract

Background: Respiratory support in very preterm infants is often a life-saving procedure and several techniques are available. There is lack of data on the current use of these techniques. Methods and aim: We analyzed a cohort of infants

Published
2012
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2. Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study

Author

Corchia, C, Fanelli, S, Gagliardi, L, Bellù, R, Zangrandi, A, Persico, A, Zanini, R, SONAR-Nurse Study Group including Bellù, R, Bertino, E, Casati, M, Cazzaniga, A, Plevani, L, Mosca, F, Baracchetti, R, Villa, E, Tandoi, F, Boccacci, S, Martinelli, S, Coscia, P, Poggiani, C, Ferrari, D, Barera, G, Poloniato, A, Ruggeri, V, Burgio, G, Carrera, G, D'Alterio, R, Merazzi, D, Lomazzi, M, Coscia, A, Borgione, S, Anselmo, C, Galletto, P, Gancia, Gp, Parola, A, Sabatini, M, Gazzolo, D, Carli, G, Filippone, M, Lago, P, Heun, N, Visentin, S, Bertolini, A, Padovani, Em, Bellettato, M, Gasparin, B, Serra, A, Santuz, P, Ellero, S, Fantini, M, Contiero, Rm, Gallo, C, Mammoliti, Pm, Ancora, G, Faldella, G, Sandri, F, Stella, M, Biasini, A, Fioravanti, L, Dessì, S, Sigali, E, Vuerich, M, Cacciavellani, R, Bragetti, P, De Curtis, M, Lucchini, R, Parente, G, Massenzi, L, Calibita, G, Haass, C, Scapillati, E, Pietro, S, Dotta, A, D'Agostino, G, Picone, S, Messina, F, Napolitano, M, Salvia, G, Moschella, S, Orfeo, L, Chello, G, Carpentieri, M, Vacchiano, T, Vetrano, G, Rabuano, R, Simonetti, Dm, Quartulli, L, Rinaldi, M, Magaldi, R, Presta, G, Greco, F, Forziati, V, Acito, A, Gatta, A, Quitadamo, P, Rotondo, S, Laforgia, N, Grassi, A, Del Cuore, F, Lucente, M, Costabile, Cd, Nicolò, A, Arco, A, Marseglia, L, Pinna, G, Rosella, V, Giuffrè, M, Marchesano, G, Inferiore, N, Corso, G, Cannuscio, A, Gargano, G, Pedoni, S, Poloni, G, Di Leo, L, Crescenzi, F, Celi, F, Betta, P, Carlo Corchia, Simone Fanelli, Luigi Gagliardi, Roberto Bellù, Antonello Zangrandi, Anna Persico, Rinaldo Zanini, SONAR-Nurse Study GroupCorchia [.., Giacomo Faldella, ], Corchia, C., Fanelli, S., Gagliardi, L., Bellù, R., Zangrandi, A., Persico, A., Zanini, R., Giuffre, M., and SONAR-Nurse Study Group

Subjects
Cross-sectional study, Staffing, Workload, Critical Care Nursing, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, Settore MED/38 - Pediatria Generale E Specialistica, Nursing, 030225 pediatrics, Intensive care, Critical care nursing, Surveys and Questionnaires, Neonatal, Intensive Care Units, Neonatal, Medicine, Humans, Surveys and Questionnaire, 030212 general & internal medicine, Location, Workplace, Cross-Sectional Studie, business.industry, Research, Nurse-Patient Relation, Infant, Newborn, Patient Acuity, Infant, Perinatology and Child Health, Newborn, Nurse-Patient Relations, Cross-Sectional Studies, Italy, Pediatric Nursing, Intensive Care Units, Workforce, Intensive care units, Nurse-patient relations, Patient acuity, Pediatrics, Perinatology and Child Health, Pediatric nursing, business, Human
Abstract

Background Neonatal units’ volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking. Methods Between March 2010-April 2011, 63 neonatal intensive care units adhering to the Italian Neonatal Network participated in the SONAR Nurse study. Their main features and work environment were investigated by questionnaires compiled by the chief and by physicians and nurses of each unit. Twelve cross-sectional monthly-repeated surveys on different shifts were performed, collecting data on number of nurses on duty and number and acuity of hospitalized infants. Results Six hundred forty five physicians and 1601 nurses compiled the questionnaires. In the cross-sectional surveys 702 reports were collected, with 11082 infant and 3226 nurse data points. A high variability was found for units’ size (4–50 total beds), daily number of patients (median 14.5, range 3.4-48.7), number of nurses per shift (median 4.2, range 0.7-10.8) and number of team meetings per month. Northern regions performed better than Central and Southern regions for frequency of training meetings, qualitative assessment of performance, motivation within the unit and nursing work environment; mean physicians’ and nurses’ age increased moving from North to South. After stratification by terciles of the mean daily number of patients, the median number of nurses per shift increased at increasing volume of activity, while the opposite was found for the nurse-to-patient ratio adjusted by patients’ acuity. On average, in units belonging to the lower tercile there was 1 nurse every 2.5 patients, while in those belonging to the higher tercile the ratio was 1 nurse every 5 patients. Conclusions In Italy, there is a high variability in organizational characteristics and work environment among neonatal units and an uneven distribution of human resources in relation to volume of activity, suggesting that the larger the unit the greater the workload for each nurse. Urgent modifications in planning and organization of services are needed in order to pursue more efficient, homogeneous and integrated regionalized neonatal care systems.

Published
2016

4. Alle origini delle emozioni: uno studio pilota sul sorriso e sull’espressione facciale di distress nel neonato pretermine di età gestazionale molto bassa

Author

Dondi M., Costabile A., Vacca T., Franchin L., Agnoli S., Lombardi O., Corchia C., and Dondi, M., Costabile, A., Vacca, T., Franchin, L., Agnoli, S., Lombardi, O., Corchia, C.

Subjects
sorriso, distress, sviluppo
Abstract

La ricerca ha come obiettivo indagare la presenza delle manifestazioni espressive del sor- riso e del distress, due configurazioni facciali fondamentali nelle fasi più precoci dello sviluppo, in un campione di nati pretermine di età gestazionale molto bassa. A questo scopo, il comporta- mento facciale di 9 neonati, videoripresi a 30 settimane di età post-concezionale e con un peso medio alla nascita, adeguato per l’età gestazionale (AGA; Appropriate for Gestational Age), di 945.6 grammi (DS = 132), è stato analizzato mediante due sistemi di codifica, il Baby FACS (Oster, in corso di stampa) ed il MAX (Izard, 1979). Entrambe le espressioni sono state esibite da più della metà del campione in una forma matura, cioè bilaterale e al più alto livello di intensità di contrazione muscolare (b/x; Ekman e Friesen, 1978). La frequenza di comparsa delle azioni facciali unilaterali è risultata tuttavia maggiore nel caso del sorriso rispetto al distress, quasi totalmente bilaterale. Inoltre, il distress presentava una durata media significativamente maggiore rispetto al sorriso. I risultati ottenuti suggeriscono una precoce asincronia evolutiva tra l’emergere delle espressioni di sorriso e distress.

Published
2008

5. La comunicazione precoce madre-bambino: un confronto fra diadi con bambino nato a termine e bambino nato pretermine

Author

TENUTA F., COSTABILE A., MARCONE, Roberto, CORCHIA C., LOMBARDI O., Tenuta, F., Costabile, A., Marcone, Roberto, Corchia, C., and Lombardi, O.

Subjects
Interazione madre-bambino, Prematurità, Osservazione longitudinale, Communication, Emotion, Fullterm, Interaction, Preterm
Abstract

Il presente lavoro si pone l’obiettivo di osservare il coinvolgimento emotivo affettivo nelle interazioni diadiche madre-bambini. La ricerca è incentrata sull’influenza che la variabile nascita pretermine ha sullo sviluppo della relazione fra madre e bambino. A tale scopo si mettono a confronto diadi con bambini nati pretermine e diadi con bambini nati a termine, attraverso una ricerca osservativa longitudinale. Il campione dei bambini nati pretermine manifesta il culmine delle abilità sociali con un ritardo medio di 1-2 mesi rispetto ai bambini a termine. Anche le madri sembrano essere influenzate da tale andamento e manifestano, nel caso dei bambini pretermine, un maggior numero di comportamenti di interazione positivi ad un livello di età successivo rispetto alle madri dei nati a termine. The aim of this work is to observe the emotional involvement which characterizes the dyadic mother-infant interaction. The focus of the research is to assess the influence that the preterm birth variable has on the development of the mother-infant relationship. To this purpose dyads with preterm children and dyads with full-term children are compared through longitudinal observation. The preterm children reach the climax of their social competences with one/ two-month delay if compared with full term children. The mothers also seem to be influenced by this trend and a more positive range of maternal behaviours appear sensibly later than in the case of preterm infants.

Published
2008

6. At the origins of emotions: A pilot study on the facial expression of distress and smiling in very low gestational age preterm newborns

Author

Dondi, M., Costabile, A., Vacca, T., Franchin, L., Agnoli, S., Lombardi, O., Corchia, C., Dondi, M., Costabile, A., Vacca, T., Franchin, L., Agnoli, S., Lombardi, O., and Corchia, C.

Subjects
Distress, Preterm infant, Facial coding systems, Facial coding system, Emotional development, Smiling, Distre
Abstract

The aim of the study was to test the presence of smiling and distress, two fundamental facial expressions in early infancy, in a group of very low gestational age preterm newborns. The facial behaviour of 9 healthy preterm newborns with an average weight of 945.6 grams (DS = 132) at birth, appropriate for gestational age (AGA), videorecorded at 30 post-conceptional weeks, was analyzed by using two coding systems, Baby FACS (Oster, in press) and MAX (Izard, 1979). The results showed that more than one-half of the sample presented both expressions bilaterally and at the higher muscular intensity level (b/x; Ekman and Friesen, 1978). The frequency of unilateral actions was higher during smiling than during distress, which was by contrast almost totally bilateral. Furthermore, mean duration of distress was significantly longer than smiling. The data suggest an early asynchrony between the emergence of smiling and distress expressions.

Published
2008

11. Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitions

Author

Davanzo, R, Ronfani, L, Brovedani, P, Demarini, S, Breastfeeding in Neonatal Intensive Care Unit Study Group, Collaborators: Cragnolin, E, Martini, P, Verlato, G, Chiandetti, L, Barba, Bd, De Nisi, G, Pedrotti, A, Tonetto, P, Fabris, Claudio, Bertino, Enrico, Mosca, F, Clerici, D, Rancati, D, Stival, G, Giovannini, M, Dall'Oglio, I, Corchia, C, Salvatori, G, Bellù, R, Zanini, R, Fanos, V, Reali, A, Assumma, M, Bianchi, A, Tonelli, G, Rinaldi, G, Minelli, G, Gatta, A, and La Gamba, G.

Subjects
medicine.medical_specialty, Pediatrics, Epidemiology, Birth weight, Gestation period, World health, Pregnancy, Intensive Care Units, Neonatal, Intensive care, neonatal intensive care, medicine, Humans, Infant, Very Low Birth Weight, Milk, Human, Obstetrics, business.industry, Infant, Newborn, Infant, Reproducibility of Results, Gestational age, Infant Formula, Cross-Sectional Studies, Italy, breast feeding, Pediatrics, Perinatology and Child Health, Population study, Female, business, very-low-birthweight infants, Breast feeding, Formula fed
Abstract

Summary Human milk has several advantages in the nutrition of very-low-birthweight (VLBW) infants. However, there are limited data on breast feeding (BF) in neonatal intensive care units (NICU). The aim of this study was to identify a practical definition of BF rate in VLBW infants and to test its applicability and reproducibility in Italian NICUs. The study population included all VLBW infants discharged from 12 level 3 NICUs, over a 12-month period. Type of feeding was recorded according to the World Health Organisation (WHO) definition, with a 72-h recall period. We enrolled 594 VLBW infants. Mean birthweight was 1105 g (SD: 267), mean gestational age was 29.2 weeks (SD: 2.7) and mean length of stay in NICUs was 62.5 days (SD: 56.5). At discharge, 30.5% of VLBW infants were exclusively breast fed, 0.2% were predominantly breast fed, 23.8% were on complementary feeding and 45.5% were exclusively formula fed. A wide variability in BF rates was seen between centres. Among exclusively breast-fed VLBW infants, only 10% sucked directly and exclusively at the breast. WHO definitions can be used to assess type of feeding at discharge from NICUs. We speculate that common feeding definitions may allow both comparisons among different NICUs and ratings of quality improvement programmes.

Published
2009

19. Survey of neonatal respiratory care and surfactant administration in very preterm infants in the Italian neonatal network

Author

Bellù R, Gagliardi L, Tagliabue P, Corchia C, Vendettuoli V, Mosca F, Zanini R, Condò M, Turoli D, Weissmann G, Vanzati M, De Nisi G, Villa E, Moro G, Guerrini P, Contiero R, Ellero S, Furlan R, Abbiati L, Borroni C, Prandi G, Fabris C, Vielmi F, Agosti M, Tandoi F, Guidali, De Curtis M, Tozzi C, Lucchini R, Battaglioli M, Lista GL, Introvini P, Ferrari F, Gallo C, Cervello P, Bellante E, Bottura C, Pasquali F, Boccacci S, Latini G, Giannuzzi R, Martinelli S, Brunelli A, Motta G, Di Nunzio ML, Vendemiati A, Zorzi C, Carli G, Alfiero, Romeo N, Mammoliti P, Mastretta E, Barberis L, Farina D, Gancia G, Dalmazzo C, Napolitano M, Messina F, Rinaldi G, Magaldi R, Rinaldi M, Litta R, Lago P, Zanardo V, Chiandetti L, Visentin S, Presta G, Cella D, Poggiani C, Ferrari D, Parati S, Lombardo F, Grigorio R, Barera G, Franco M, Poloniato A, Colombo A, Burgio G, Sala E, Barberi I, Tiralongo V, Arco A, Careggi F, Dani C, Pratesi S, Mignatti V, Ancora G, Faldella G, Grandi S, Stronati M, Perotti G, Chirico G, Migliori C, De Marini S, Forleo V, Mansi G, Bona G, Stucchi I, Savastio, Ferrero F, Parola A, Padovani EM, Viviani E, Pecoraro L, Tiberina FI, Agostino R, Gizzi C, Massenzi L, Messner H, Staffier A, Salvia G, Esposito L, Forziati V, Latorre G, Sandri F, Alati S, Demaria F, Lombardi O, Costabile CD, Scarpelli G, Cavalli C, Volante E, Proietti D, Ganguzza O, Spinella B, Pietro RS, Haass C, Scapillati E, Consigli C, Gatta A, Quitadamo P, Boldrini A, Vuerich M, Sigali E, Ghirri P, Fiorini P, Petrucci L, Moroni M, Braghetti P, Casucci P, Minelli L, Mezzetti D, Orfeo L, De Luca MG, Laforgia N, Grassi A, Gesu RB, Dotta A, Savignoni F, Bagnoli F, De Felice C, Badii S, Biasini A, Belluzzi A, Stella M, Romagnoli C, Zecca E, Barone G, Colleselli P, Vecchiato L, Nicolussi D, Monaldi N, Giliberti P, Chello G, Rojo S, Giovanettoni C, Colnaghi CA, Verucci E, Placidi G, Belloni C, Carrera G, Zambetti C, Biban P, Serra A, Carnielli V, Pedini A, Vetrano G, Furcolo G, Pasquariello B, Falco L, Ausanio G, Bernardo I, Marchesano G, Nosari N, Sarnelli P, Maccabruni M, Merazzi D, Gazzolo D, Sabatini FT, Colivicchi M, Del Vecchio A, Tarantino M, Gargano G, Pedori S, Bellettato M, Pesavento R, Cesaro A, Nicolò A, Mondello I, Pugliese A, Iervolino C, Corsello G, Giuffré M, Betta M, Romeo MG, Saporito A, D'Incecco C, Perrone B, Rodonò MG, Serra G, Franceschi A, Risso FM, Carpentieri M, Cigliano MP, Casilino R, Paolillo P, Picone S, Marra A, Rossetti D, Testa T, Del Cuore F., PALUDETTO, ROBERTO, CAPASSO, LETIZIA, RAIMONDI, FRANCESCO, Bellù, R, Gagliardi, L, Tagliabue, P, Corchia, C, Vendettuoli, V, Mosca, F, Zanini, R, Corsello, G, Giuffrè, M, Italian Neonatal Network., Condò, M, Turoli, D, Weissmann, G, Vanzati, M, De Nisi, G, Villa, E, Moro, G, Guerrini, P, Contiero, R, Ellero, S, Furlan, R, Abbiati, L, Borroni, C, Prandi, G, Fabris, C, Vielmi, F, Agosti, M, Tandoi, F, Guidali, De Curtis, M, Tozzi, C, Lucchini, R, Battaglioli, M, Lista, Gl, Introvini, P, Ferrari, F, Gallo, C, Cervello, P, Bellante, E, Bottura, C, Pasquali, F, Boccacci, S, Latini, G, Giannuzzi, R, Martinelli, S, Brunelli, A, Motta, G, Di Nunzio, Ml, Vendemiati, A, Zorzi, C, Carli, G, Alfiero, Romeo, N, Mammoliti, P, Mastretta, E, Barberis, L, Farina, D, Gancia, G, Dalmazzo, C, Napolitano, M, Messina, F, Rinaldi, G, Magaldi, R, Rinaldi, M, Litta, R, Lago, P, Zanardo, V, Chiandetti, L, Visentin, S, Presta, G, Cella, D, Poggiani, C, Ferrari, D, Parati, S, Lombardo, F, Grigorio, R, Barera, G, Franco, M, Poloniato, A, Colombo, A, Burgio, G, Sala, E, Barberi, I, Tiralongo, V, Arco, A, Careggi, F, Dani, C, Pratesi, S, Mignatti, V, Ancora, G, Faldella, G, Grandi, S, Stronati, M, Perotti, G, Chirico, G, Migliori, C, De Marini, S, Forleo, V, Paludetto, Roberto, Capasso, Letizia, Mansi, G, Raimondi, Francesco, Bona, G, Stucchi, I, Savastio, Ferrero, F, Parola, A, Padovani, Em, Viviani, E, Pecoraro, L, Tiberina, Fi, Agostino, R, Gizzi, C, Massenzi, L, Messner, H, Staffier, A, Salvia, G, Esposito, L, Forziati, V, Latorre, G, Sandri, F, Alati, S, Demaria, F, Lombardi, O, Costabile, Cd, Scarpelli, G, Cavalli, C, Volante, E, Proietti, D, Ganguzza, O, Spinella, B, Pietro, R, Haass, C, Scapillati, E, Consigli, C, Gatta, A, Quitadamo, P, Boldrini, A, Vuerich, M, Sigali, E, Ghirri, P, Fiorini, P, Petrucci, L, Moroni, M, Braghetti, P, Casucci, P, Minelli, L, Mezzetti, D, Orfeo, L, De Luca, Mg, Laforgia, N, Grassi, A, Gesu, Rb, Dotta, A, Savignoni, F, Bagnoli, F, De Felice, C, Badii, S, Biasini, A, Belluzzi, A, Stella, M, Romagnoli, C, Zecca, E, Barone, G, Colleselli, P, Vecchiato, L, Nicolussi, D, Monaldi, N, Giliberti, P, Chello, G, Rojo, S, Giovanettoni, C, Colnaghi, Ca, Verucci, E, Placidi, G, Belloni, C, Carrera, G, Zambetti, C, Biban, P, Serra, A, Carnielli, V, Pedini, A, Vetrano, G, Furcolo, G, Pasquariello, B, Falco, L, Ausanio, G, Bernardo, I, Marchesano, G, Nosari, N, Sarnelli, P, Maccabruni, M, Merazzi, D, Gazzolo, D, Sabatini, Ft, Colivicchi, M, Del Vecchio, A, Tarantino, M, Gargano, G, Pedori, S, Bellettato, M, Pesavento, R, Cesaro, A, Nicolò, A, Mondello, I, Pugliese, A, Iervolino, C, Giuffré, M, Betta, M, Romeo, Mg, Saporito, A, D'Incecco, C, Perrone, B, Rodonò, Mg, Serra, G, Franceschi, A, Risso, Fm, Carpentieri, M, Cigliano, Mp, Casilino, R, Paolillo, P, Picone, S, Marra, A, Rossetti, D, Testa, T, and Del Cuore, F.

Subjects
Preterm infants, Ventilation, Ventilatory support, Medicine (all), Drug Utilization, Humans, Infant Mortality, Infant, Newborn, Infant, Very Low Birth Weight, Intubation, Intratracheal, Italy, Oxygen Inhalation Therapy, Pulmonary Surfactants, Respiration, Artificial, Infant, Premature, Settore MED/38 - Pediatria Generale E Specialistica, Premature, Very Low Birth Weight, Respiration, Infant, Newborn, national survay, Intratracheal, Very preterm infant, national survay, neonatal respiratory care, Very preterm infant, Artificial, Preterm infant, neonatal respiratory care, Intubation
Abstract

INTRODUCTION: Variation of respiratory care is described between centers around the world. The Italian Neonatal Network (INN), as a national group of the Vermont-Oxford Network (VON) allows to perform a wide analysis of respiratory care in very low birth weight infants. METHODS: We analyzed the dataset of infants enrolled in the INN in 2009 and 2010 and, for surfactant administration only, from 2006 to 2010 from 83 participating centers. All definitions are those of the (VON). A questionnaire analysis was also performed with a questionnaire on centers practices. RESULTS: We report data for 8297 infants. Data on ventilator practices and outcomes are outlined. Variation for both practices and outcome is found. Trend in surfactant administration is also analyzed. CONCLUSIONS. The great variation across hospitals in all the surveyed techniques points to the possibility of implementing potentially better practices with the aim of reducing unwanted variation. These data also show the power of large neonatal networks in identifying areas for potential improvement.

25. Gestational age and hospital utilization : three-years follow-up of an area-based birth cohort

Author

Corchia, C., Lapucci, E., Franco, F., Farchi, S., Petrou, Stavros, and Lallo, D.

Subjects
RJ101, RA, humanities
Abstract

OBJECTIVE:\ud To investigate differences by gestational age in emergency department visits and re-hospitalizations during the three years following childbirth discharge.\ud \ud METHODS:\ud We performed a historical cohort study in Lazio Region, Italy, for infants born in 2007-2008 to resident mothers. Health administrative data were used. Analysis was performed by multinomial logistic regression.\ud \ud RESULTS:\ud Of 90 545 infants, more than 50% had at least one emergency department visit, and 18.8% at least one re-hospitalization. After the exclusion of infants with congenital anomalies, relative risk ratios of re-hospitalization and, to a lesser extent, of emergency department visits increased by decreasing gestational age; the two events were also higher for mothers ≤35 years of age, with low education and of Italian nationality. Residency outside the metropolitan area was associated with an increased risk of re-hospitalization and a decreased risk of emergency department visits.\ud \ud CONCLUSION:\ud During the three years following childbirth discharge, re-hospitalizations and, to a lesser extent, emergency department use are inversely related to gestational age at birth; socio-demographic factors have an effect on the risk of infant use of hospital resources independent of gestational age.

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