Advances in Neonatal Care (Adv Neonatal Care )

Publisher: National Association of Neonatal Nurses, Elsevier


This exciting full-color journal is dedicated to improving the outcomes of infants and their families. As the official journal of the National Association of Neonatal Nurses, Advances in Neonatal Care presents scientifically sound, clinically relevant articles focusing on the interdisciplinary aspects of care. A rich variety of thought-provoking articles and features not only keep readers up-to-date on this challenging and rapidly changing field, but also promote new approaches to controversial issues. Many articles are enhanced by unique, online only video features.

  • Impact factor
  • 5-year impact
  • Cited half-life
  • Immediacy index
  • Eigenfactor
  • Article influence
  • Website
    Advances in Neonatal Care website
  • Other titles
    Advances in neonatal care
  • ISSN
  • OCLC
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Voluntary deposit by author of pre-print allowed on Institutions open scholarly website and pre-print servers
    • Voluntary deposit by author of authors post-print allowed on institutions open scholarly website including Institutional Repository
    • Deposit due to Funding Body, Institutional and Governmental mandate only allowed where separate agreement between repository and publisher exists
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PMC after 12 months
    • Authors who are required to deposit in subject repositories may also use Sponsorship Option
    • Pre-print can not be deposited for The Lancet
  • Classification
    ​ green

Publications in this journal

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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Advances in Neonatal Care 05/2011; 11(3):223.
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Advances in Neonatal Care 07/2009; 9(4):185–186.
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Advances in Neonatal Care 07/2009; 9(4):188–189.
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Advances in Neonatal Care 07/2009; 9(4):188.
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    ABSTRACT: Rapid sequence intubation (RSI) is premedication prior to intubation that includes atropine, a sedative, and a neuromuscular blockage. Rapid sequence intubation is infrequently performed in neonates despite evidence that it is safe and effective. Neonates that experience endotracheal intubation often display apnea and cardiac arrhythmias, decreased or obstructed nasal airflow, increased systolic blood pressure, and decreased heart rate and transcutaneous oxygen tension. Infants can also experience increased anterior fontanel pressure, which can place them at greater risk for intraventricular hemorrhage. Rapid sequence intubation has been shown to facilitate better intubation conditions including no movement from the infant and better visualization of the airway. Infants receiving RSI were successfully intubated twice as fast as infants who were not premedicated. Infants with premedication also had fewer changes in baseline heart rate. Neonatal RSI can be easily and safely performed in the neonate. Knowledge and skill allow for the best conditions when intubating the infant. Future research must focus on the best combination of medications for RSI in the neonate.
    Advances in Neonatal Care 07/2009; 9(3):111-7; quiz 118-9.
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    ABSTRACT: There is a little-recognized cohort of NICU patients whose outcomes are the result of a "benevolent injustice" in their healthcare course. Many of these infants are saved by technology; however, they are left both medically fragile and medically dependent, and many of them are required to live in a medical facility. Many of these babies never get to go home with their parents. This emerging cohort of patients may evolve from the difficult ability to prognosticate outcomes for neonates, overtreatment, and acquiescing to parental demands for continued aggressive care. Neonatology is an unpredictable process and one that is never intended to harm, but carries with it the potential of devastating consequences, thus creating a benevolent injustice.
    Advances in Neonatal Care 07/2009; 9(3):132-6.
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    ABSTRACT: Retinopathy of prematurity (ROP) remains a concern for many preterm infants. Early detection and timely treatment have been shown to be effective in improving visual outcomes; moreover, it is crucial that a series of indirect ophthalmic examinations be performed until an infant is considered no longer at risk for the disease. The purpose of this systematic review is to summarize and evaluate the published evidence regarding characteristics and effectiveness of pain management interventions during the ROP examination. Implications for practice are discussed and suggestions for further research are made. Despite the general consensus that ROP examination is a painful procedure with considerable amount of discomfort, evidence shows that pain management during the ROP examination is inadequate. Although there are currently clear recommendations and guidelines for performing the ROP examination, there are no standard protocols for pharmacological and nonpharmacological pain management during the ROP examination. This is an area where much work is still needed to address the needs of the infant during this critical examination.
    Advances in Neonatal Care 07/2009; 9(3):99-110.
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    ABSTRACT: Klippel-Trenaunay syndrome is a rare but well-documented congenital malformation. Klippel-Trenaunay syndrome has sometimes been used interchangeably with Klippel-Trenaunay-Weber syndrome. However, Klippel-Trenaunay syndrome is the correct term used for the triad of congenital anomalies. Klippel-Trenaunay-Weber syndrome or Parkes-Weber syndrome is accepted as a separate entity consisting of the triad of Klippel-Trenaunay syndrome accompanied by a clinically apparent arteriovenous fistula. Hemodynamically insignificant arteriovenous malformations do not preclude a diagnosis of Klippel-Trenaunay syndrome. It is important to differentiate between the 2 syndromes because treatment and prognosis are so different. Parkes-Weber syndrome has a poor prognosis for limb viability. This article describes a case study of an infant presenting with Klippel-Trenaunay including a review of the syndrome and treatment recommendations.
    Advances in Neonatal Care 07/2009; 9(3):120-4.
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    ABSTRACT: The advanced practice nursing role in neonatal intensive care enjoys an almost 40-year history. The 1970s and the 1980s were fraught with growing pains, including what to call these providers, and role clarity that was defined in most settings by community need. With the birth of NANN, 25 years ago, the neonatal nurse practitioner (NNP) role began to receive support and advocacy that led to the development of educational standards and definition of the role. This article reviews the role's history and identifies current and future issues that will require attention by the national NNP leadership.
    Advances in Neonatal Care 07/2009; 9(3):125-8.
  • Advances in Neonatal Care 07/2009; 9(3):91-2.
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    ABSTRACT: Evidence is needed to guide NICU use of lansoprazole (Prevacid), ranitidine (Zantac), and metoclopramide (Reglan). As a step toward that goal, we conducted a historic cohort analysis of all patients who received any of these medications in 4 Intermountain Healthcare NICUs during the year 2006. Data were obtained from all patients admitted between January 1 and December 31, 2006, to any of 4 Intermountain Healthcare NICUs. This was a retrospective descriptive design. Data were obtained from electronic pharmacy records and electronic medical records. The NICUs involved were blinded and included McKay-Dee Hospital Center, Ogden, Utah; LDS Hospital, Salt Lake City, Utah; Utah Valley Regional Medical Center, Provo, Utah; and Dixie Regional Medical Center, St George, Utah. Although the demographics of the patients at the 4 centers were similar, significant differences were seen among the centers in drug use patterns. Lansoprazole use ranged from a high of 17% of patients in one center to a low of 7% of patients in another. Ranitidine use ranged from 9% in one center to 1% in another. Metoclopramide use ranged from 9% of patients in one center to <1% in another. The extreme variability among the centers in use patterns of these 3 medications suggests lack of an adequate evidence base to guide practice and indicates that case controlled studies or random controlled trials are needed to devise a consistent evidence-based approach.
    Advances in Neonatal Care 06/2009; 9(3):129-31.
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    ABSTRACT: Nurses are in a prime position to provide support to parents when a baby is born extremely premature and then expires. How the nurse responds to the shocked and grieving parents will impact how they experience and remember their loss. This article is a personal account of an unsuccessful neonatal transport. The nurse recalls the circumstances surrounding this event and the results that followed.
    Advances in Neonatal Care 05/2009; 9(2):82-4.
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    ABSTRACT: Neonatal hemochromatosis is a rare disease of iron metabolism, characterized by the excess accumulation of iron in the tissues. This occurs in utero and can lead to fetal demise or an infant who presents with advanced liver disease in the neonatal period. A case of neonatal hemochromatosis is reported in a 37-week infant who presented at birth with thrombocytopenia, coagulopathy, and abnormal liver imaging studies. The diagnoses of infection and metabolic errors were excluded before the confirmation of neonatal hemochromatosis was made. This diagnosis was confirmed by elevated ferritin levels and extrahepatic siderosis excluding the reticuloendothelial system. Anti-oxidant therapy was initiated with N-acetyl cysteine, selenium, vitamins C and E and intravenous immunoglobulin. The infant demonstrated a positive response and was discharged home with outpatient follow up. The clinical presentation of neonatal hemochromatosis is reviewed as well as diagnosis and treatment strategies.
    Advances in Neonatal Care 05/2009; 9(2):72-6.
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    ABSTRACT: A preliminary study of a new optical oscillometric method to noninvasively measure systolic, mean, and diastolic blood pressures, in addition to heart and respiratory rates in very small extremities, is described. It employs transillumination of an extremity and measures the optical oscillation amplitude during cuff deflation from suprasystolic to zero pressure. The amplitude of the optical pulsatile oscillations is similar to that produced with the conventional pneumatic oscillometric method; however, the pulsatile optical signal is much larger and is present at all times when the cuff is deflated. Two types of blood pressure verification studies were performed: (1) a weanling piglet study using a weanling piglet tail and (2) a human study using the little fingers of adult participants. For the weanling piglet study, direct femoral artery pressure, tail-cuff pressure, and optical oscillations were recorded in 5 anesthetized weanling piglets ranging in weight from 2 to 4 kg. Ten measurements were made in the pressure range of 30 to 175 mm Hg. For human study, data were obtained from 23 adult participants of both sexes with a little finger circumference of 4 cm or less. Radial artery pressure, measured with the conventional pneumatic oscillometric method, was used as the standard and was compared with the simultaneous optical oscillometric pressure in the little finger of the opposite arm. This is an initial study demonstrating the optical oscillometric technique as a viable alternative for noninvasive blood pressure measurement in low birth-weight infants. The weanling piglet data show a high correlation between direct arterial pressure and this new optical oscillometric method over a pressure range of approximately 30 to 175 mm Hg. The correlation coefficients of linear regression were 0.93, 0.93, and 0.91, respectively. The human little finger data show a high correlation between the pneumatic oscillometric mean arterial pressure and this new optical oscillometric method over a pressure range of approximately 40 to 140 mm Hg. The correlation coefficient of linear regression was 0.87. This new optical oscillometric technique simplifies noninvasive blood pressure measurement because it was designed specifically for small-diameter extremities such as those found in low birth-weight infants. This new optical oscillometric device has the added benefit of continually monitoring pulse and respiration rates.
    Advances in Neonatal Care 05/2009; 9(2):77-81.
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    ABSTRACT: Caudal regression syndrome, also referred to as caudal dysplasia and sacral agenesis syndrome, is a rare congenital malformation characterized by varying degrees of developmental failure early in gestation. It involves the lower extremities, the lumbar and coccygeal vertebrae, and corresponding segments of the spinal cord. This is a rare disorder, and true pathogenesis is unclear. The etiology is thought to be related to maternal diabetes, genetic predisposition, and vascular hypoperfusion, but no true causative factor has been determined. Fetal diagnostic tools allow for early recognition of the syndrome, and careful examination of the newborn is essential to determine the extent of the disorder. Associated organ system dysfunction depends on the severity of the disease. Related defects are structural, and systematic problems including respiratory, cardiac, gastrointestinal, urinary, orthopedic, and neurologic can be present in varying degrees of severity and in different combinations. A multidisciplinary approach to management is crucial. Because the primary pathology is irreversible, treatment is only supportive.
    Advances in Neonatal Care 05/2009; 9(2):61-9; quiz 70-1.
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    ABSTRACT: Electronic documentation systems have become integral to improving the quality of healthcare, reducing medical errors, and advancing the delivery of evidence-based medical care. A smooth transition from paper charting to an electronic documentation system is challenging. Using quality improvement tools and building on the clinical microsystems concept can assist with a smooth transition. Specific strategies include involving all stakeholders in the development and implementation of the plan, assessing the culture of the department, and identifying processes and patterns that require attention. Specific steps include developing a statement of aim, formulating a specific path to reach the aim, evaluating the progress of implementation, and creating a template for future process improvement. This article describes the process used in one midwestern NICU to implement an integrated electronic documentation system using a clinical microsystems approach and quality improvement methods. Challenges encountered and lessons learned are discussed.
    Advances in Neonatal Care 05/2009; 9(2):53-60.
  • Advances in Neonatal Care 05/2009; 9(2):47-9.
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Advances in Neonatal Care 03/2009; 9(2):86.
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    ABSTRACT: Air leak in the neonatal population can be a deadly situation. Neonates have many risk factors that can contribute to air leak. These include, but are not limited to, respiratory distress syndrome; mechanical ventilation; sepsis; pneumonia; aspiration of meconium, blood, or amniotic fluid; and congenital malformations. In the NICU, the staff must be prepared to diagnose and treat pneumothoraces in a timely manner. Pathophysiology of air leaks in the neonate including the anatomy of the chest and diagnosis, indications, and common methods for the treatment of a pneumothorax in an infant is explained in this article. In addition, the latest form of treatment for neonates, known as the modified pigtail catheter, is described. A comprehensive literature review of the evidence behind the use of the pigtail catheter in neonates will be incorporated. Finally, the step-by-step placement of this catheter using the modified Seldinger technique will be illustrated and described in detail.
    Advances in Neonatal Care 03/2009; 9(1):7-16.
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    ABSTRACT: Down syndrome is a genetic disorder, occurring when an individual has all or part of an extra copy of chromosome 21. Parents of children with Down syndrome are often confused by the term genetic disorder because they associate the term with inheritance but have also learned that Down syndrome is not typically inherited. These parents may have questions about the nature of chromosomes, how Down syndrome occurs, recurrence risk and more. This article attempts to address many of the common questions parents of children with Down syndrome express regarding the genetics of the disorder including the mechanisms by which Down syndrome occurs: nondisjunction, translocation and mosaicism, as well as providing information about prenatal testing options, how the diagnosis is made and where parents may go for further information.
    Advances in Neonatal Care 03/2009; 9(1):27-30.

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