Parental Experiences of Genetic Testing

Genetic testing is increasingly used in clinical practice in the neonatal period, including in NICUs. This testing may have psychological consequences for parents. To best support families, neonatal clinicians should be aware of the various ways in which parents view and respond to genetic testing. In this review, we summarize research on the parental experience of having a newborn infant undergo genetic testing.

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

OBJECTIVE

The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes.

STUDY DESIGN

This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann-Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event.

RESULTS

In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups.

CONCLUSION

Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU.

KEY POINTS

· Code blue events are four times more common in PICU.. · NICU code events are 2.5 times shorter in duration compared with PICU events.. · NICU code events are more likely to be attributed to a problem with an airway..

Electrode surface concentrations for mixed transfer processes: transfer by diffusion and chemical reaction for a plane electrode

An expression has been derived and tables computed for the concentration of oxidant and reductant at the electrode surface as a function of time and polarizing potential in the case where an irreversible chemical reaction follows a reversible electron transfer reaction under the conditions of a somewhat idealized polarographic system.

Rate of advancement of reactions in turbulent flows

When a reacting substance or mixture is caused to flow in a cylindrical reactor, all portions of the stream will not flow at the same rate and will exhibit different residence times and, accordingly, are subject to different extents of degrees of reaction. The average degrees of reaction following the residence time distribution proper to laminar flow are given in the earlier publication1 and this paper extends the treatment to that of turbulent flow. In the earlier treatment of laminar flow the ratio of average extent of reaction with non-interacting streams to that of complete intermingling, or the C/Cm, is plotted against the ratio of the times of flow with those of reaction (S). The C/Cm versus S curves are all above unity and increase with increasing S, with the exception of very high orders of chemical reaction for which values of C/Cm are all unity. In the case of turbulent flow the values of C/Cm are more nearly unity at all values of S.

The Effect of Residence Time Distribution on the Rate of Advancement of the Reaction

In any form of continuous reactor the different reagent molecules spend different residence times in the reacting zone. The degree to which a reaction advances after a lapse of nominal residence time may be somewhat different from that expected from classical (micro) kinetics and the known order of the reaction. If the reaction mixture passes laminarly through a reasonably large cylindrical reactor-one in which intermolecular diffusion is negligible-the effective measure of the advancement of the reaction in terms of the residual concentration of the reagent - measured (i) as an actual distributed system C and (ii) as an idealized system in which all molecules spend an equal tlme of residence Cm. may be expressed by the equation: Equation (29) where n is order of reaction, S=knC0n-1τ0, and τ0 is the minimal time of residence (time for the central core). Equation (29) becomes meaningless when n=1 and is replaced by Equation (30) The ratio C/Cm increases as S increases; the increase, however, is the less pronounced the higher the value of n. If the mixture passes through a mixed tank reactor advancement of the degree of the reaction is measured by a function given by Metzner and Pigford. For a second order of reaction a correct treatment can only be carried out if a distinction is made between the square on the mean concentration and the mean of the square concentration.