Gains have been made primarily by standardization and optimization of nonpharmacologic means. The care of infants with in utero opioid exposure has improved considerably over the past 10 years. “Perhaps the ultimate goal should not be to decide whether to treat an infant with medication but to prevent poor outcomes, including neurologic harm and death.” – by Ken Downey Jr.ĭisclosures: The authors report no relevant financial disclosures. “Certainly, the work of Devlin et al highlights that much more needs to be known about how an infant responds postnatally to intrauterine drug exposure and the optimum screening, diagnostic, and treatment strategies,” they wrote. They said adopting a simplified tool will only be effective if it is accepted by clinicians and parents or caretakers, “which is often not the case.” In a related commentary, Ju Lee Oei, MD, from the University of New South Wales in Australia, and Trecia Wouldes, PhD, from the University of Auckland in New Zealand, characterized the tool as attractively simple, but said several questions need to be addressed, including whether the association between the eight items and NAS remains consistent over time. The eight items were: sleep less than 3 hours after feeding tremors when disturbed or undisturbed increased muscle tone body temperature greater than or equal to 37.2☌ respiratory rate greater than 60 breaths per minute excessive sucking poor feeding and regurgitation. They found that eight of the remaining items were “independently associated with receipt of pharmacologic therapy.” The median time to treatment from birth was 3 days.ĭevlin and colleagues combined two tremor items from the FNAST tool and removed three items - convulsions, high-pitched cry and hyperactive Moro reflex - from further analysis because they were either not observed or had “extremely different frequencies” in the cohorts. Among 424 neonates included in the primary analysis, 238 were treated. Neonates had opioid exposure at a gestational age of at least 36 weeks. ![]() They validated their model using an external cohort of neonates enrolled in the Maternal Opioid Treatment: Human Experimental Research (MOTHER). “It is important to prospectively validate this scale, which could be widely used and lead to the standardization of the clinical approach and management of neonates prenatally exposed to opioids.”įor the study, Devlin and colleagues retrospectively reviewed medical records of neonates with antenatal opioid exposure using three cohorts from University of Louisville, the University of Kentucky and Tufts University. ![]() Devlin, DO, associate professor of pediatrics at the University of Louisville School of Medicine, and colleagues wrote in JAMA Network Open. “This shorter assessment tool could simplify clinical assessment by focusing on components that are relatively consistent across sites,” Lori A. Researchers determined that only eight of the FNAST’s 21 screening items are necessary to properly diagnose an infant with NAS. Simplifying the Finnegan Neonatal Abstinence Scoring Tool, or FNAST, could improve its use in making treatment decisions for neonatal abstinence syndrome, or NAS, study findings showed. If you continue to have this issue please contact to Healio
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |