Browsing by Author "Krishnegowda, Sushma"
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Publication A Study of Variation in the Tube Feeding Rate by Nurses in a Tertiary NICU(Nepal Paediatric Society (JNPS), 2016) Krishnegowda, Sushma; Vasudev, Prajwala Hassan; Doreswamy, Srinivasa Murthy; Veena, S.; Hemavathi, M.Abstract: Introduction: 50-60% of the low birth weight babies in a neonatal unit are on gravity feed via gavage tube as they often are not strong enough to sustain on oral feeds. Successful feeding depends on nursing skill and individual variation can be expected. As with many other nursing practices in NICU, considerable variation can be expected in gravity feeding rate as well. The objective was to determine the intra individual and inter individual variation in the rate of gravity feeding among the nurses. Material and Methods: This was a Prospective study done in a Tertiary Neonatal care unit. Babies weighing < 2 kgon enteral feeds were included in study. The nurses carried out feeding in the standard prescribed manner. Time taken for feeds was noted. Results: 21 nurses participated in the study. 15 babies were included and there were 342 feed events. During 75(22%) feeding events, the nurses had an assignment of less than four babies. During rest of the 267 (78%) feeding events, they had more than four babies assigned for care. The median volume of feed was 14 ml and median duration was 8 minutes. Feeding rate variation within same nurse varied from one to 37.5 times their base line rate and in between the nurses varied by minimum of 17 times. Conclusion: A wide intra and interpersonal variation among the nurses, with respect to the rate of feeding of newborns was observed in our study.Publication Effect of Sildenafil on Mortality in Term Neonates with Hypoxemic Respiratory Failure due to Persistent Pulmonary Hypertension (SIPHON) - A Randomised Control Trial(Nepal Paediatric Society (JNPS), 2021) Thandaveshwara, Deepti; Krishnegowda, Sushma; Hosur, Divya; Doreswamy, Srinivasa MurthyAbstract: Introduction: Persistent Pulmonary Hypertension (PPHN) complicates the transition from intrauterine to extrauterine life in some neonates. Sildenafil is known to reduce pulmonary pressures. However, its effect on reducing mortality is unclear. This study is conducted to determine the effect of Sildenafil in reducing all-cause mortality rate in term newborns with hypoxemic respiratory failure due to pulmonary hypertension. Methods: This was a double-blinded randomised control trial done in a level 3 neonatal intensive care unit. Term neonates on mechanical ventilation with an Oxygenation Index (OI) > 15, and echocardiography suggesting PPHN were included in the study. The drug group received intravenous Sildenafil and the placebo group normal saline. The difference in the mortality rate between the two groups was analysed. Results: Eleven babies were randomised to the drug group and 12 to the placebo group. Both the groups matched in terms of their baseline characteristics. The difference in the drop of OI and right ventricular systolic pressure (RVSP) between the drug and placebo groups was not statistically significant. The relative risk of mortality was 0.436 in the intervention group (95% CI 0.105 to 1.80). The difference in the mortality rate was not statistically significant with P- value of 0.252. The rate of complications such as necrotising enterocolitis, sepsis, and pneumothorax was not different between the two groups. Conclusions: Intravenous sildenafil does not have any significant benefit over placebo in reducing all-cause mortality, oxygenation index, RVSP or complications when compared to placebo.