From the Cradle to the Grave: Neonatal Intensive Care 1973-2017

Abstract

The peer-reviewed journal articles comprising this thesis were published during the modern era of neonatal intensive care from 1973 through 2017. The published work is novel, original, and eclectic because it concerns the neonatal intensive care unit populace: sick newborns, bereaved parents, parents of sick newborns, neonatal nurses, and neonatologists. The types of study and examples of research results are as follows. First, studies of sick newborns that include: (1) clinical case reports, such as the treatment of refractory neonatal seizures with lamotrigine, (2) case series, such as the clinicopathological features of newborns with severe congenital tricuspid incompetence, (3) cohort studies showing, for example, (i) the lack of correlation between blood pressure and blood volume and the negligible beneficial effects of albumin infusion in hypotensive preterm newborns and (ii) the high mortality rate following cardiopulmonary resuscitation for cardiac arrest in a neonatal intensive care unit, and (4) reports of novel procedures and treatments showing, for example, (i) the practicality of peripheral artery cannulation and (ii) the efficacy of dexamethasone in weaning term newborns with pulmonary barotrauma from mechanical ventilation. Second, cohort studies of personality and psychological health showing, for example, (1) proneness to negative self-conscious emotion (guilt and shame) predicts grief in perinatally bereaved parents, (2) proneness to ‘problematic emotions’ (guilt, shame, envy, and jealousy) and fear of death predict grief in reproductively bereaved mothers, (3) proneness to guilt, shame, and fear of death, other facets of personality (e.g., adult attachment styles, assumptive world view schemas, and ways of coping with stress) and neonatal intensive care unit parent stressors predict posttraumatic growth, changes in outlook, and psychological health in parents of sick newborns. Third, a cohort study showing work role stress and perceived social support predict neonatal nurses’ professional quality of life (burnout, secondary traumatic stress, and compassion satisfaction). Fourth, cohort studies of neonatologists showing, for example, neonatologists’ personal fear of death and dying correlates with their care of newborns at the end-of-life.