Neonateshttp://hdl.handle.net/20.500.12904/2112024-03-28T12:28:41Z2024-03-28T12:28:41Z'Keeping the beat': what is the best way to perform neonatal chest compressions?Cusack, Jonathanhttp://hdl.handle.net/20.500.12904/175022023-08-30T10:17:24Z2023-06-16T00:00:00Z'Keeping the beat': what is the best way to perform neonatal chest compressions?
Cusack, Jonathan
2023-06-16T00:00:00ZA national survey of hereditary angioedema and acquired C1 inhibitor deficiency in the United KingdomPrice, Arthurhttp://hdl.handle.net/20.500.12904/174462023-08-09T14:19:55Z2023-05-03T00:00:00ZA national survey of hereditary angioedema and acquired C1 inhibitor deficiency in the United Kingdom
Price, Arthur
Background: Detailed demographic data on people with hereditary angioedema (HAE) and acquired C1 inhibitor deficiency in the United Kingdom are relatively limited. Better demographic data would be beneficial in planning service provision, identifying areas of improvement, and improving care. Objective: To obtain more accurate data on the demographics of HAE and acquired C1 inhibitor deficiency in the United Kingdom, including treatment modalities and services available to patients. Methods: A survey was distributed to all centers in the United Kingdom that look after patients with HAE and acquired C1 inhibitor deficiency to collect these data. Results: The survey identified 1152 patients with HAE-1/2 (58% female and 92% type 1), 22 patients with HAE with normal C1 inhibitor, and 91 patients with acquired C1 inhibitor deficiency. Data were provided by 37 centers across the United Kingdom. This gives a minimum prevalence of 1:59,000 for HAE-1/2 and 1:734,000 for acquired C1 inhibitor deficiency in the United Kingdom. A total of 45% of patients with HAE were on long-term prophylaxis (LTP) with the most used medication being danazol (55% of all patients on LTP). Eighty-two percent of patients with HAE had a home supply of acute treatment with C1 inhibitor or icatibant. A total of 45% of patients had a supply of icatibant and 56% had a supply of C1 inhibitor at home. Conclusions: Data obtained from the survey provide useful information about the demographics and treatment modalities used in HAE and acquired C1 inhibitor deficiency in the United Kingdom. These data are useful for planning service provision and improving services for these patients.
2023-05-03T00:00:00ZNeonatal health care costs of very preterm babies in England: a retrospective analysis of a national birth cohortPillay, Thillagavathiehttp://hdl.handle.net/20.500.12904/173152023-07-03T08:42:23Z2023-05-02T00:00:00ZNeonatal health care costs of very preterm babies in England: a retrospective analysis of a national birth cohort
Pillay, Thillagavathie
Objectives: Babies born between 27+0 and 31+6 weeks of gestation represent the largest group of very preterm babies requiring National Health Service (NHS) care; however, up-to-date, cost figures for the UK are not currently available. This study estimates neonatal costs to hospital discharge for this group of very preterm babies in England. Design: Retrospective analysis of resource use data recorded within the National Neonatal Research Database. Setting: Neonatal units in England. Patients: Babies born between 27+0 and 31+6 weeks of gestation in England and discharged from a neonatal unit between 2014 and 2018. Main outcome measures: Days receiving different levels of neonatal care were costed, along with other specialised clinical activities. Mean resource use and costs per baby are presented by gestational age at birth, along with total costs for the cohort. Results: Based on data for 28 154 very preterm babies, the annual total costs of neonatal care were estimated to be £262 million, with 96% of costs attributable to routine daily care provided by units. The mean (SD) total cost per baby of this routine care varied by gestational age at birth; £75 594 (£34 874) at 27 weeks as compared with £27 401 (£14 947) at 31 weeks. Conclusions: Neonatal healthcare costs for very preterm babies vary substantially by gestational age at birth. The findings presented here are a useful resource to stakeholders including NHS managers, clinicians, researchers and policymakers.
2023-05-02T00:00:00ZSurrogate decision making in crisisPillay, Thillagavathiehttp://hdl.handle.net/20.500.12904/170422023-05-18T08:35:34Z2021-03-11T00:00:00ZSurrogate decision making in crisis
Pillay, Thillagavathie
Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in discussions around complex decision-making issues . Discussions around continuation or discontinuation of life-sustaining are challenging even in the most straightforward of cases, but what happens when the birth mother is critically unwell? Such cases can lead to uncertainty around who should assume the parental role for these difficult discussions . In this round table discussion, we explore the ethical, moral and legal uncertainties raised by coincident severe maternal and neonatal illness in the context of surrogacy.
2021-03-11T00:00:00Z