Advanced Practice Session

Thursday, July 12, 2007

1:00 – 2:00 pm  Sensory Regulation Through Touch and Massage

Touch and massage are powerful mediums for human connections. Touch can elicit and strengthen sensory perception, neural regulation and enhance brain development. Helping families to connect with and care for their infants in the NICU promotes infant family attachment, builds family confidence and positive nurturing interactions. Families can be guided to provide safe, sensitive touch and massage for infant organization and regulation laying the foundation for immediate and long lasting positive social and emotional regulation and development. Early touch and massage can be integrated into routine cares and designed to address the individual psychological and neural-behavioral needs of infants.

Presenters: From the University of New Mexico, Children’s Hospital; Dawn Ehrhard-Wingard, DOM, SMT, IMI, OTR and Nancie Furgang, MA, OTRK 

2:00 – 3:00 pm  Individual Developmental Approach to Assessment and Feeding of the Pre-term Infant

This presentation reviews the developmental aspects impacting the pre-term infant’s capacity to safely and effectively feed. The presentation also covers aspects of neuro behavioral and developmental challenges faced by the pre-term or medically fragile infants who are at risk for atypical progression in their feeding capacity.

Presenters: From the University of New Mexico, Children’s Hospital; Nancie Furgang, MA, OTRK and Nancy Rasch, OTR/L, BCP

3:00 – 4:00 pm  Review of the Neonatal Resuscitation Program: What Changed in 2006 and What Did Not

The decision to resuscitate a pre-term baby is often the first challenge faced both by doctors and parents. This interactive presentation explores the changes to the Neonatal Resuscitation Program (NRP) in 2006 and gives attendees a better understanding of the importance of proper communication to families in this fragile situation.

Presenter: Glenda Edwards Robertson, RN, MA, University of New Mexico, Children’s Hospital

4:00 – 5:00 pm  Providing Behaviorally and Developmentally Supportive Care During Respiratory Therapy Interventions

A multi-disciplinary team of Respiratory and Occupational Therapists presents considerations and techniques to improve and provide proper developmental care for infants on continuous positive airway pressure (CPAP) and other respiratory adjuncts.

Presenters: From the University of New Mexico, Children’s Hospital; Gerri Duran, MS, OT/L, FAOTA; Nancie Furgang, MA, OTRK and Leah McBurney, RRT, NPS

8:00 – 9:00 pm  Keynote Presentation: Inhaled Nitric Oxide in Premature Infants

Review the results of recent clinical trials designed to study the role of inhaled nitric oxide in the prevention of bronchopulmonary dysplasia in premature newborns.

Presenter: John Kinsella, MD, Professor of Pediatrics and Neonatology, The Children's Hospital and University of Colorado School of Medicine

Conference Lecture Series

Friday, July 13, 2007

8:00 – 8:45 am Necrotizing Enterocolitis (NEC): Drugs, Bugs and Things That Go Bump in the Night

Necrotizing Entercolitis, or NEC, is the most commonly acquired gastrointestinal emergency in the newborn period affecting 6% to 8 % of pre-term infants weighing less than 1,500 grams. While there are many risk factors for NEC, prematurity is by far the greatest. The diagnosis of NEC requires a high index of suspicion since there are definitive diagnostic tests other than an abdominal radiograph. The treatment of NEC is generally supportive; however, an exploratory laparotomy or drain may be needed. Strategies to prevent NEC have generally been ineffective, but the administration of probiotics may be effective.

Presenter: Dr. Richard Polin, Columbia University Medical Center and Presbyterian Healthcare Medical Center

8:45 – 9:30 am  Nutrition Management of Neonatal Short Bowel Syndrome

This presentation outlines strategies for nutrition support in neonatal short gut. Attendees will explore management of ostomy losses, enteral feeding, pitfalls of nutrition support and complications of indwelling catheters. This presentation also presents the complications of short bowel syndrome.

Presenter: Dr. Lucille McLoughlin, University of New Mexico, Children’s Hospital

9:30 – 10:15 am Surgical Options for the Neonate with NEC

This presentation discusses the surgical options and interventions for the neonate with NEC and explores the indications for operative intervention and the rationale for each intervention. Decision making steps for operative intervention in NEC are discussed along with relevant controversies in current surgical care.

Presenter: Dr. Stephen Jolley, Pediatric Surgeons of Alaska

10:30 – 11:15 am Intestinal Rehabilitation in the Era of Transplant

This presentation discusses the long-term goals of intestinal rehabilitation and its associated challenges. Also addressed are the advances in the care of intestinal failure, both medical and surgical, including intestinal transplant as a long-term option.

Presenter: Dr. Lucille McLoughlin, University of New Mexico, Children’s Hospital

11:15 – 12:00 pm Gastroesophageal Reflux Disease in the Pre-term and Term Infant

This presentation discusses the definition of gastroesophageal reflux disease (GERD) and how to document GERD in the infant population. The relationship of GERD to prematurity in the neonatal population is presented. Complications of GERD in newborns will be discussed, with a particular focus on respiratory symptoms and sudden death.

Presenter: Dr. Stephen Jolley, Pediatric Surgeons of Alaska

1:30 – 2:15 pm Long-term Outcomes of Extremely Low Birth-weight Infants at Young Adulthood

Extremely low birth-weight survivors from the post-neonatal intensive care era have now reached adulthood. It appears that the majority of young adults have adapted better than predicted and place a high valuation on their quality of life. In this presentation, attendees are given information on the transition of these babies to young adulthood from the McMaster cohort and other recent studies.

Presenter: Dr. Saroj Saigal, FRCP(C), McMaster University, Department of Pediatrics

2:15 – 3:00 pm Definition of Hypotension in the VLBW Neonate During the Transitional Period

This presentation reviews the physiologic principles which are potentially useful in the definition of hypotension. It also addresses the lack of data and the limitations in our ability to define the clinically relevant age dependent blood pressure values in gestational and postnatal tissue.

Presenter: Dr. Istvan Seri, USC Division of Neonatal Medicine, Children’s Hospital of Los Angeles and the Keck School of Medicine

Saturday, July 14, 2007

8:00 – 8:45 am Identification of Endothelial Stem/Progenitor Cells from Human Umbilical Cord Blood and Potential Therapeutic Uses

Endothelial stem/progenitor cells have recently been identified from human umbilical cord blood. Endothelial progenitor cells have high proliferative potential and the ability to form new blood vessels both in vitro and in vivo. A clinical application of both cord blood derived and mobilized adult peripheral blood endothelial progenitor cells are emerging and clinical trials are currently underway to test their ability as a cell based therapy for vascular disease. This presentation describes the original identification and characterization of endothelial progenitor cells from cord blood and the therapeutic and diagnostic potential of these cells in understanding the pathogenesis and treatment of a variety of cardiovascular diseases.

Presenter: Dr. David Ingram, Indiana University Cancer Center, Department of Pediatrics

8:45 – 9:30 am Ethical Issues in Neonatal Care

The NICU has a number of current ethical issues that we struggle with as care providers. Some of the most difficult are the resuscitation of “fetal infants” withdrawal of nutrition and hydration in futile cases and lethal fetal anomalies carried to term. Attendees discuss the need to have access to a multidisciplinary team for the ethical issues faced in the NICU. Attendees will also be exposed to proper communication verbiage for families in the NICU, in order to provide the best care possible.

Presenter: Dr. Rebecca Moran, Assistant Professor, University of New Mexico, Children’s Hospital

9:30 – 10:15 am Prenatal Inflammation, Postnatal Consequences

Exposure to prenatal inflammation (chorioamnionitis) may have far reaching postnatal consequences for term and pre-term infants. This presentation presents evidence of such consequences in organ systems such as the lung, heart and brain.

Presenter: Dr. Kristi Watterberg, Professor and Chief of Neonatology, University of New Mexico, Department of Pediatrics

10:30 – 11:15 am Outcomes of Infants with Neonatal Encephalopathy

Neonatal encephalopathy (NE) occurs in 6/1000 live births in the developing world. The effects of NE can be fairly severe and long lasting. This presentation addresses the causes, classification and long-term effects of NE as well as the outcomes following newer therapies such as brain cooling/hypothermia. 

Presenter: Dr. Saroj Saigal, FRCP(C), McMaster University, Department of Pediatrics

11:15 – 12:00 pm Brain Rescue for Neonatal Hypoxic/Ischemic Encephalopathy

Topics covered in this session include the evidence supporting induced hypothermia as a neuroprotective strategy and unanswered questions regarding its clinical application.

Presenter: Dr. LuAnn Papile, Professor of Pediatrics, Baylor College of Medicine

Sunday, July 15, 2007

8:00 – 8:45 am Ventilation Styles: Do They Make A Difference? The Columbia Experience with CPAP

Brochopulmonary dysplasia (BPD) is one of the most serious complications in neonatal intensive care. While many strategies have been suggested, the only proven way to prevent BPD is not to ventilate. Continuous positive airway pressure (CPAP) is a non-invasive form of respiratory support, which has a sound experimental animal basis. Randomized trials of prophylactic or early CPAP in newborn babies are in progress but the data has not been published. CPAP is most likely to be effective for infants greater than 26 weeks gestation. Below this gestational age, intubations and surfactant may be advantageous.

Presenter: Dr. Richard Polin, Columbia University Medical Center and Presbyterian Healthcare Medical Center

8:45 – 9:30 am Patent Ductus Arteriosus: Evidence For and Against Treatment

Newborns with patent ductus arterious (PDA) may or may not show signs of complications. However, it is possible that a newborn with PDA can develop poor feeding habits, shortness of breath, even heart failure. In this session, attendees review the existing evidence supporting or refuting the necessity of closing the PDA during the neonatal period.

Presenter: Dr. Ronald Clyman, University of California at San Francisco

9:30 – 10:15 am Postnatal Steroids and BPD

Postnatal steroids have been used since the 1980’s to treat or prevent bronchopulmonary dysplasia. Significant side effects have limited their use. This presentation reviews the current status of research and use of steroids in this field, including future directions concerning steroid use.

Presenter: Dr. Kristi Watterberg, Professor and Chief of Neonatology, University of New Mexico, Department of Pediatrics

10:30 – 11:15 am Hypotension and Treatment

This presentation addresses etiology-oriented treatment strategies for neonatal shock. A review of available evidence for the effectiveness of treatment modalities improving meaningful neonatal outcomes is addressed.

Presenter: Dr. Istvan Seri, USC Division of Neonatal Medicine, Children’s Hospital of Los Angeles and the Keck School of Medicine

11:15 – 12:00 pm Transfusions and Red Cell Growth Factor Use in Neonates

This presentation reviews changes in neonatal transfusion practices, summarizes randomized studies evaluating transfusion guidelines in pre-term infants and develops an approach to administering red cell transfusions in neonates. The presentation also presents new uses for red cell growth factors in neonates.

Presenter: Dr. Robin Ohls, Professor of Pediatrics, University of New Mexico, Department of Pediatrics