Cord milking at VLBW delivery, followed by drawing all admission laboratory tests from the placenta

2.50
Hdl Handle:
http://hdl.handle.net/10755/308431
Category:
Abstract
Type:
Presentation
Title:
Cord milking at VLBW delivery, followed by drawing all admission laboratory tests from the placenta
Author(s):
Baer, Vickie L; Lambert, Diane K.; Christensen, Robert D.; Noorlander, Lori
Lead Author STTI Affiliation:
Non-member
Author Details:
Vickie L Baer, RN, BSN, vickie.baer@imail.org; Diane K. Lambert, RN, BSN; Robert D. Christensen, MD; Lori Noorlander, RN, BSN
Abstract:

Session presented on: Monday, November 18, 2013

ABSTRACT

Cord milking at VLBW delivery, followed by drawing all admission laboratory tests from the placenta.

Objective:  Reducing blood transfusions among VLBW neonates (very low birth weight, <1500g) can be achieved by milking the umbilical cord before birth (1,2), and by drawing no blood initially on the neonate, but instead drawing the initial laboratory studies using fetal blood in the placenta (3,4). However it is not clear how feasible these two techniques are in actual practice, nor is the risk of neonatal hyperviscosity known.

Results:  Feasibility of placental drawing was tested at 96 VLBW births. In 91 the blood tests were successfully obtained this way. The hemoglobin generally increased in the first 24 hours, (p<0.001) and fewer received transfusions or vasopressors (p<0.001). Thirty-six others were subjected to cord milking followed by placental drawing. Blood viscosity was then measured twice in the next 12 hours. None had a viscosity ≥12 cP (a level that defines hyperviscosity among term neonates). Also, those with the highest viscosity levels (5.0 - 7.5 cP) did not have the signs associated with hyperviscosity (plethora, hypotonia, hypoglycemia, hyperbilirubinemia, or thrombocytopenia).

Conclusion:It is feasible to use cord milking and placental phlebotomy at VLBW delivery. Doing so will reduce transfusions and improve hemodynamic stability without causing hyperviscosity.

Keywords:
Neonate; transfusion; viscosity
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleCord milking at VLBW delivery, followed by drawing all admission laboratory tests from the placentaen_GB
dc.contributor.authorBaer, Vickie Len_GB
dc.contributor.authorLambert, Diane K.en_GB
dc.contributor.authorChristensen, Robert D.en_GB
dc.contributor.authorNoorlander, Lorien_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsVickie L Baer, RN, BSN, vickie.baer@imail.org; Diane K. Lambert, RN, BSN; Robert D. Christensen, MD; Lori Noorlander, RN, BSNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308431-
dc.description.abstract<p>Session presented on: Monday, November 18, 2013</p><b>ABSTRACT</b><p align="center"><b>Cord milking at VLBW delivery, followed by drawing all admission laboratory tests from the placenta.</b><p><b>Objective:</b>  Reducing blood transfusions among VLBW neonates (very low birth weight, <1500g) can be achieved by milking the umbilical cord before birth (1,2), and by drawing no blood initially on the neonate, but instead drawing the initial laboratory studies using fetal blood in the placenta (3,4). However it is not clear how feasible these two techniques are in actual practice, nor is the risk of neonatal hyperviscosity known. <p><b>Results:</b>  Feasibility of placental drawing was tested at 96 VLBW births. In 91 the blood tests were successfully obtained this way. The hemoglobin generally increased in the first 24 hours, (<i>p</i><0.001) and fewer received transfusions or vasopressors (<i>p</i><0.001). Thirty-six others were subjected to cord milking followed by placental drawing. Blood viscosity was then measured twice in the next 12 hours. None had a viscosity ≥12 cP (a level that defines hyperviscosity among term neonates). Also, those with the highest viscosity levels (5.0 - 7.5 cP) did not have the signs associated with hyperviscosity (plethora, hypotonia, hypoglycemia, hyperbilirubinemia, or thrombocytopenia). <p><b>Conclusion:</b>It is feasible to use cord milking and placental phlebotomy at VLBW delivery. Doing so will reduce transfusions and improve hemodynamic stability without causing hyperviscosity.en_GB
dc.subjectNeonateen_GB
dc.subjecttransfusionen_GB
dc.subjectviscosityen_GB
dc.date.available2013-12-19T17:31:14Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:31:14Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
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