Neonatal Pnömonide Hemşirelik Bakımı

Semra Söngüt

doi:10.38079/igusabder.1257070

Review

Nursing Care in Neonatal Pneumonia

Year 2023, Issue: 21, 1286 - 1303, 05.01.2024

Semra Söngüt

https://doi.org/10.38079/igusabder.1257070

Abstract

Neonatal pneumonia is a serious respiratory tract infection disease with high mortality and morbidity potential, caused by various microorganisms, especially bacteria. Neonatal pneumonia remains to be an important health problem, especially in developing countries, and it is reported that 152,000-490,000 babies younger than 1 year old die from pneumonia every year in the world. Neonatal pneumonia with an incidence of 1-35%, is seen with a frequency of 1% among term babies and 10% preterm babies. The incidence varies according to gestational age, intubation status, newborn care level and standard, race and socioeconomic status. The mortality rate due to pneumonia is generally inversely proportional to gestational age and birth weight. Neonatal pneumonias are classified as “Congenital and Early Onset Pneumonia” and “Late-Onset Pneumonia” according to the onset time, and there are many risk factors such as maternal, perinatal and mechanical ventilation. Clinical manifestations of neonatal pneumonia are nonspecific, and symptoms include varying degrees of respiratory distress, suspicious-looking tracheal aspirates, cough, apnea, unstable body temperature, malnutrition, abdominal distention, and lethargy. In this respect, pediatric nurses should routinely monitor and evaluate the infant's respiratory status and oxygenation, fluid status and sepsis risk, although they mostly provide supportive care in the nursing care of newborns diagnosed with pneumonia.

Keywords

Nursing care, neonatal pneumonia, pediatric nurse

Project Number

References

1. Hooven TA, Polin RA. Pneumonia. Seminars in Fetal & Neonatal Medicine. 2017;22(4):206-13. doi: 10.1016/j.siny.2017.03.002.
2. Özer EA, Demirel G, Tüzün F. Term yenidoğanda solunum sıkıntısı tanı, tedavi ve korunma rehberi. Türk Neonatoloji Derneği. 2021:24-30.
3. Reiterer F. Neonatal Pneumonia. In: Resch R, ed. Neonatal Bacterial Infection. 2013:19-32. doi: 10.5772/54310.
4. Viscardi RM. Prenatal and postnatal microbial colonisation and respiratory outcome in preterm infants. In: Bancaları E, Polin R, eds. The Newborn Lung. 2nd edn. 2012:135-162.
5. Whidbey C, Vornhagen J, Gendrin C, et al. A streptococcal lipid toxin induces membrane permeabilization and pyroptosis leading to fetal injury. EMBO Mol Med. 2015;7(4):488–505.
6. Spaan AN, Henry T, van Rooijen WJM, et al. The staphylococcal toxin panton-valentine leukocidin targets human c5a receptors. Cell Host Microbe. 2013;13(5):584-94.
7. Wynn JL, Wong HR. Pathophysiology and treatment of septic shock in neonates. Clin Perinatol. 2010;37(2):439-79.
8. Hutton EK, Thorpe J. Consequences of meconium stained amniotic fluid: What does the evidence tell us? Early Hum Dev. 2014;90(7):333-9.
9. Lamagni TL, Keshishian C, Efstratiou A, et al. Emerging trends in the epidemiology of invasive group b streptococcal disease in England and wales, 1991-2010. Clin Infect Dis. 2013;57(5):682-8.
10. Garland JS. Strategies to prevent ventilator-associated pneumonia in neonates. Clin Perinatol. 2010;37(3):629-43.
11. Britt RD, Faksh A, Vogel E, Martin RJ, Pabelick CM, Prakash YS. Perinatal factors in neonatal and pediatric lung diseases. Expert Rev Respir Med. 2013;7(5):515-31.
12. Dowling DJ, Levy O. Ontogeny of early life immunity. Trends Immunol. 2014;35(7):299-310.
13. Saini Y, Wilkinson KJ, Terrell KA, et al. Neonatal pulmonary macrophage depletion coupled to defective mucus clearance increases susceptibility to pneumonia and alters pulmonary immune responses. Am J Respir Cell Mol Biol. 2016;54:210-21.
14. Curfman AL, Glissmeyer EW, Ahmad FA, et al. Initial presentation of neonatal herpes simplex virus infection. J Pediatr. 2016;172:121-126.e1.
15. James SH, Kimberlin DW. Neonatal herpes simplex virus infection. Infect Dis Clin North Am. 2015;29(3):391-400.
16. Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213(4 Suppl):S29-52.
17. Kawanishi F, Yoshinaga M, Morita M, et al. Risk factors for ventilator-associated pneumonia in neonatal intensive care unit patients. J Infect Chemother. 2014;20(10):627-30.
18. Wójkowska-Mach J, Borszewska-Kornacka M, Domańska, J, et al. Early-onset infections of very-low-birth-weight infants in polish neonatal intensive care units. Pediatr Infect Dis J. 2012;31(7):691-5. doi: 10.1097/INF.0b013e3182567b74.
19. Cernada M, Aguar M, Brugada M, et al. Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique. Pediatr Crit Care Med. 2013;14(1):55-61.
20. Hastalık Kontrol ve Önleme Merkezleri (CDC). Pneumonia (Ventilator-associated [VAP] and nonventilator-associated pneumonia [PNEU]) Event. https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf. Erişim Tarihi 15 Haziran 2022.
21. Cantey JB, Patel SJ. Antimicrobial stewardship in the NICU. Infect Dis Clin North Am. 2014;28(2):247-61.
22. Brady MT, Polin RA. Prevention and management of infants with suspected or proven neonatal sepsis. Pediatrics. 2013;132(1):166-8.
23. Matera MG, Rogliani P, Ora J, Cazzola M. Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents. Expert Opin Pharmacother. 2018;19(18):2043-2053.
24. Ebeledike C, Ahmad T, Martin SD. Pediatric pneumonia (Nursing). Updated 2020 Nov 21. In: StatPearls, 2020. https://www.ncbi.nlm.nih.gov/books/NBK568682/#nurse-article-27365.r21. Erişim Tarihi 17 Haziran 2022.
25. Amerikan Pediatri Akademisi- American Academy of Pediatrics. Herpes Simplex. In: Kimberlin DW, Brady MT, Jackson MA, eds. Red Book: Report of the Committee on Infectious Diseases. 31st edn. Elk Grove Village; 2018:437.
26. Kimberlin DW, Jester PM, Sanchez PJ, et al. Valganciclovir for symptomatic congenital cytomegalovirus disease. N Engl J Med. 2015;372(10):933-43.
27. Azab SFA, Sherbiny HS, Saleh SH, et al. Reducing ventilator-associated pneumonia in neonatal intensive care unit using “VAP prevention bundle: a cohort study. BMC Infect Dis. 2015;15(1):314.
28. Weber CD. Applying adult ventilator-associated pneumonia bundle evidence to the ventilated neonate. Adv Neonatal Care. 2016;16(3):178-90.
29. Türk Toraks Derneği. https://toraks.org.tr/site/community/library/3. Erişim Tarihi 15 Haziran 2022.
30. Mojen KL, Rassouli M, Tajalli S, Baghestani AR, Jafari Z. Clinical assessment of nursing care regarding prevention of ventilator-associated pneumonia in neonates. Iranian Journal of Neonatology. 2019;10(4):19-24. doi10.22038/ijn.2019.37550.1581.
31. Dipanjali R, Shivananda PM, Yashoda S. Effectiveness of an educational intervention on knowledge and practice of staff nurses on prevention of ventilator associated pneumonia among neonates in neonatal intensive care unit. International Journal of Caring Sciences. 2020;13(2):1421-30.
32. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Society of Critical Care Medicine. 2017;45(3):486-552. doi: 10.1097/CCM.0000000000002255.
33. Erdemir F, Türk G. Hemşirelik Tanıları El Kitabı. 15. ed. Çeviri: Carpenito LJ. Handbook of Nursing Diagnosis 15th Edition. Ankara: Nobel Tıp Kitabevleri Tic.Ltd. Şti. 2021.
34. Kleinpell R, Blot S, Boulanger C, Fulbrook P, Blackwood B. International critical care nursing considerations and quality indicators for the 2017 surviving sepsis campaign guidelines. Intensive Care Medicine. 2019;45:1663–66.
35. Aitken LM, Williams G, Harvey M, et al. Nursing considerations to complement the surviving sepsis campaign guidelines. Crit Care Med. 2011;39(7):1800-18.
36. Düzkaya DS, Bozkurt G. Çocuklarda sepsis ve hemşirelik bakımı. Yoğun Bakım Hemşireliği Dergisi. 2013;17(1):21-8.
37. Darby JB, Singh A, Quinonez R. Management of complicated pneumonia in childhood: A review of recent literatüre. Rev Recent Clin Trials. 2017;12(4):253-259. doi: 10.2174/1574887112666170816144110.
38. Annisa R, Nurhaeni N, Wanda D. Inhalation with bronchodilator combination effective in reducing length of hospital stay in children with pneumonia. Enferm Clin. 2018;28 Suppl 1:23-26. doi: 10.1016/S1130-8621(18)30030-5.
39. Prusakowski MK, Chen AP. Pediatric sepsis. Emerg Med Clin North Am. 2017;35(1):123-138. doi: 10.1016/j.emc.2016.08.008.
40. Lauderbaugha D, Holubb P, Turnerc K, Popien T. Reducing ventilator associated pneumonia in the NICU through oral care education: a quality improvement Project. Journal of Neonatal Nursing. 2019;25(3):127-29. doi: 10.1016/j.jnn.2019.01.001.
41. Arpacı T, Altay N. Yenidoğan yoğun bakım ünitelerinde bireyselleştirilmiş gelişimsel bakım: Güncel yaklaşımlar. Türkiye Klinikleri. 2017;9(3):245-54.
42. Kaynak S, Yılmaz HB, Başbakkal Z, Yardımcı F. Yenidoğan yoğun bakım ünitesinde gelişimsel bakım. KSU Medical Journal. 2020;15(3):82-7.
43. Gross M, Engel C, Trotter A. Evaluating the effect of a neonatal care bundle for the prevention of intraventricular hemorrhage in preterm infants. Children. 2021;8:257. doi: 10.3390/children8040257.
44. Shah NA, Wusthoff CJ. Intracranial hemorrhage in the neonate. Neonatal Network. 2016;35(2):67-72. doi: 10.1891/0730-0832.35.2.67.
45. Yeo KT, Thomas R, Chow SS, et al. Improving incidence trends of severe intraventricular haemorrhages in preterm infants <32 weeks gestation: A cohort study. Arch Dis Child Fetal Neonatal Ed. 2020;105:145–150.
46. Kara M, Caner İ, Tekgündüz KŞ. Yenidoğan beslenmesinde sık karşılaşılan sorunlar. Klinik Tıp Pediatri Dergisi. 2016;8(2):14-18.
47. Engorn BM, Kahntroff S, Frank KM, et al. Perioperative hypothermia in neonatal intensive care unit patients: effectiveness of a thermoregulation intervention and associated risk factors. Pediatr Anaesth. 2017;27(2):196-204.
48. Kenna R. Nursing guidelines on the care of infants with thermoregulation instability 3rd ed. Nurse Practice. 2017;3:1-29.
49. Çiğdem Z. Yenidoğan cildinin özellikleri ve değerlendirilmesi. Türkiye Klinikleri Pediatric Nursing-Special Topics. 2015;1(2):1-5.
50. Madhu R, Chandran VV, Anandan V, et al. Indian academy of pediatrics guidelines for pediatric skin care. Indian Pediatrics. 2021;58(15):153-61.
51. Peytavi UB, Lavender T, Jenerowicz D, et al. Recommendations from a European Round Table Meeting on best practice healthy infant skin care. Pediatr Dermatol. 2016;33:311-21.

Neonatal Pnömonide Hemşirelik Bakımı

Year 2023, Issue: 21, 1286 - 1303, 05.01.2024

Semra Söngüt

https://doi.org/10.38079/igusabder.1257070

Abstract

Neonatal pnömoni, başta bakteriler olmak üzere çeşitli mikroorganizmaların neden olduğu, yüksek mortalite ve morbidite potansiyeli olan ciddi bir solunum yolu enfeksiyon hastalığıdır. Neonatal pnömoni, özellikle gelişmekte olan ülkeler için önemli bir sağlık sorunu olmaya devam etmekte olup, Dünyada her yıl 1 yaşından küçük 152.000-490.000 bebeğin pnömoniden öldüğü bildirilmektedir. %1-35 arasında insidansa sahip olan neonatal pnömoni, term bebekler için %1, preterm bebekler için ise %10 sıklığında görülmektedir. İnsidans; gebelik yaşı, entübasyon durumu, yenidoğan bakım düzeyi ve standardı, ırk ve sosyoekonomik duruma göre değişiklik göstermektedir. Pnömoniye bağlı ölüm oranı genellikle gebelik yaşı ve doğum ağırlığı ile ters orantılıdır. Neonatal pnömoniler başlangıç zamanına göre “Konjenital ve Erken Başlangıçlı Pnömoni” ile “Geç Başlangıçlı Pnömoni” olarak sınıflandırılmakta olup, maternal, perinatal ve mekanik ventilasyon gibi pek çok risk faktörü bulunmaktadır. Neonatal pnömonide klinik belirtiler spesifik olmayıp, semptomlar arasında çeşitli derecelerde solunum sıkıntısı, şüpheli görünen trakeal aspiratlar, öksürük, apne, unstabil vücut sıcaklığı, yetersiz beslenme, abdominal distansiyon ve letarji yer almaktadır. Bu doğrultuda pediatri hemşireleri, pnömoni tanısı bulunan yenidoğanların hemşirelik bakımında çoğunlukla destekleyici bakım uygulamakla birlikte, bebeğin solunum durumu ve oksijenasyonunu, sıvı durumunu ve sepsis riskini rutin olarak izlemesi ve değerlendirmesi gerekmektedir.

Keywords

Hemşirelik bakımı, neoanatal pnömoni, pediatri hemşiresi

Supporting Institution

Project Number

References

1. Hooven TA, Polin RA. Pneumonia. Seminars in Fetal & Neonatal Medicine. 2017;22(4):206-13. doi: 10.1016/j.siny.2017.03.002.
2. Özer EA, Demirel G, Tüzün F. Term yenidoğanda solunum sıkıntısı tanı, tedavi ve korunma rehberi. Türk Neonatoloji Derneği. 2021:24-30.
3. Reiterer F. Neonatal Pneumonia. In: Resch R, ed. Neonatal Bacterial Infection. 2013:19-32. doi: 10.5772/54310.
4. Viscardi RM. Prenatal and postnatal microbial colonisation and respiratory outcome in preterm infants. In: Bancaları E, Polin R, eds. The Newborn Lung. 2nd edn. 2012:135-162.
5. Whidbey C, Vornhagen J, Gendrin C, et al. A streptococcal lipid toxin induces membrane permeabilization and pyroptosis leading to fetal injury. EMBO Mol Med. 2015;7(4):488–505.
6. Spaan AN, Henry T, van Rooijen WJM, et al. The staphylococcal toxin panton-valentine leukocidin targets human c5a receptors. Cell Host Microbe. 2013;13(5):584-94.
7. Wynn JL, Wong HR. Pathophysiology and treatment of septic shock in neonates. Clin Perinatol. 2010;37(2):439-79.
8. Hutton EK, Thorpe J. Consequences of meconium stained amniotic fluid: What does the evidence tell us? Early Hum Dev. 2014;90(7):333-9.
9. Lamagni TL, Keshishian C, Efstratiou A, et al. Emerging trends in the epidemiology of invasive group b streptococcal disease in England and wales, 1991-2010. Clin Infect Dis. 2013;57(5):682-8.
10. Garland JS. Strategies to prevent ventilator-associated pneumonia in neonates. Clin Perinatol. 2010;37(3):629-43.
11. Britt RD, Faksh A, Vogel E, Martin RJ, Pabelick CM, Prakash YS. Perinatal factors in neonatal and pediatric lung diseases. Expert Rev Respir Med. 2013;7(5):515-31.
12. Dowling DJ, Levy O. Ontogeny of early life immunity. Trends Immunol. 2014;35(7):299-310.
13. Saini Y, Wilkinson KJ, Terrell KA, et al. Neonatal pulmonary macrophage depletion coupled to defective mucus clearance increases susceptibility to pneumonia and alters pulmonary immune responses. Am J Respir Cell Mol Biol. 2016;54:210-21.
14. Curfman AL, Glissmeyer EW, Ahmad FA, et al. Initial presentation of neonatal herpes simplex virus infection. J Pediatr. 2016;172:121-126.e1.
15. James SH, Kimberlin DW. Neonatal herpes simplex virus infection. Infect Dis Clin North Am. 2015;29(3):391-400.
16. Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213(4 Suppl):S29-52.
17. Kawanishi F, Yoshinaga M, Morita M, et al. Risk factors for ventilator-associated pneumonia in neonatal intensive care unit patients. J Infect Chemother. 2014;20(10):627-30.
18. Wójkowska-Mach J, Borszewska-Kornacka M, Domańska, J, et al. Early-onset infections of very-low-birth-weight infants in polish neonatal intensive care units. Pediatr Infect Dis J. 2012;31(7):691-5. doi: 10.1097/INF.0b013e3182567b74.
19. Cernada M, Aguar M, Brugada M, et al. Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique. Pediatr Crit Care Med. 2013;14(1):55-61.
20. Hastalık Kontrol ve Önleme Merkezleri (CDC). Pneumonia (Ventilator-associated [VAP] and nonventilator-associated pneumonia [PNEU]) Event. https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf. Erişim Tarihi 15 Haziran 2022.
21. Cantey JB, Patel SJ. Antimicrobial stewardship in the NICU. Infect Dis Clin North Am. 2014;28(2):247-61.
22. Brady MT, Polin RA. Prevention and management of infants with suspected or proven neonatal sepsis. Pediatrics. 2013;132(1):166-8.
23. Matera MG, Rogliani P, Ora J, Cazzola M. Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents. Expert Opin Pharmacother. 2018;19(18):2043-2053.
24. Ebeledike C, Ahmad T, Martin SD. Pediatric pneumonia (Nursing). Updated 2020 Nov 21. In: StatPearls, 2020. https://www.ncbi.nlm.nih.gov/books/NBK568682/#nurse-article-27365.r21. Erişim Tarihi 17 Haziran 2022.
25. Amerikan Pediatri Akademisi- American Academy of Pediatrics. Herpes Simplex. In: Kimberlin DW, Brady MT, Jackson MA, eds. Red Book: Report of the Committee on Infectious Diseases. 31st edn. Elk Grove Village; 2018:437.
26. Kimberlin DW, Jester PM, Sanchez PJ, et al. Valganciclovir for symptomatic congenital cytomegalovirus disease. N Engl J Med. 2015;372(10):933-43.
27. Azab SFA, Sherbiny HS, Saleh SH, et al. Reducing ventilator-associated pneumonia in neonatal intensive care unit using “VAP prevention bundle: a cohort study. BMC Infect Dis. 2015;15(1):314.
28. Weber CD. Applying adult ventilator-associated pneumonia bundle evidence to the ventilated neonate. Adv Neonatal Care. 2016;16(3):178-90.
29. Türk Toraks Derneği. https://toraks.org.tr/site/community/library/3. Erişim Tarihi 15 Haziran 2022.
30. Mojen KL, Rassouli M, Tajalli S, Baghestani AR, Jafari Z. Clinical assessment of nursing care regarding prevention of ventilator-associated pneumonia in neonates. Iranian Journal of Neonatology. 2019;10(4):19-24. doi10.22038/ijn.2019.37550.1581.
31. Dipanjali R, Shivananda PM, Yashoda S. Effectiveness of an educational intervention on knowledge and practice of staff nurses on prevention of ventilator associated pneumonia among neonates in neonatal intensive care unit. International Journal of Caring Sciences. 2020;13(2):1421-30.
32. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Society of Critical Care Medicine. 2017;45(3):486-552. doi: 10.1097/CCM.0000000000002255.
33. Erdemir F, Türk G. Hemşirelik Tanıları El Kitabı. 15. ed. Çeviri: Carpenito LJ. Handbook of Nursing Diagnosis 15th Edition. Ankara: Nobel Tıp Kitabevleri Tic.Ltd. Şti. 2021.
34. Kleinpell R, Blot S, Boulanger C, Fulbrook P, Blackwood B. International critical care nursing considerations and quality indicators for the 2017 surviving sepsis campaign guidelines. Intensive Care Medicine. 2019;45:1663–66.
35. Aitken LM, Williams G, Harvey M, et al. Nursing considerations to complement the surviving sepsis campaign guidelines. Crit Care Med. 2011;39(7):1800-18.
36. Düzkaya DS, Bozkurt G. Çocuklarda sepsis ve hemşirelik bakımı. Yoğun Bakım Hemşireliği Dergisi. 2013;17(1):21-8.
37. Darby JB, Singh A, Quinonez R. Management of complicated pneumonia in childhood: A review of recent literatüre. Rev Recent Clin Trials. 2017;12(4):253-259. doi: 10.2174/1574887112666170816144110.
38. Annisa R, Nurhaeni N, Wanda D. Inhalation with bronchodilator combination effective in reducing length of hospital stay in children with pneumonia. Enferm Clin. 2018;28 Suppl 1:23-26. doi: 10.1016/S1130-8621(18)30030-5.
39. Prusakowski MK, Chen AP. Pediatric sepsis. Emerg Med Clin North Am. 2017;35(1):123-138. doi: 10.1016/j.emc.2016.08.008.
40. Lauderbaugha D, Holubb P, Turnerc K, Popien T. Reducing ventilator associated pneumonia in the NICU through oral care education: a quality improvement Project. Journal of Neonatal Nursing. 2019;25(3):127-29. doi: 10.1016/j.jnn.2019.01.001.
41. Arpacı T, Altay N. Yenidoğan yoğun bakım ünitelerinde bireyselleştirilmiş gelişimsel bakım: Güncel yaklaşımlar. Türkiye Klinikleri. 2017;9(3):245-54.
42. Kaynak S, Yılmaz HB, Başbakkal Z, Yardımcı F. Yenidoğan yoğun bakım ünitesinde gelişimsel bakım. KSU Medical Journal. 2020;15(3):82-7.
43. Gross M, Engel C, Trotter A. Evaluating the effect of a neonatal care bundle for the prevention of intraventricular hemorrhage in preterm infants. Children. 2021;8:257. doi: 10.3390/children8040257.
44. Shah NA, Wusthoff CJ. Intracranial hemorrhage in the neonate. Neonatal Network. 2016;35(2):67-72. doi: 10.1891/0730-0832.35.2.67.
45. Yeo KT, Thomas R, Chow SS, et al. Improving incidence trends of severe intraventricular haemorrhages in preterm infants <32 weeks gestation: A cohort study. Arch Dis Child Fetal Neonatal Ed. 2020;105:145–150.
46. Kara M, Caner İ, Tekgündüz KŞ. Yenidoğan beslenmesinde sık karşılaşılan sorunlar. Klinik Tıp Pediatri Dergisi. 2016;8(2):14-18.
47. Engorn BM, Kahntroff S, Frank KM, et al. Perioperative hypothermia in neonatal intensive care unit patients: effectiveness of a thermoregulation intervention and associated risk factors. Pediatr Anaesth. 2017;27(2):196-204.
48. Kenna R. Nursing guidelines on the care of infants with thermoregulation instability 3rd ed. Nurse Practice. 2017;3:1-29.
49. Çiğdem Z. Yenidoğan cildinin özellikleri ve değerlendirilmesi. Türkiye Klinikleri Pediatric Nursing-Special Topics. 2015;1(2):1-5.
50. Madhu R, Chandran VV, Anandan V, et al. Indian academy of pediatrics guidelines for pediatric skin care. Indian Pediatrics. 2021;58(15):153-61.
51. Peytavi UB, Lavender T, Jenerowicz D, et al. Recommendations from a European Round Table Meeting on best practice healthy infant skin care. Pediatr Dermatol. 2016;33:311-21.

There are 51 citations in total.

Details

Primary Language	Turkish
Subjects	Clinical Sciences
Journal Section	Articles
Authors	Semra Söngüt 0000-0003-1952-7980
Project Number	-
Early Pub Date	January 8, 2024
Publication Date	January 5, 2024
Acceptance Date	December 5, 2023
Published in Issue	Year 2023 Issue: 21

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JAMA	Söngüt S. Neonatal Pnömonide Hemşirelik Bakımı. IGUSABDER. 2024;:1286–1303.

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