Browsing by Author "Van Wyk, L."
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- ItemNeonatal hypotension survey : a South African perspective(Health & Medical Publishing Group, 2019-06-25) Van Wyk, L.; Smith, J.; Hall, M.Background. Neonatal hypotension remains one of the most controversial topics in neonatology. Various definitions are used but lack an evidence base. Owing to the variation in defining a low blood pressure (BP), significant differences in pharmacological manipulation of BP are evident. Objectives. The aim of the present research was to determine the diagnostic criteria for neonatal hypotension and management strategies for neonatal hypotension in South Africa. Methods. A 29-point questionnaire was designed to determine the criteria used by South African neonatologists and paediatricians to diagnose and manage neonatal hypotension. The survey was conducted at two different time points in 2017. Results. The combination of the two surveys resulted in a 9.3% (47/507) response rate. A BP below the gestational age (in weeks) was the most common definition used for neonatal hypotension (75%). Most clinicians (86%) administered fluid prior to initiating inotrope therapy. Dopamine, dobutamine and adrenaline were the most common first-, second- and third-line anti-hypotensive drugs used. Most clinicians (77%) did not use a hypotension management guideline. Conclusion. Neonatal hypotension definition and management in South Africa are similar to international patterns, despite a lack of evidence to support the diagnosis and management strategies.
- ItemScreening for gestational diabetes : examining a breakfast meal test(MedPharm Publications, 2016) Marais, Colin; Van Wyk, L.; Conradie, M.; Hall, D.Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal Clinic at Tygerberg Academic Hospital, Cape Town, South Africa. Subjects: Fifty pregnant women who met the local selection criteria for diabetes screening. Outcome measures: The contents of the patient-provided breakfast meal tests were evaluated individually for total carbohydrate amount and compared with the 75 grams of carbohydrate provided by the oral glucose tolerance test (OGTT). Results: The median carbohydrate amount was 71 g but the range (55–145 g) was wide. Only seven meals (14%) fell within 10% of the 75 g carbohydrate target. Conclusion: The patient-provided breakfast meal showed wide variation in carbohydrate amount. If a meal test is to be used instead of the formal OGTT a carefully measured, prepared, palatable, readily available product would need to be sourced and provided.