Neonatal Death. What is neonatal death? Neonatal death is when a baby dies in Neonatal sepsis. Perinatal viral infections.
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Neonatal Death. What is neonatal death? Neonatal death is when a baby dies in Neonatal sepsis. Perinatal viral infections. Fanaroff and Martin's Neonatal -Perinatal Postnatal bacterial infections. Neonatal hypertension. Neonatal hypertension HT is a frequently under reported condition and is seen uncommonly in the intensive care unit. It has been diagnosed long back but still is the least studied field in neonatology.
There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes.
There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.
Neonatal Hypoglycemia. Lower blood glucose values are common in the healthy neonate immediately after birth as compared to older infants, children, and adults.
These transiently lower glucose values improve and reach normal ranges within hours after birth. Such transitional hypoglycemia is common in the healthy newborn.
A minority of neonates experience a more prolonged and severe hypoglycemia, usually associated with specific risk factors and possibly a congenital hypoglycemia syndrome.
Despite the lack of a specific blood glucose value that defines hypoglycemia, concern for substantial neurologic morbidity in the neonatal population has led to the generation of guidelines by both the American Academy of Pediatrics AAP and the Pediatric Endocrine Society PES. Similarities between the 2 guidelines include recognition that the transitional form of neonatal hypoglycemia likely resolves within 48 hours after birth and that hypoglycemia that persists beyond that duration may be pathologic.
One major difference between the 2 sets of guidelines is the goal blood glucose value in the neonate. This article reviews transitional and pathologic hypoglycemia in the neonate and presents a framework for understanding the nuances of the AAP and PES guidelines for neonatal hypoglycemia.
All rights reserved. Neonatal pain. PubMed Central. Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools.
However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates , but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development.
Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose.
There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback.
Neonatal hypoglycemia. Enhanced understanding of metabolic disturbances and genetic disorders that underlie alterations in postnatal glucose homeostasis has added useful information to understanding transitional hypoglycemia. This growth in knowledge still has not led to what we need to know: "How low is too low and for how long? Glucose is essential for cerebral metabolism.
Unsurprisingly therefore, hypoglycemia may result in encephalopathy. Knowledge of the homeostatic mechanisms that maintain blood glucose concentrations within a tight range is the key for diagnosis and appropriate management of hypoglycemia. Neonatal hypoglycemia can be transient and is commonly observed in at-risk infants.
A wide range of rare endocrine and metabolic disorders can present with neonatal hypoglycemia, of which congenital hyperinsulinism is responsible for the most severe form of hypoglycemia. Collection of appropriate blood samples for hormones and intermediary metabolites during an episode of hypoglycemia is critical for diagnosis and appropriate management. Prompt diagnosis with aggressive early intervention remains the mainstay of treatment to avert irreversible brain damage.
The screening and management for neonatal hypoglycemia remains a confusing and contentious problem in neonatology. The purpose of this article is to contrast recent recommendations from the American Academy of Pediatrics and the Pediatric Endocrine Society.
Using different methodologies, the organizations have significant differences on whom to screen and what levels of glucose should be used for management.
The neuroendocrine approach is contrasted with a neurodevelopmental strategy to find levels that exceed those associated with neuroglycopenia.
The questions remain the same when it comes to screening and management of neonatal low-glucose levels. Recent outcome studies with differing results continue to add to the controversy as to what to do at the bedside. It is uncertain if universal screening of glucose levels in the first hours should be applied to all newborn infants.
Persistent hypoglycemic syndromes must be identified prior to discharge. Hypoglycemia in the newborn may be associated with both acute decompensation and long-term neuronal loss. Studies of the cause of hypoglycemic brain damage and the relationship of hypoglycemia to disorders associated with hyperinsulinism have aided in our understanding of this common clinical finding.
A recent consensus workshop concluded that there has been little progress toward a precise numerical definition of neonatal hypoglycemia. Nonetheless, newer brain imaging modalities have provided insight into the relationship between neuronal energy deficiency and central nervous system damage. Laboratory studies have begun to reveal the mechanism of hypoglycemic damage. In addition, there is new information about hyperinsulinemic hypoglycemia of genetic, environmental, and iatrogenic origin.
The quantitative definition of hypoglycemia in the newborn remains elusive because it is a surrogate marker for central nervous system energy deficiency. Nonetheless, the recognition that hyperinsulinemic hypoglycemia, which produces profound central nervous system energy deficiency, is most likely to lead to long-term central nervous system damage, has altered management of children with hypoglycemia. In addition, imaging studies on neonates and laboratory evaluation in animal models have provided insight into the mechanism of neuronal damage.
Neonatal euthanasia. Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts.
Due to the realization that some infants suffer unbearably ie, the burdens of suffering outweigh the benefits of life , the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.
However, birth asphyxia is a worldwide problem and can lead to death or serious sequelae. Assisted ventilation in preterm infants is briefly described.
New devices to improve the care of newborn infants, such as the laryngeal mask airway or CO2 detectors to confirm tracheal tube placement, are also discussed. Significant changes have occurred in some practices and are included in this document. Neonatal transport is necessary where a neonate is transferred between two care units. It provides all the skills of a dedicated team, representing a real mobile neonatal intensive care unit. Informing and involving the families is essential during this transport, which can be a source of stress for the child and its family.
Neonatal gastric perforation. Gastric perforation in neonates is a catastrophe associated with high morbidity. Most are due to underlying primary pathology. Retrospective study of consecutive complete data sets of neonates presenting with gastric perforation. Department of Paediatric Surgery, Nelson R. Eight neonates treated for gastric perforation between January and April Morbidity and mortality.
There was an equal number of males and females. Median birth weight was 2. Five of the eight neonates were premature. Primary pathologies were associated with perforation in seven of the eight neonates. Prematurity, low birth weight and pneumonia were contributing factors to the poor outcome. Active perinatal management, early treatment of primary pathologies, and protection of the stomach against distension in neonates at risk are essential in the management of neonatal gastric perforation.
Neonatal fluid management. Perioperative fluid management in paediatrics has been the subject of many controversies in recent years, but fluid management in the neonatal period has not been considered in most reviews and guidelines. The literature regarding neonatal fluid management mainly appears in the paediatric textbooks and few recent data are available, except for resuscitation and fluid loading during shock and major surgery.
This article aims at reviewing basic physiological considerations important for neonatal fluid management and mainly focusses on fluid maintenance and replacement during surgery. Controversies in neonatal resuscitation. Despite recent advances in perinatal medicine and in the art of neonatal resuscitation, resuscitation strategy and treatment methods in the delivery room should be individualized depending on the unique characteristics of the neonate.
The constantly increasing evidence has resulted in significant treatment controversies, which need to be resolved with further clinical and experimental research. Oral Lesions in Neonates. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease.
The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. Int J Clin Pediatr Dent ;9 2 Neonatal head injuries.
Important User Information: Remote access to EBSCO's databases is permitted to patrons of subscribing institutions accessing from remote locations for personal, non-commercial use. However, remote access to EBSCO's databases from non-subscribing institutions is not allowed if the purpose of the use is for commercial gain through cost reduction or avoidance for a non-subscribing institution. Abstract: Acute dacryocystitis is an inflammation of the lacrimal sac and nasolacrimal duct, mostly secondary infection process, or senile duct stenosis, trauma, tumors, sinusitis, or chronic conjunctivitis and canaliculitis. The age groups most affected are infants and elderly, especially women.
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Estesioneuroblastoma Atypical acute dacryocystitis. Case report: We report the case of a 15 year-old-woman who was diagnosed with acute dacryocystitis in her left eye. After a dacryocystorhinostomy she presented a relapse of her medical profile.