Anemia of Prematurity - Portal Neonatal

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PICTURES Section 10 of 11 Picture 1. Central apnea is defined as the cessation of both airflow and respiratory effort. Picture 2. Mixed apnea contains elements of both central and obstructive apnea. Picture 3. Periodic breathing is defined as periods of regular respiration for as long as 20 seconds followed by apneic periods no longer than 10 seconds that occur at least 3 times in succession. Picture 4. Apnea monitoring in a premature neonate
BIBLIOGRAPHY Section 11 of 11 • Barrington KJ, Finer N, Li D: Predischarge respiratory recordings in very low birth weight newborn infants. J Pediatr 1996 Dec; 129(6): 934-40[Medline]. • Booth IW: Silent gastro-oesophageal reflux: how much do we miss? Arch Dis Child 1992 Nov; 67(11): 1325-7[Medline]. • Brooks JG: Apparent life-threatening events and apnea of infancy. Clin Perinatol 1992 Dec; 19(4): 809-38[Medline]. • Butcher-Puech MC, Henderson-Smart DJ, Holley D: Relation between apnoea duration and type and neurological status of preterm infants. Arch Dis Child 1985 Oct; 60(10): 953-8. • Carlo WA, Martin RJ, Versteegh FG: The effect of respiratory distress syndrome on chest wall movements and respiratory pauses in preterm infants. Am Rev Respir Dis 1982; 126(1): 103-7 • Darnall RA, Kattwinkel J, Nattie C: Margin of safety for discharge after apnea in preterm infants. Pediatrics 1997 Nov; 100(5): 795-801[Medline]. • Eichenwald EC, Aina A, Stark AR: Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks. Pediatrics 1997 Sep; 100(3 Pt 1): 354-9[Medline]. • Gerhardt T, Bancalari E: Apnea of prematurity: I. Lung function and regulation of breathing. Pediatrics 1984 Jul; 74(1): 58-62[Medline]. • Gerhardt T, Bancalari E: Apnea of prematurity: II. Respiratory reflexes. Pediatrics 1984 Jul; 74(1): 63-6[Medline]. • Henderson-Smart DJ, Ponsonby AL, Murphy E: Reducing the risk of sudden infant death syndrome: a review of the scientific literature. J Paediatr Child Health 1998 Jun; 34(3): 213-9 • Henderson-Smart DJ, Butcher-Puech MC, Edwards DA: Incidence and mechanism of bradycardia during apnoea in preterm infants. Arch Dis Child 1986 Mar; 61(3): 227-32. • Jardine DS, Rogers K: Relationship of benzyl alcohol to kernicterus, intraventricular hemorrhage, and mortality in preterm infants. Pediatrics 1989 Feb; 83(2): 153-60[Medline]. • Kelly DH, Shannon DC: Periodic breathing in infants with near-miss sudden infant death syndrome. Pediatrics 1979; 63(3): 355-60[Medline]. • Kitchen WH, Yu VY, Orgill AA: Collaborative study of very-low-birth-weight infants. Correlation of handicap with risk factors. Am J Dis Child 1983 Jun; 137(6): 555-9[Medline]. • Lipsky CL, Gibson E, Cullen JJ: When does apnea of prematurity resolve? Pediatr Res 1993; 33: 267A. • Lipsky CL, Gibson E, Cullen JA: The timing of SIDS deaths in premature infants in an urban population. Clin Pediatr (Phila) 1995 Aug; 34(8): 410-4[Medline]. • Menon AP, Schefft GL, Thach BT: Apnea associated with regurgitation in infants. J Pediatr 1985 Apr; 106(4): 625-9[Medline]. • Miller MJ, Martin RJ: Pathophysiology of apnea of prematurity. In: Fetal and Neonatal Physiology. 2nd ed. 1998: 1129-43. • Newell SJ, Booth IW, Morgan ME: Gastro-oesophageal reflux in preterm infants. Arch Dis Child 1989 Jun; 64(6): 780-6[Medline]. • Oyen N, Markestad T, Skaerven R: Combined effects of sleeping position and prenatal risk factors in sudden infant death syndrome: the Nordic Epidemiological SIDS Study. Pediatrics 1997 Oct; 100(4): 613-21[Medline]. • Perlman JM, Volpe JJ: Episodes of apnea and bradycardia in the preterm newborn: impact on cerebral circulation. Pediatrics 1985; 76(3): 333-8[Medline]. • Rigatto H, Brady JP: Periodic breathing and apnea in preterm infants. I. Evidence for hypoventilation possibly due to central respiratory depression. Pediatrics 1972 Aug; 50(2): 202-18[Medline]. • Rigatto H: Maturation of breathing. Clin Perinatol 1992 Dec; 19(4): 739-56[Medline]. • Southall DP, Levitt GA, Richards JM: Undetected episodes of prolonged apnea and severe bradycardia in preterm infants. Pediatrics 1983 Oct; 72(4): 541-51[Medline]. • Spitzer AR, Fox WW: Infant apnea. Pediatr Clin North Am 1986 Jun; 33(3): 561-81[Medline]. • Spitzer AR, Gibson E: Home monitoring. Clin Perinatol 1992 Dec; 19(4): 907-26[Medline]. • Stefano JL, Anday EK, Davis JM: Pneumograms in premature infants: a study of longitudinal data. Am J Perinatol 1991 May; 8(3): 170-3[Medline].
Page 1 and 2: e.medecine NEONATOLOGY 2006
Page 3 and 4: 24. Neonatal Hypertension..........
Page 5 and 6: Although EPO is not the only erythr
Page 7 and 8: Causes: • AOP results from a comb
Page 9 and 10: • Reducing the number of donor ex
Page 11 and 12: FOLLOW-UP Section 8 of 10 Further O
Page 13 and 14: Apnea of Prematurity Last Updated:
Page 15 and 16: The primary problem for premature n
Page 17 and 18: pressure. Bradycardia may begin wit
Page 19 and 20: TREATMENT Section 6 of 11 Medical C
Page 21 and 22: Drug Name Doxapram (Dopram) -- Stim
Page 23 and 24: Prognosis: • The natural history
Page 25: o Despite the number of premature i
Page 29 and 30: Tidal volume is the volume of gas i
Page 31 and 32: 5 time constants. The resulting tim
Page 33 and 34: Once the diagnosis of RDS is establ
Page 35 and 36: PATHOPHYSIOLOGY-BASED VENTILATORY S
Page 37 and 38: High-frequency ventilation:High-fre
Page 39 and 40: Picture 2. Determinants of oxygenat
Page 41 and 42: Birth Trauma Last Updated: August 4
Page 43 and 44: The extent of hemorrhage may be sev
Page 45 and 46: CRANIAL NERVE AND SPINAL CORD INJUR
Page 47 and 48: unpredictable unavoidable complicat
Page 49 and 50: Bowel Obstruction in the Newborn La
Page 51 and 52: The prenatal diagnosis of a bowel o
Page 53 and 54: demonstrate the normal fixation pat
Page 55 and 56: Other causes of proximal bowel obst
Page 57 and 58: Hirschsprung disease Hirschsprung d
Page 59 and 60: POSTOPERATIVE CARE FOLLOWING SURGER
Page 61 and 62: Picture 4. Bowel obstruction in the
Page 63 and 64: Breast Milk Jaundice Last Updated:
Page 65 and 66: DIFFERENTIALS Section 4 of 9 Anemia
Page 67 and 68: Consultations: Diet: • Consider c
Page 69 and 70: Bronchopulmonary Dysplasia Last Upd
Page 71 and 72: CLINICAL Section 3 of 11 History: B
Page 73 and 74: of BPD and in the need for continue
Page 75 and 76: Physical: • Infants with BPD have
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discomfort. Many new synchronized v
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treat acute bronchospasm; however,
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• Excessive glucose loads may inc
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Interactions Beta-adrenergic blocke
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Drug Category: Pulmonary vasodilato
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MISCELLANEOUS Section 9 of 11 Medic
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• Frank L, Groseclose E: Oxygen t
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• Northway WH Jr: Bronchopulmonar
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Congenital Diaphragmatic Hernia Las
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DIFFERENTIALS Section 4 of 10 Aspir
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o Inhaled nitric oxide may be used
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Drug Name Pediatric Dose Contraindi
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Drug Name Pediatric Dose Vecuronium
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Prognosis: • Pulmonary recovery:
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• O'Toole SJ, Irish MS, Holm BA:
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This article reviews the mechanics
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Positioning the infant Positioning
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stress and fatigue in both parents
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As the mother's milk supply is esta
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Engorgement Engorgement is a common
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Ethical Issues in Neonatal Care Las
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GOALS OF NEONATAL INTENSIVE CARE Se
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Other guidelines of ethical import
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In some situations, tragic situatio
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BIBLIOGRAPHY Section 8 of 8 • AAP
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CLINICAL FEATURES Section 4 of 7 Th
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Comparisons of the nutrient content
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Indomethacin is used prophylactical
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FOLLOW-UP CARE Section 5 of 7 Nearl
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BIBLIOGRAPHY Section 7 of 7 • Bha
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Fluid, Electrolyte, and Nutrition M
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Clinical evaluation • Weight fact
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o Hypernatremia is defined as a ser
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intake from protein is included in
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Energy ENTERAL NUTRITION MANAGEMENT
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growth and bone mineral content has
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Hemolytic Disease of Newborn Last U
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CLINICAL Section 3 of 11 History: W
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• Serologic tests Imaging Studies
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IVT in 1981. With ultrasonographic
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status (eg, watching for hypoglycem
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� The mechanism by which unconjug
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BIBLIOGRAPHY Section 11 of 11 • B
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Race: No racial predilection exists
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Drug Name Pediatric Dose Phytonadio
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Human Milk and Lactation Last Updat
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LACTATION Section 5 of 11 Two essen
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IMMUNOLOGIC PROPERTIES OF HUMAN MIL
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Picture 3. Human milk and lactation
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• Isaacs CE, Thormar H: The role
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Hydrops Fetalis Last Updated: June
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Also of note is a computer simulati
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Physical: The presence of any of th
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o Once disorders of hemoglobin alph
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Structural anomalies Table 2. Cardi
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o B19V o Cytomegalovirus (CMV) o Sy
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o Sjögren syndrome A (uncertain in
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most commonly thrombocytopenia, is
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Lab Studies: WORKUP Section 5 of 10
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o Karyotyping is always indicated i
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TREATMENT Section 6 of 10 Medical C
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• Space-occupying masses, which i
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of antidiabetic agents and antagoni
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Drug Name Sotalol (Betapace) -- Rec
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• Cowan RH, Waldo AL, Harris HB:
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• Silverman NH, Schmidt KG: Ventr
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At the cellular level, neuronal inj
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o Disturbances of ocular motion, su
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DIFFERENTIALS Section 4 of 10 Methy
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TREATMENT Section 6 of 10 Medical C
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Interactions Benzodiazepines, cimet
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o Allopurinol: Slight improvements
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• Patel J, Edwards AD: Prediction
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Increased insulin levels stimulate
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irth; symptoms may include jitterin
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speculated to be secondary to incre
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Procedures: o Clinical features of
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• Cardiac management o If signs o
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Pediatric Dose Contraindications In
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FOLLOW-UP Section 8 of 10 Further O
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limiting step in the process, relea
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History: CLINICAL Section 3 of 11
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at equilibrium conditions, the isom
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• A number of guidelines for the
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Exchange transfusion Exchange trans
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FOLLOW-UP Section 8 of 11 Further I
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BIBLIOGRAPHY Section 11 of 11 • A
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Kernicterus Last Updated: November
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CLINICAL Section 3 of 11 History: A
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o Extravasated blood: Significant a
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milk intake because of reduced mamm
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department and must be heavily seda
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Diet: Depending on the degree of ne
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Transfer: The recently reported cas
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Prognosis: The spectrum of neurolog
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Picture 5. Kernicterus. Neuronal ch
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Airway obstruction Complete obstruc
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MEDICATION Section 7 of 11 In addit
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Drug Category: Sedatives -- Maximiz
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Transfer: • Although stabilizatio
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BIBLIOGRAPHY Section 11 of 11 • A
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occurs even later (ie, during days
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• Delivery room management of inf
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MISCELLANEOUS Section 7 of 9 Medica
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Necrotizing Enterocolitis Last Upda
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Race: Some studies indicate higher
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o With abdominal ultrasonography, a
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o Stage IB � Diagnosis is the sam
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Pregnancy C - Safety for use during
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Drug Name Epinephrine (Adrenaline)
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Pediatric Dose Contraindications In
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• Short-gut syndrome o This is a
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Picture 5. Necrotizing enterocoliti
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Neonatal Hypertension Last Updated:
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o Although BP readings obtained usi
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Other Problems to be Considered: Re
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as nitroprusside, that may make it
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Surgical Care: Surgery is rarely in
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decrease in cardiac output; triazol
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Contraindications Documented hypers
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• Flynn JT: Neonatal hypertension
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Neonatal Resuscitation Last Updated
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Fetal pulmonary physiology The feta
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Flow studies have revealed that rel
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Table 2. Equipment for Neonatal Res
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Airway management Once the infant i
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Cardiovascular support and chest co
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Once the appropriate functional res
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Premature infants are also at high
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Because secretions or oral feedings
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The team should be led and organize
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Intubation and suctioning for mecon
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Neonatal Sepsis Last Updated: June
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The fetus has some preimmune immuno
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when chorioamnionitis accompanies t
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weeks of infection, the proportion
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cultures, clinicians may elect to c
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o The clinician may require differe
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Precautions Drug Name Pediatric Dos
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Pregnancy B - Usually safe but bene
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Neural Tube Defects in the Neonatal
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An experienced pediatrician or surg
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EPIDEMIOLOGY Section 3 of 11 Severa
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ETIOLOGY Section 5 of 11 Over the l
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AFP concentration in the maternal s
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separated his patients into 3 diffe
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Head ultrasound can be performed du
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OUTCOME AND PROGNOSIS OF CHILDREN W
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Picture 2. Neural tube defects in t
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Picture 8. Neural tube defects in t
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• Sutton LN, Adzick NS, Bilaniuk
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Pathophysiology: • The umbilical
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• Omphalitis also may be the init
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• Supportive care: In addition to
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Drug Name Clindamycin (Cleocin) --
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multiple organisms) that lead direc
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• McKenna H, Johnson D: Bacteria
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Several processes combine to form t
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Frequency: • In the US: Combined
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• Polyhydramnios suggests fetal i
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aby with a giant omphalocele or in
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Prognosis: without extensively unde
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Picture 3. Omphalocele and gastrosc
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Picture 11. Omphalocele and gastros
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Picture 20.Omphalocele and gastrosc
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Perinatal Drug Abuse and Neonatal D
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Race: • The difficulty in assessi
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ehavioral and cognitive changes. Ma
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• All medically treated newborns
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Drug Category: Barbiturates -- Alth
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• Cognitive and developmental def
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Perioperative Pain Management in Ne
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The relative potency of each volati
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Opioid administration remains the m
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Use a short beveled needle to minim
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• Lerman J, Robinson S, Willis MM
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Pathophysiology: Site of origin The
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Pathogenesis of sequelae The major
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• Hypertension or beat-to-beat va
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Interactions suspected necrotizing
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PICTURES Section 10 of 11 Picture 1
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Picture 8. Periventricular hemorrha
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• Roberts JR: Drug therapy in inf
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Following the initial insult, wheth
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FOLLOW-UP Section 7 of 10 Further O
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Picture 6. Cranial CT scan, axial i
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Polycythemia of the Newborn Last Up
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Causes: • Increased fetal erythro
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FOLLOW-UP Section 7 of 9 Further In
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Polyhydramnios and Oligohydramnios
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Causes: umbilical artery, gastroint
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TREATMENT Section 5 of 9 Medical Ca
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Prognosis: • Polyhydramnios o If
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Pulmonary Interstitial Emphysema La
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compared to 39 of 169 among infants
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• Selective main bronchial intuba
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• Other considerations o Avoid us
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• Gaylord MS, Quissell BJ, Lair M
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The components of pulmonary surfact
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WORKUP Section 5 of 11 Lab Studies:
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in infants who respond poorly or ar
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intensive care setting, and be anxi
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Table 6. Meta-Analysis of Clinical
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Drug Name Pediatric Dose of acute a
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The postnatal use of surfactant the
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Picture 5. A schematic diagram of t
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Retinopathy of Prematurity Last Upd
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• Examination recommendations Oth
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Picture 5. Retinopathy of prematuri
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• Raju TN, Langenberg P, Bhutani
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• Contractility is a semiquantita
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• Uncompensated o During uncompen
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mL/kg of volume expansion should re
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MEDICATION Section 7 of 10 Drug Cat
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Drug Name cyanide toxicity; sodium
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Pregnancy Precautions Drug Name fur
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Transient Tachypnea of the Newborn
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DIFFERENTIALS Section 4 of 11 Pneum
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Drug Name Pediatric Dose Gentamicin
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Transport of the Critically Ill New
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Communications To initiate the tran
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Table 1. Advantages and disadvantag
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Table 2. A comparison of the advant
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Flight team personnel also are affe
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PICTURES Section 10 of 11 Picture 1
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Anemia of Prematurity - Portal Neonatal

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