Anemia of Prematurity - Portal Neonatal

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• Laurence KM: Effect of early surgery for spina bifida cystica on survival and quality of life. Lancet 1974 Feb 23; 1(7852): 301-4[Medline]. • Lemire RJ: Neural tube defects. JAMA 1988 Jan 22-29; 259(4): 558-62[Medline]. • Lemire RJ, Beckwith JB, Warkany J: Anencephaly. NY: Raven Press; 1978:1-271. • Lindhout D, Omtzigt JG: Teratogenic effects of antiepileptic drugs: implications for the management of epilepsy in women of childbearing age . Epilepsia 1994; 35: S19-28[Medline]. • Lorber J, Ward AM: Spina bifida--a vanishing nightmare? Arch Dis Child 1985 Nov; 60(11): 1086-91[Medline]. • Luthy DA, Wardinsky T, Shurtleff DB, et al: Cesarean section before the onset of labor and subsequent motor function in infants with meningomyelocele diagnosed antenatally [see comments]. N Engl J Med 1991 Mar 7; 324(10): 662-6[Medline]. • MacMahon B, Yen S, Rothman KJ: Potato blight and neural-tube defects. Lancet 1973 Mar 17; 1(7803): 598-9[Medline]. • Mangels KJ, Tulipan N, Tsao LY, et al: Fetal MRI in the evaluation of intrauterine myelomeningocele. Pediatr Neurosurg 2000 Mar; 32(3): 124-31[Medline]. • Marin-Padilla M: Cephalic axial skeletal-neural dysraphic disorders: embryology and pathology. Can J Neurol Sci 1991 May; 18(2): 153-69[Medline]. • McLone DG, Naidich TP: Developmental morphology of the subarachnoid space, brain vasculature, and contiguous structures, and the cause of the Chiari II malformation. AJNR Am J Neuroradiol 1992 Mar-Apr; 13(2): 463-82[Medline]. • McLone DG: Continuing concepts in the management of spina bifida. Pediatr Neurosurg 1992; 18(5-6): 254-6[Medline]. • Menkes JH, Sarnat HB: Malformations of the Central Nervous Sytem. Child Neurology 2000; 2: 305-331. • Mills JL, Conley MR: Periconceptional vitamin supplementation to prevent neural tube defects: how can we do it? . Eur J Obst Gynecol Reprod Biol 1995; 61: 49-55[Medline]. • Morales PA: Urologic management of children with myelomeningocele. Med Clin North Am 1969 May; 53(3): 496-501[Medline]. • Moskowitz D, Shurtleff DB, Weinberger E, et al: Anatomy of the spinal cord in patients with meningomyelocele with and without hypoplasia or hydromyelia. Eur J Pediatr Surg 1998 Dec; 8 Suppl 1: 18-21[Medline]. • MRC Vitamin Study Research Group: Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991 Jul 20; 338(8760): 131-7[Medline]. • Naggan L, MacMahon B: Ethnic differences in the prevalence of anencephaly and sina bifida in Boston, Massachusetts. N Engl J Med 1967 Nov 23; 277(21): 1119-23[Medline]. • Park TS: Myelomeningocele. In: Principles and Practice of Pediatric Neurosurgery. Thieme Medical Publishers; 1999:291-320. • Roberts HE, Moore CA, Cragan JD, et al: Impact of prenatal diagnosis on the birth prevalence of neural tube defects, Atlanta, 1990-1991. Pediatrics 1995 Nov; 96(5 Pt 1): 880- 3[Medline]. • Rosa FW: Spina bifida in infants of women treated with carbamazepine during pregnancy. N Engl J Med 1991 Mar 7; 324(10): 674-7[Medline]. • Shurtleff D, Lemire R, Warkany J: Embryology, etiology, and epidemiology. In: Myelodysplasias and Exstrophies: Significance, Prevention and Treatments. NY: WB Saunders Co; 1986:39-64. • Shurtleff DB, Lemire RJ: Epidemiology, etiologic factors, and prenatal diagnosis of open spinal dysraphism. Neurosurg Clin N Am 1995 Apr; 6(2): 183-93[Medline]. • Smith MS, Edwards MJ, Upfold JB: The effects of hyperthermia on the fetus. Dev Med Child Neurol 1986 Dec; 28(6): 806-9[Medline]. • Smithells RW, Sheppard S, Schorah CJ: Vitamin dificiencies and neural tube defects. Arch Dis Child 1976 Dec; 51(12): 944-50[Medline]. • Smithells RW, Sheppard S, Schorah CJ, et al: Apparent prevention of neural tube defects by periconceptional vitamin supplementation. Arch Dis Child 1981 Dec; 56(12): 911-8[Medline]. • Smithells RW, Sheppard S, Schorah CJ, et al: Possible prevention of neural-tube defects by periconceptional vitamin supplementation. Lancet 1980 Feb 16; 1(8164): 339-40[Medline]. • Stein SC, Feldman JG, Friedlander M, et al: Is myelomeningocele a disappearing disease? Pediatrics 1982 May; 69(5): 511-4[Medline]. • Steinbok P, Irvine B, Cochrane DD, et al: Long-term outcome and complications of children born with meningomyelocele . Child's Nerv Syst 1992; 8: 92-96[Medline].
• Sutton LN, Adzick NS, Bilaniuk LT, et al: Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele [see comments]. JAMA 1999 Nov 17; 282(19): 1826-31[Medline]. • Tulipan N, Hernanz-Schulman M, Lowe LH, et al: Intrauterine myelomeningocele repair reverses preexisting hindbrain herniation. Pediatr Neurosurg 1999 Sep; 31(3): 137- 42[Medline]. • Tulipan N, Hernanz-Schulman M, Bruner JP: Reduced hindbrain herniation after intrauterine myelomeningocele repair: A report of four cases. Pediatr Neurosurg 1998 Nov; 29(5): 274- 8[Medline]. • Tulipan N, Bruner JP: Myelomeningocele repair in utero: a report of three cases. Pediatr Neurosurg 1998 Apr; 28(4): 177-80[Medline]. • Yates JR, Ferguson-Smith MA, Shenkin A, et al: Is disordered folate metabolism the basis for the genetic predisposition to neural tube defects? Clin Genet 1987 May; 31(5): 279- 87[Medline]. • Yen IH, Khoury MJ, Erickson JD: The changing epidemiology of neural tube defects. United States, 1968- 1989. Am J Dis Child 1992 Jul; 146(7): 857-61[Medline]. Neural Tube Defects in the Neonatal Period excerpt © Copyright 2005, eMedicine.com, Inc.
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e.medecine NEONATOLOGY 2006
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24. Neonatal Hypertension..........
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Although EPO is not the only erythr
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Causes: • AOP results from a comb
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• Reducing the number of donor ex
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FOLLOW-UP Section 8 of 10 Further O
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Apnea of Prematurity Last Updated:
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The primary problem for premature n
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pressure. Bradycardia may begin wit
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TREATMENT Section 6 of 11 Medical C
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Drug Name Doxapram (Dopram) -- Stim
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Prognosis: • The natural history
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o Despite the number of premature i
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BIBLIOGRAPHY Section 11 of 11 • B
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Tidal volume is the volume of gas i
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5 time constants. The resulting tim
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Once the diagnosis of RDS is establ
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PATHOPHYSIOLOGY-BASED VENTILATORY S
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High-frequency ventilation:High-fre
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Picture 2. Determinants of oxygenat
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Birth Trauma Last Updated: August 4
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The extent of hemorrhage may be sev
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CRANIAL NERVE AND SPINAL CORD INJUR
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unpredictable unavoidable complicat
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Bowel Obstruction in the Newborn La
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The prenatal diagnosis of a bowel o
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demonstrate the normal fixation pat
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Other causes of proximal bowel obst
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Hirschsprung disease Hirschsprung d
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POSTOPERATIVE CARE FOLLOWING SURGER
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Picture 4. Bowel obstruction in the
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Breast Milk Jaundice Last Updated:
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DIFFERENTIALS Section 4 of 9 Anemia
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Consultations: Diet: • Consider c
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Bronchopulmonary Dysplasia Last Upd
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CLINICAL Section 3 of 11 History: B
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of BPD and in the need for continue
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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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• 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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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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MISCELLANEOUS Section 9 of 11 Medic
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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
Page 337 and 338: Airway management Once the infant i
Page 339 and 340: Cardiovascular support and chest co
Page 341 and 342: Once the appropriate functional res
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Page 345 and 346: Because secretions or oral feedings
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Page 349 and 350: Intubation and suctioning for mecon
Page 351 and 352: Neonatal Sepsis Last Updated: June
Page 353 and 354: The fetus has some preimmune immuno
Page 355 and 356: when chorioamnionitis accompanies t
Page 357 and 358: weeks of infection, the proportion
Page 359 and 360: cultures, clinicians may elect to c
Page 361 and 362: o The clinician may require differe
Page 363 and 364: Precautions Drug Name Pediatric Dos
Page 365 and 366: Pregnancy B - Usually safe but bene
Page 367 and 368: MISCELLANEOUS Section 9 of 11 Medic
Page 369 and 370: Neural Tube Defects in the Neonatal
Page 371 and 372: An experienced pediatrician or surg
Page 373 and 374: EPIDEMIOLOGY Section 3 of 11 Severa
Page 375 and 376: ETIOLOGY Section 5 of 11 Over the l
Page 377 and 378: AFP concentration in the maternal s
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Page 381 and 382: Head ultrasound can be performed du
Page 383 and 384: OUTCOME AND PROGNOSIS OF CHILDREN W
Page 385 and 386: Picture 2. Neural tube defects in t
Page 387: Picture 8. Neural tube defects in t
Page 391 and 392: Pathophysiology: • The umbilical
Page 393 and 394: • Omphalitis also may be the init
Page 395 and 396: • Supportive care: In addition to
Page 397 and 398: Drug Name Clindamycin (Cleocin) --
Page 399 and 400: multiple organisms) that lead direc
Page 401 and 402: • McKenna H, Johnson D: Bacteria
Page 403 and 404: Several processes combine to form t
Page 405 and 406: Frequency: • In the US: Combined
Page 407 and 408: • Polyhydramnios suggests fetal i
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Page 411 and 412: Prognosis: without extensively unde
Page 413 and 414: Picture 3. Omphalocele and gastrosc
Page 415 and 416: Picture 11. Omphalocele and gastros
Page 417 and 418: Picture 20.Omphalocele and gastrosc
Page 419 and 420: Perinatal Drug Abuse and Neonatal D
Page 421 and 422: Race: • The difficulty in assessi
Page 423 and 424: ehavioral and cognitive changes. Ma
Page 425 and 426: • All medically treated newborns
Page 427 and 428: Drug Category: Barbiturates -- Alth
Page 429 and 430: • Cognitive and developmental def
Page 431 and 432: Perioperative Pain Management in Ne
Page 433 and 434: The relative potency of each volati
Page 435 and 436: Opioid administration remains the m
Page 437 and 438: 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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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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