Anemia of Prematurity - Portal Neonatal

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BIBLIOGRAPHY Section 10 of 10 • Adamkiewicz TV, Goodman D, Burke B, et al: Neonatal Clostridium sordellii toxic omphalitis. Pediatr Infect Dis J 1993 Mar; 12(3): 253-7[Medline]. • Airede AI: Pathogens in neonatalomphalitis. J Trop Pediatr 1992 Jun; 38(3): 129-31[Medline]. • Barrett FF, Mason EO Jr, Fleming D: Brief clinical and laboratory observations. J Pediatr 1979 May; 94(5): 796-800[Medline]. • Bogdan JC, Rapkin RH: Clostridia infection in the newborn. Pediatrics 1976 Jul; 58(1): 120- 2[Medline]. • Boyle G, Rosenberg HK, O'Neill J: An unusual presentation of an infected urachal cyst. Review of urachal anomalies. Clin Pediatr (Phila) 1988 Mar; 27(3): 130-4[Medline]. • Bradley JS: Wound and deep-tissue infections. In: Pediatric Infectious Diseases: Principles and Practice. 1995: 723-32. • Brook I: Microbiology of necrotizing fasciitis associated with omphalitis in the newborn infant. J Perinatol 1998 Jan-Feb; 18(1): 28-30[Medline]. • Brook I: Anaerobic infections in the neonate. Adv Pediatr 1994; 41: 369-83[Medline]. • Brook I: Bacteriology of neonatal omphalitis. J Infect 1982; 5: 127-31. • Brook I, Dunkle LM: Anaerobic infections. In: McMillan J, De Angelis CD, Feigin RD, eds. Oski's Pediatrics: Principles and Practice. 3rd ed. Lippincott Williams & Wilkins; 1999: 937-50. • Carney WI Jr, May GA: Omphalitis in the adult. Arch Surg 1973 Feb; 106(2): 229-30[Medline]. • Cushing AH: Omphalitis: a review. Pediatr Infect Dis 1985 May-Jun; 4(3): 282-5[Medline]. • Davies PA: Infection of the embryo, fetus, and newborn. Br J Hosp Med 1972; 8: 13-26. • Dinauer MC: The phagocyte system and disorders of granulopoiesis and granulocyte function. In: Nathan DG, Orkin SH, Oski FA, Lampert R, eds. Nathan and Oski's Hematology of Infancy and Childhood. 5th ed. W B Saunders Co; 1998: 889-967. • Elhassani SB: The umbilical cord: care, anomalies, and diseases. South Med J 1984 Jun; 77(6): 730-6[Medline]. • Fairchild JP, Graber CD, Vogel EH: Flora of the umbilical stump. J Pediatr 1958; 53: 538-46. • Geil CC, Castle WK, Mortimer EA Jr: Group A streptococcal infections in newborn nurseries. Pediatrics 1970 Dec; 46(6): 849-54[Medline]. • Gezon HM, Schaberg MJ, Klein JO: Concurrent epidemics of Staphylococcus aureus and group A Streptococcus disease in a newborn nursery. Control with penicillin G and hexachlorophene bathing. Pediatrics 1973 Feb; 51(2): 383-90[Medline]. • Gladstone IM, Clapper L, Thorp JW, Wright DI: Randomized study of six umbilical cord care regimens. Comparing length of attachment, microbial control, and satisfaction. Clin Pediatr (Phila) 1988 Mar; 27(3): 127-9[Medline]. • Gormley D: Neonatal anaerobic (clostridial) cellulitis and omphalitis. Arch Dermatol 1977 May; 113(5): 683-4[Medline]. • Grimwood K, Evans GA, Govender ST, Woods DE: Clostridium sordellii infection and toxin neutralization. Pediatr Infect Dis J 1990 Aug; 9(8): 582-5[Medline]. • Guvenc H, Aygun AD, Yasar F, et al: Omphalitis in term and preterm appropriate for gestational age and small for gestational age infants. J Trop Pediatr 1997 Dec; 43(6): 368- 72[Medline]. • Holland SM, Gullin JI: Neutrophil disorders. In: Samter's Immunologic Diseases. 5th ed. Little, Brown & Co; 1995: 529-50. • Hsieh WS, Yang PH, Chao HC, Lai JY: Neonatal necrotizing fasciitis: a report of three cases and review of the literature. Pediatrics 1999 Apr; 103(4): e53[Medline]. • Kosloske AM, Bartow SA: Debridement of periumbilical necrotizing fasciitis: importance of excision of the umbilical vessels and urachal remnant. J Pediatr Surg 1991 Jul; 26(7): 808- 10[Medline]. • Kosloske AM, Cushing AH, Borden TA, et al: Cellulitis and necrotizing fasciitis of the abdominal wall in pediatric patients. J Pediatr Surg 1981 Jun; 16(3): 246-51[Medline]. • Lally KP, Atkinson JB, Woolley MM, Mahour GH: Necrotizing fasciitis. A serious sequela of omphalitis in the newborn. Ann Surg 1984 Jan; 199(1): 101-3[Medline]. • Mason WH, Andrews R, Ross LA, Wright HT Jr: Omphalitis in the newborn infant. Pediatr Infect Dis J 1989 Aug; 8(8): 521-5[Medline].
• McKenna H, Johnson D: Bacteria in neonatal omphalitis. Pathology 1977 Apr; 9(2): 111- 3[Medline]. • Meberg A, Schoyen R: Hydrophobic material in routine umbilical cord care and prevention of infections in newborn infants. Scand J Infect Dis 1990; 22(6): 729-33[Medline]. • Moss RL, Musemeche CA, Kosloske AM: Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. J Pediatr Surg 1996 Aug; 31(8): 1142-6[Medline]. • Nelson JD, Dillon HC Jr, Howard JB: A prolonged nursery epidemic associated with a newly recognized type of group A streptococcus. J Pediatr 1976 Nov; 89(5): 792-6[Medline]. • Nezelof C: Chronic omphalitis in a 4-month-old girl. Pathol Res Pract 1991 Mar; 187(2-3): 334- 7; discussion 337-40[Medline]. • O'Brien PH, Meredith HC, Vujic I, Schabel SI: Obstructive jaundice caused by cavernous transformation of the portal vein post neonatal omphalitis. J S C Med Assoc 1979 May; 75(5): 209-10[Medline]. • Oudesluys-Murphy AM, Eilers GA, de Groot CJ: The time of separation of the umbilical cord. Eur J Pediatr 1987 Jul; 146(4): 387-9[Medline]. • Pildes RS, Ramamurthy RS, Vidyasagar D: Effect of triple dye on staphylococcal colonization in the newborn infant. J Pediatr 1973 Jun; 82(6): 987-90[Medline]. • Samuel M, Freeman NV, Vaishnav A, et al: Necrotizing fasciitis: a serious complication of omphalitis in neonates. J Pediatr Surg 1994 Nov; 29(11): 1414-6[Medline]. • Sawin RS, Schaller RT, Tapper D, et al: Early recognition of neonatal abdominal wall necrotizing fasciitis. Am J Surg 1994 May; 167(5): 481-4[Medline]. • Spark RP, Wike DA: Nontetanus clostridial neonatal fatality after home delivery. Ariz Med 1983 Oct; 40(10): 697-700[Medline]. • Speck WT, Driscoll JM, Polin RA, et al: Staphylococcal and streptococcal colonization of the newborn infant: effect of antiseptic cord care. Am J Dis Child 1977 Sep; 131(9): 1005- 8[Medline]. • Stark V, Harrisson SP: Staphylococcus aureus colonization of the newborn in a Darlington hospital. J Hosp Infect 1992 Jul; 21(3): 205-11[Medline]. • Stunden RJ, Brown RA, Rode H, et al: Umbilical gangrene in the newborn. J Pediatr Surg 1988 Feb; 23(2): 130-4[Medline]. • Ward TT, Saltzman E, Chiang S: Infected urachal remnants in the adult: case report and review. Clin Infect Dis 1993 Jan; 16(1): 26-9[Medline]. Omphalitis 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
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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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Page 351 and 352: Neonatal Sepsis Last Updated: June
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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 and 388: Picture 8. Neural tube defects in t
Page 389 and 390: • Sutton LN, Adzick NS, Bilaniuk
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: multiple organisms) that lead direc
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
Page 439 and 440: • Lerman J, Robinson S, Willis MM
Page 441 and 442: Pathophysiology: Site of origin The
Page 443 and 444: Pathogenesis of sequelae The major
Page 445 and 446: • Hypertension or beat-to-beat va
Page 447 and 448: Interactions suspected necrotizing
Page 449 and 450: 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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Anemia of Prematurity - Portal Neonatal

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