Anemia of Prematurity - Portal Neonatal

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• Busija DW, Heistad DD: Effects of indomethacin on cerebral blood flow during hypercapnia in cats. Am J Physiol 1983 Apr; 244(4): H519-24[Medline]. • Fanaroff AA, Martin RJ: The central nervous system: Intracranial hemorrhage. In: Neonatal- Perinatal Medicine: Diseases of the fetus and infant 1997; 891-893. • Fanconi S, Duc G: Intratracheal suctioning in sick preterm infants: prevention of intracranial hypertension and cerebral hypoperfusion by muscle paralysis. Pediatrics 1987 Apr; 79(4): 538-43[Medline]. • Garland JS, Buck R, Leviton A: Effect of maternal glucocorticoid exposure on risk of severe intraventricular hemorrhage in surfactant-treated preterm infants. J Pediatr 1995 Feb; 126(2): 272-9[Medline]. • Garland JS, Buck R, Leviton A: Effect of maternal glucocorticoid exposure on risk of severe intraventricular hemorrhage in surfactant-treated preterm infants. J Pediatr 1995 Feb; 126(2): 272-9[Medline]. • Goddard-Finegold J, Armstrong D, Zeller RS: Intraventricular hemorrhage, following volume expansion after hypovolemic hypotension in the newborn beagle. J Pediatr 1982 May; 100(5): 796-9[Medline]. • Hammerman C, Glaser J, Schimmel MS: Continuous versus multiple rapid infusions of indomethacin: effects on cerebral blood flow velocity. Pediatrics 1995 Feb; 95(2): 244- 8[Medline]. • Krishnamoorthy KS, Kuban KC, Leviton A: Periventricular-intraventricular hemorrhage, sonographic localization, phenobarbital, and motor abnormalities in low birth weight infants. Pediatrics 1990 Jun; 85(6): 1027-33[Medline]. • Leffler CW, Busija DW, Beasley DG: Effect of therapeutic dose of indomethacin on the cerebral circulation of newborn pigs. Pediatr Res 1987 Feb; 21(2): 188-92[Medline]. • Maher P, Lane B, Ballard R: Does indomethacin cause extension of intracranial hemorrhages: a preliminary study. Pediatrics 1985 Mar; 75(3): 497-500[Medline]. • Mardoum R, Bejar R, Merritt TA: Controlled study of the effects of indomethacin on cerebral blood flow velocities in newborn infants. J Pediatr 1991 Jan; 118(1): 112-5[Medline]. • McLendon D, Check J, Carteaux P, et al: Implementation of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants. Pediatrics 2003 Apr; 111(4 Pt 2): e497-503[Medline]. • Ment LR, Oh W, Ehrenkranz RA: Low-dose indomethacin and prevention of intraventricular hemorrhage: a multicenter randomized trial. Pediatrics 1994 Apr; 93(4): 543-50[Medline]. • Ment LR, Oh W, Ehrenkranz RA: Low-dose indomethacin therapy and extension of intraventricular hemorrhage: a multicenter randomized trial. J Pediatr 1994 Jun; 124(6): 951- 5[Medline]. • Ment LR, Stewart WB, Ardito TA: Indomethacin promotes germinal matrix microvessel maturation in the newborn beagle pup. Stroke 1992 Aug; 23(8): 1132-7[Medline]. • Ment LR, Oh W, Ehrenkranz RA: Antenatal steroids, delivery mode, and intraventricular hemorrhage in preterm infants. Am J Obstet Gynecol 1995 Mar; 172(3): 795-800[Medline]. • Ment LR, Vohr B, Oh W: Neurodevelopmental outcome at 36 months' corrected age of preterm infants in the Multicenter Indomethacin Intraventricular Hemorrhage Prevention Trial. Pediatrics 1996 Oct; 98(4 Pt 1): 714-8[Medline]. • Ment LR, Vohr B, Allan W: Outcome of children in the indomethacin intraventricular hemorrhage prevention trial. Pediatrics 2000 Mar; 105(3 Pt 1): 485-91[Medline]. • Ment LR, Ehrenkranz RA, Duncan CC: Intraventricular hemorrhage of the preterm neonate: prevention studies. Semin Perinatol 1988 Oct; 12(4): 359-72[Medline]. • Ment LR, Stewart WB, Ardito TA: Indomethacin promotes germinal matrix microvessel maturation in the newborn beagle pup. Stroke 1992 Aug; 23(8): 1132-7[Medline]. • Perlman J, Thach B: Respiratory origin of fluctuations in arterial blood pressure in premature infants with respiratory distress syndrome. Pediatrics 1988 Mar; 81(3): 399-403[Medline]. • Perlman JM, Goodman S, Kreusser KL: Reduction in intraventricular hemorrhage by elimination of fluctuating cerebral blood-flow velocity in preterm infants with respiratory distress syndrome. N Engl J Med 1985 May 23; 312(21): 1353-7[Medline]. • Perlman JM, McMenamin JB, Volpe JJ: Fluctuating cerebral blood-flow velocity in respiratorydistress syndrome. Relation to the development of intraventricular hemorrhage. N Engl J Med 1983 Jul 28; 309(4): 204-9[Medline]. • Perlman JM, Volpe JJ: Prevention of neonatal intraventricular hemorrhage. Clin Neuropharmacol 1987 Apr; 10(2): 126-42[Medline].
• Roberts JR: Drug therapy in infants. In: Pharmacologic Principles and Clinical Experience. 1984: 229-233, 261-269. • Thomas SJ, Morgan MA, Asrat T: The risk of periventricular-intraventricular hemorrhage with vacuum extraction of neonates weighing 2000 grams or less. J Perinatol 1997 Jan-Feb; 17(1): 37-41[Medline]. • van Bel F, Klautz RJ, Steendijk P: The influence of indomethacin on the autoregulatory ability of the cerebral vascular bed in the newborn lamb. Pediatr Res 1993 Aug; 34(2): 178- 81[Medline]. • Ventriculomegaly Trial Group: Randomized trial of early tapping in neonatal posthemorrhagic ventricular dilatation. Arch Dis Child 1990 Jan; 65(1 Spec No): 3-10[Medline]. • Volpe JJ: Intracranial hemorrhage: Germinal matrix hemorrhage of the premature infant. In: Neurology of the Newborn 1995: 403-463. • Whitaker AH, Feldman JF, Van Rossem R: Neonatal cranial ultrasound abnormalities in low birth weight infants: relation to cognitive outcomes at six years of age. Pediatrics 1996 Oct; 98(4 Pt 1): 719-29[Medline]. Periventricular Hemorrhage-Intraventricular Hemorrhage 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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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
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
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
Page 451: Picture 8. Periventricular hemorrha
Page 455 and 456: Following the initial insult, wheth
Page 457 and 458: FOLLOW-UP Section 7 of 10 Further O
Page 459 and 460: Picture 6. Cranial CT scan, axial i
Page 461 and 462: Polycythemia of the Newborn Last Up
Page 463 and 464: Causes: • Increased fetal erythro
Page 465 and 466: FOLLOW-UP Section 7 of 9 Further In
Page 467 and 468: Polyhydramnios and Oligohydramnios
Page 469 and 470: Causes: umbilical artery, gastroint
Page 471 and 472: TREATMENT Section 5 of 9 Medical Ca
Page 473 and 474: Prognosis: • Polyhydramnios o If
Page 475 and 476: Pulmonary Interstitial Emphysema La
Page 477 and 478: compared to 39 of 169 among infants
Page 479 and 480: • Selective main bronchial intuba
Page 481 and 482: • Other considerations o Avoid us
Page 483 and 484: • Gaylord MS, Quissell BJ, Lair M
Page 485 and 486: The components of pulmonary surfact
Page 487 and 488: WORKUP Section 5 of 11 Lab Studies:
Page 489 and 490: in infants who respond poorly or ar
Page 491 and 492: intensive care setting, and be anxi
Page 493 and 494: Table 6. Meta-Analysis of Clinical
Page 495 and 496: Drug Name Pediatric Dose of acute a
Page 497 and 498: The postnatal use of surfactant the
Page 499 and 500: Picture 5. A schematic diagram of t
Page 501 and 502: 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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