Anemia of Prematurity - Portal Neonatal

More documents

Recommendations

Info

Pregnancy C - Safety for use during pregnancy has not been established. Precautions Drug Name Caution in elderly patients, prostatic hypertrophy, hypertension, cardiovascular disease, diabetes mellitus, hyperthyroidism, and cerebrovascular insufficiency; rapid IV infusions may cause death from cerebrovascular hemorrhage or cardiac arrhythmias Hydralazine (Apresoline) -- Decreases systemic resistance through direct vasodilation of arterioles. Adult Dose 10-20 mg IV prn q4-6h Pediatric Dose 0.1-0.5 mg/kg IV q3-6h Contraindications Documented hypersensitivity; mitral valve rheumatic heart disease Interactions MAOIs and beta-blockers may increase toxicity; pharmacologic effects may be decreased by indomethacin Pregnancy C - Safety for use during pregnancy has not been established. Precautions Implicated in MI; caution in suspected coronary artery disease Drug Name Isoproterenol (Isuprel) -- Has beta1- and beta2-adrenergic receptor activity. Binds beta-receptors of heart, smooth muscle of bronchi, skeletal muscle, vasculature, and alimentary tract. Has positive inotropic and chronotropic actions. Adult Dose 2-10 mcg/min IV; titrate to desired heart rate and blood pressure Pediatric Dose 0.05-0.5 mcg/kg/min IV Contraindications Interactions Documented hypersensitivity; tachyarrhythmias; tachycardia or heart block caused by digitalis intoxication; ventricular arrhythmias that require inotropic therapy; angina pectoris Bretylium increases action of vasopressors on adrenergic receptors, which may in turn result in arrhythmias; guanethidine may increase effect of direct-acting vasopressors, possibly resulting in severe hypertension; tricyclic antidepressants may potentiate pressor response of direct-acting vasopressors Pregnancy C - Safety for use during pregnancy has not been established. Precautions Drug Name Adult Dose By increasing myocardial oxygen requirements while decreasing effective coronary perfusion, may have a deleterious effect on the injured or failing heart; in patients with organic disease of the AV node and its branches, paradoxically worsens heart block or precipitates Adams-Stokes attacks; caution in coronary artery disease, coronary insufficiency, diabetes or hyperthyroidism, and sensitivity to sympathomimetic amines; if heart rate >110 bpm, may decrease infusion rate or temporarily discontinue infusion Nitroprusside (Nitropress) -- Produces vasodilation and increases inotropic activity of the heart. At higher dosages, may exacerbate myocardial ischemia by increasing heart rate. Begin infusion at 0.3-0.5 mcg/kg/min IV, titrate to desired effect using increments of 0.5 mcg/kg/min; average dose is 1-6 mcg/kg/min Pediatric Dose 0.5-8 mcg/kg/min IV Contraindications Documented hypersensitivity; subaortic stenosis; idiopathic hypertrophic and atrial fibrillation or flutter Interactions Effects are additive when administered with other hypotensive agents Pregnancy C - Safety for use during pregnancy has not been established. Precautions Caution in increased intracranial pressure, hepatic failure, severe renal impairment, and hypothyroidism; in renal or hepatic insufficiency, nitroprusside levels may increase and can cause
Drug Name cyanide toxicity; sodium nitroprusside has the ability to lower blood pressure and should use only in patients with mean arterial pressures >70 mm Hg Norepinephrine (Levophed) -- For protracted hypotension following adequate fluid-volume replacement. Stimulates beta1- and alphaadrenergic receptors, increasing cardiac muscle contractility and heart rate as well as vasoconstriction, resulting in systemic blood pressure and coronary blood flow increases. After obtaining a response, the rate of flow should be adjusted and maintained at a low-normal blood pressure, such as 80-100 mm Hg systolic, sufficient to perfuse vital organs. Adult Dose 4 mcg/min IV; titrate to desired response Pediatric Dose 0.05-1 mcg/kg/min IV Contraindications Documented hypersensitivity; peripheral or mesenteric vascular thrombosis (ischemia may be increased and the area of the infarct extended) Interactions Enhances the pressor response by blocking reflex bradycardia Pregnancy C - Safety for use during pregnancy has not been established. Precautions Drug Name Adult Dose 5-20 mg IV Correct blood-volume depletion, if possible, before administration; extravasation may cause severe tissue necrosis, administer into a large vein; caution in occlusive vascular disease Phentolamine (Regitine) -- Alpha1- and alpha2-adrenergic blocking agent that blocks circulating epinephrine and norepinephrine action, reducing hypertension resulting from catecholamine effects on alphareceptors. Pediatric Dose 1-20 mcg/kg/min IV Contraindications Interactions Documented hypersensitivity; coronary or cerebral arteriosclerosis; renal impairment Concurrent administration of epinephrine or ephedrine may decrease effects; ethanol increases toxicity Pregnancy C - Safety for use during pregnancy has not been established. Precautions Caution in tachycardia, peptic ulcer, and gastritis; cerebrovascular occlusions and myocardial infarctions can occur following administration Drug Category: Volume expanders -- Use of crystalloid or colloid solutions is appropriate, unless the source of hypovolemia is hemorrhage, in which case whole or reconstituted blood is more appropriate. Drug Name Pediatric Dose 10-20 mL/kg IV Sodium chloride (Adsorbonac, Salinex) -- Isotonic sodium chloride solution is a low-cost alternative that is readily available. Contraindications Fluid retention; hypernatremia Interactions May decrease levels of lithium when administered concurrently Pregnancy C - Safety for use during pregnancy has not been established. Precautions Caution in congestive heart failure, hypertension, edema, liver cirrhosis, renal insufficiency, and sodium toxicity
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 and 26:
o Despite the number of premature i
Page 27 and 28:
BIBLIOGRAPHY Section 11 of 11 • B
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
Page 77 and 78:
discomfort. Many new synchronized v
Page 79 and 80:
treat acute bronchospasm; however,
Page 81 and 82:
• Excessive glucose loads may inc
Page 83 and 84:
Interactions Beta-adrenergic blocke
Page 85 and 86:
Drug Category: Pulmonary vasodilato
Page 87 and 88:
MISCELLANEOUS Section 9 of 11 Medic
Page 89 and 90:
• Frank L, Groseclose E: Oxygen t
Page 91 and 92:
• Northway WH Jr: Bronchopulmonar
Page 93 and 94:
Congenital Diaphragmatic Hernia Las
Page 95 and 96:
DIFFERENTIALS Section 4 of 10 Aspir
Page 97 and 98:
o Inhaled nitric oxide may be used
Page 99 and 100:
Drug Name Pediatric Dose Contraindi
Page 101 and 102:
Drug Name Pediatric Dose Vecuronium
Page 103 and 104:
Prognosis: • Pulmonary recovery:
Page 105 and 106:
• O'Toole SJ, Irish MS, Holm BA:
Page 107 and 108:
This article reviews the mechanics
Page 109 and 110:
Positioning the infant Positioning
Page 111 and 112:
stress and fatigue in both parents
Page 113 and 114:
As the mother's milk supply is esta
Page 115 and 116:
Engorgement Engorgement is a common
Page 117 and 118:
Ethical Issues in Neonatal Care Las
Page 119 and 120:
GOALS OF NEONATAL INTENSIVE CARE Se
Page 121 and 122:
Other guidelines of ethical import
Page 123 and 124:
In some situations, tragic situatio
Page 125 and 126:
BIBLIOGRAPHY Section 8 of 8 • AAP
Page 127 and 128:
CLINICAL FEATURES Section 4 of 7 Th
Page 129 and 130:
Comparisons of the nutrient content
Page 131 and 132:
Indomethacin is used prophylactical
Page 133 and 134:
FOLLOW-UP CARE Section 5 of 7 Nearl
Page 135 and 136:
BIBLIOGRAPHY Section 7 of 7 • Bha
Page 137 and 138:
Fluid, Electrolyte, and Nutrition M
Page 139 and 140:
Clinical evaluation • Weight fact
Page 141 and 142:
o Hypernatremia is defined as a ser
Page 143 and 144:
intake from protein is included in
Page 145 and 146:
Energy ENTERAL NUTRITION MANAGEMENT
Page 147 and 148:
growth and bone mineral content has
Page 149 and 150:
Hemolytic Disease of Newborn Last U
Page 151 and 152:
CLINICAL Section 3 of 11 History: W
Page 153 and 154:
• Serologic tests Imaging Studies
Page 155 and 156:
IVT in 1981. With ultrasonographic
Page 157 and 158:
status (eg, watching for hypoglycem
Page 159 and 160:
� The mechanism by which unconjug
Page 161 and 162:
BIBLIOGRAPHY Section 11 of 11 • B
Page 163 and 164:
Race: No racial predilection exists
Page 165 and 166:
Drug Name Pediatric Dose Phytonadio
Page 167 and 168:
Human Milk and Lactation Last Updat
Page 169 and 170:
LACTATION Section 5 of 11 Two essen
Page 171 and 172:
IMMUNOLOGIC PROPERTIES OF HUMAN MIL
Page 173 and 174:
Picture 3. Human milk and lactation
Page 175 and 176:
• Isaacs CE, Thormar H: The role
Page 177 and 178:
Hydrops Fetalis Last Updated: June
Page 179 and 180:
Also of note is a computer simulati
Page 181 and 182:
Physical: The presence of any of th
Page 183 and 184:
o Once disorders of hemoglobin alph
Page 185 and 186:
Structural anomalies Table 2. Cardi
Page 187 and 188:
o B19V o Cytomegalovirus (CMV) o Sy
Page 189 and 190:
o Sjögren syndrome A (uncertain in
Page 191 and 192:
most commonly thrombocytopenia, is
Page 193 and 194:
Lab Studies: WORKUP Section 5 of 10
Page 195 and 196:
o Karyotyping is always indicated i
Page 197 and 198:
Page 199 and 200:
• Space-occupying masses, which i
Page 201 and 202:
of antidiabetic agents and antagoni
Page 203 and 204:
Drug Name Sotalol (Betapace) -- Rec
Page 205 and 206:
• Cowan RH, Waldo AL, Harris HB:
Page 207 and 208:
• Silverman NH, Schmidt KG: Ventr
Page 209 and 210:
At the cellular level, neuronal inj
Page 211 and 212:
o Disturbances of ocular motion, su
Page 213 and 214:
DIFFERENTIALS Section 4 of 10 Methy
Page 215 and 216:
Page 217 and 218:
Interactions Benzodiazepines, cimet
Page 219 and 220:
o Allopurinol: Slight improvements
Page 221 and 222:
• Patel J, Edwards AD: Prediction
Page 223 and 224:
Increased insulin levels stimulate
Page 225 and 226:
irth; symptoms may include jitterin
Page 227 and 228:
speculated to be secondary to incre
Page 229 and 230:
Procedures: o Clinical features of
Page 231 and 232:
• Cardiac management o If signs o
Page 233 and 234:
Pediatric Dose Contraindications In
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
limiting step in the process, relea
Page 241 and 242:
History: CLINICAL Section 3 of 11
Page 243 and 244:
Page 245 and 246:
at equilibrium conditions, the isom
Page 247 and 248:
• A number of guidelines for the
Page 249 and 250:
Exchange transfusion Exchange trans
Page 251 and 252:
FOLLOW-UP Section 8 of 11 Further I
Page 253 and 254:
BIBLIOGRAPHY Section 11 of 11 • A
Page 255 and 256:
Kernicterus Last Updated: November
Page 257 and 258:
CLINICAL Section 3 of 11 History: A
Page 259 and 260:
o Extravasated blood: Significant a
Page 261 and 262:
milk intake because of reduced mamm
Page 263 and 264:
department and must be heavily seda
Page 265 and 266:
Diet: Depending on the degree of ne
Page 267 and 268:
Transfer: The recently reported cas
Page 269 and 270:
Prognosis: The spectrum of neurolog
Page 271 and 272:
Picture 5. Kernicterus. Neuronal ch
Page 273 and 274:
Airway obstruction Complete obstruc
Page 275 and 276:
Page 277 and 278:
MEDICATION Section 7 of 11 In addit
Page 279 and 280:
Drug Category: Sedatives -- Maximiz
Page 281 and 282:
Transfer: • Although stabilizatio
Page 283 and 284:
BIBLIOGRAPHY Section 11 of 11 • A
Page 285 and 286:
occurs even later (ie, during days
Page 287 and 288:
• Delivery room management of inf
Page 289 and 290:
MISCELLANEOUS Section 7 of 9 Medica
Page 291 and 292:
Necrotizing Enterocolitis Last Upda
Page 293 and 294:
Race: Some studies indicate higher
Page 295 and 296:
Page 297 and 298:
o With abdominal ultrasonography, a
Page 299 and 300:
o Stage IB � Diagnosis is the sam
Page 301 and 302:
Pregnancy C - Safety for use during
Page 303 and 304:
Drug Name Epinephrine (Adrenaline)
Page 305 and 306:
Pediatric Dose Contraindications In
Page 307 and 308:
• Short-gut syndrome o This is a
Page 309 and 310:
Picture 5. Necrotizing enterocoliti
Page 311 and 312:
Neonatal Hypertension Last Updated:
Page 313 and 314:
o Although BP readings obtained usi
Page 315 and 316:
Other Problems to be Considered: Re
Page 317 and 318:
as nitroprusside, that may make it
Page 319 and 320:
Surgical Care: Surgery is rarely in
Page 321 and 322:
decrease in cardiac output; triazol
Page 323 and 324:
Contraindications Documented hypers
Page 325 and 326:
FOLLOW-UP Section 8 of 10 Further I
Page 327 and 328:
• Flynn JT: Neonatal hypertension
Page 329 and 330:
Neonatal Resuscitation Last Updated
Page 331 and 332:
Fetal pulmonary physiology The feta
Page 333 and 334:
Flow studies have revealed that rel
Page 335 and 336:
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
Page 343 and 344:
Premature infants are also at high
Page 345 and 346:
Because secretions or oral feedings
Page 347 and 348:
The team should be led and organize
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:
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
Page 379 and 380:
separated his patients into 3 diffe
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 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
Page 409 and 410:
aby with a giant omphalocele or in
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 and 452:
Picture 8. Periventricular hemorrha
Page 453 and 454:
• Roberts JR: Drug therapy in inf
Page 455 and 456:
Following the initial insult, wheth
Page 457 and 458:
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
Page 503 and 504: • Examination recommendations Oth
Page 505 and 506: FOLLOW-UP Section 7 of 10 Further I
Page 507 and 508: Picture 5. Retinopathy of prematuri
Page 509 and 510: • Raju TN, Langenberg P, Bhutani
Page 511 and 512: • Contractility is a semiquantita
Page 513 and 514: • Uncompensated o During uncompen
Page 515 and 516: mL/kg of volume expansion should re
Page 517: MEDICATION Section 7 of 10 Drug Cat
Page 521 and 522: Pregnancy Precautions Drug Name fur
Page 523 and 524: Transient Tachypnea of the Newborn
Page 525 and 526: DIFFERENTIALS Section 4 of 11 Pneum
Page 527 and 528: Drug Name Pediatric Dose Gentamicin
Page 529 and 530: Transport of the Critically Ill New
Page 531 and 532: Communications To initiate the tran
Page 533 and 534: Table 1. Advantages and disadvantag
Page 535 and 536: Table 2. A comparison of the advant
Page 537 and 538: Flight team personnel also are affe
Page 539 and 540: PICTURES Section 10 of 11 Picture 1
show all

Anemia of Prematurity - Portal Neonatal

Create successful ePaper yourself

Delete template?

Save as template?