Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Recent Advances in Pediatrics (Special Volume 25): Perspectives in Neonatology
Suraj Gupte
PART 1: SPOTLIGHT: NEONATAL NUTRITION
1:
Nutrition in the Newborns: An Overview
INTRODUCTION
NUTRITIONAL NEEDS OF A NEWBORN
Fluid Requirements
Caloric Requirements
Protein, Carbohydrate, Fat, Vitamin and Mineral Requirements
NUTRITIONAL IMPLICATIONS FOR THE TERM INFANT
BREASTFEEDING THE LATE PRETERM INFANT
NUTRITIONAL IMPLICATIONS FOR THE PREMATURE INFANT
ENTERAL NUTRITION
Feeding Methods
Macronutrient and Micronutrient Requirements in the Enterally-fed Premature
PARENTERAL NUTRITION (PN)
A. Indications
B. Peripheral Versus Central
C. Monitoring during Parenteral Nutrition
D. Potential Complications Associated with Parenteral Nutrition
FEEDING IN SPECIFIC DISEASES/SITUATIONS
Congenital Anomalies
Cleft Lip and Cleft Palate
Hypotonic Baby
Pierre Robin Syndrome
Choanal Atresia
Macroglossia
Systemic Diseases
Gastroesophageal Reflux (GER)
Necrotizing Enterocolitis (NEC)
Broncho-pulmonary Dysplasia (BPD)
Congenital Heart Disease
Nutritional Therapies in Selected Inborn Errors of Metabolism
2:
Immunonutrients in Neonatal Practice
INTRODUCTION
ETIOPATHOGENESIS OF DISEASE IN NEONATES
IMMUNONUTRIENTS
Milk
Glutamine
Arginine
Nucleotides
Probiotics and Prebiotics
Omega-3 Polyunsaturated Fatty Acids (PUFAs)
Lactoferrin
CURRENT DILEMMAS AND FUTURE PERSPECTIVES
3:
Nutrition of the High-risk Neonates
INTRODUCTION
APPROACH TO NUTRITION
GUIDELINES
PREMATURITY/LOW-BIRTH WEIGHT
NECROTIZING ENTEROCOLITIS
SPONTANEOUS INTESTINAL PERFORATION
LIVER FAILURE
RENAL FAILURE
SHORT GUT SYNDROME
POSTDISCHARGE FOLLOW-UP
4:
Vitamin D in the Perinatal Period: Emerging Concepts
INTRODUCTION
SOURCES OF VITAMIN D
ROLE OF VITAMIN D IN THE PREGNANT MOTHER
ROLE OF VITAMIN D IN THE FETUS AND YOUNG INFANT
SUPPLEMENTATION DURING PREGNANCY
SUPPLEMENTATION IN THE NEONATES AND INFANTS
RECENT ADVANCES
Effect of Vitamin D on the Innate Immune System
Effect of Vitamin D Status in Pregnancy and Fetal Size
High Dose Supplementation in Term Neonates
5:
Human Milk Banking: The Movement Crying for Rejuvenation
INTRODUCTION
BACKGROUND PHILOSOPHY
CHEQUERED HISTORY
APPLICATIONS
REGULATORY MODALITIES
Potential Donors
Screening
Collection
Pasteurization
Chances of Contamination of Breast Milk
Storage and Dispatch
Funding
RISKS
CURRENT SCENARIO IN RESOURCE-LIMITED COUNTRIES
HOPES, CONCERNS AND PERSPECTIVES
PART 2: MISCELLANEOUS TOPICS
6:
Neonatal Resuscitation
INTRODUCTION
ASSESSMENT OF OXYGEN, NEED AND ADMINISTRATION OF OXYGEN
PULSE OXIMETRY
ADMINISTRATION OF SUPPLEMENTARY OXYGEN
INITIAL OXYGEN CONCENTRATION FOR RESUSCITATION IN CASE OF PPV
DRUGS
SUPPORTIVE CARE
Ongoing Care
Areas where NO changes have been made
7:
Early-term Neonates: Are They Really Term?
INTRODUCTION
FACTORS CONTRIBUTING TO INCREASED BIRTH RATE OF EARLY TERM INFANTS
HEALTH RISKS ASSOCIATED WITH EARLY TERM BIRTH
Need for Hospital Care
Feeding Challenges
Respiratory Risks
Morbidity and Mortality
Long-term Outcomes
PREVENTION OF NONMEDICALLY-INDICATED EARLY TERM DELIVERIES
8:
Neonatal Transport: Current Status
INTRODUCTION
NEONATAL TRANSPORT: AN EVOLVING CONCEPT IN INDIA
TYPES OF TRANSPORT
Indications for Transport
ORGANIZATION OF A NEONATAL TRANSPORT SERVICE
Communication
History
Personnel
Equipment
Necessary equipment for the transport of sick newborn infants
CLINICAL STABILIZATION BEFORE TRANSFER
Infant Care During the Journey
Monitor
COMMUNICATION AND DOCUMENTATION
QUALITY ASSURANCE
FINANCIAL IMPLICATIONS
USE OF CPAP IN NEONATAL TRANSPORT
Use of Nitric Oxide During Neonatal Transfers
Future Perspectives
9:
Biomarkers for Encephalopathy in Perinatal Asphyxia
INTRODUCTION
IMPORTANT BIOMARKERS
CLINICAL APPLICATIONS OF BIOMARKERS2, 3, 51
10:
Therapeutic Hypothermia on Oxidative Stress-induced DNA Damage in Perinatal Asphyxia
INTRODUCTION
PATHOPHYSIOLOGY OF HYPOXIC ISCHEMIC ENCEPHALOPATHY
Primary Energy Failure
Latent Period
Secondary Energy Failure
OXIDATIVE STRESS AND DNA DAMAGE IN ASPHYXIA
EVALUATION OF DNA DAMAGE
EFFECT OF THERAPEUTIC HYPOTHERMIA ON OXIDATIVE STRESS-INDUCED DNA DAMAGE
METHODS OF HYPOTHERMIA
Cooling Devices
Servo-controlled Cooling Devices
Ice and Gel Packs
Phase-changing Material Mattresses
Adverse Effects of Hypothermia
ADJUVANT THERAPIES WITH HYPOTHERMIA
11:
Neuroprotection in the Newborns
INTRODUCTION
PATHOGENESIS OF NEONATAL BRAIN INJURY
Glutamate-receptor-mediated Injury
IDENTIFYING BABIES AT RISK
NEUROPROTECTIVE THERAPIES/STRATEGIES
Hypothermia
Mechanism of Hypothermic Neuroprotection
Clinical Trials
Growth Factors
Erythropoietin
Vascular Endothelial Growth Factor (VEGF)
Stem Cell Therapy
Antioxidants
Allopurinol
Deferoxamine
Anti-excitotoxic/Glutamergic Inhibitors
Dizocilipine (MK801)
Memantine
Topiramate
Magnesium Sulfate
Anti-inflammatory Therapy
Minocycline
Cell Death Inhibitors
Combination Therapy
12:
Noninvasive Respiratory Support: Nasal CPAP and Noninvasive Ventilation
INTRODUCTION
HOW DOES CPAP WORK?
INDICATIONS OF CPAP
DEVICES FOR CPAP
CPAP Interfaces
DEVICES FOR GENERATING PRESSURE
TIMING OF CPAP FOR RESPIRATORY DISTRESS SYNDROME (RDS): HOW EARLY?
PROPHYLACTIC CPAP
DELIVERY ROOM CPAP
OPTIMAL PRESSURE OF CPAP
USE OF SURFACTANT WITH CPAP
Prophylactic Surfactant vs Early CPAP with selective use of surfactant
CPAP AFTER SURFACTANT ADMINISTRATION
MIST AND OTHER METHODS OF SURFACTANT REPLACEMENT
WEANING OFF CPAP
FAILURE OF CPAP AND ITS PREDICTORS
CPAP FOR POST-EXTUBATION SCENARIOS
NONINVASIVE RESPIRATORY VENTILATION (NIV)
MECHANISM OF ACTION
TYPES OF NIPPV AND INSTRUMENTS
INDICATIONS
SUGGESTED VENTILATOR SETTINGS AND CRITERIA FOR USE OF NIV
For Secondary Mode:40, 46
Complications of Nasal Ventilation
NASAL IPPV VS NASAL CPAP: WHICH IS BETTER?
COMMONLY ENCOUNTERED PRACTICAL PROBLEMS
13:
Neural Tube Defects
INTRODUCTION
SPECTRUM
EPIDEMIOLOGY
EMBRYOLOGY
ETIOLOGY
Spina Bifida Occulta
Meningocele
Meningomyeloceles
Anencephaly
Encephalocele
MANAGEMENT
PREVENTION
14:
Newborn Screening
INTRODUCTION
CRITERIA FOR SCREENING PROGRAMS
The Condition
The Test
The Treatment
The Screening Program
Specimen Collection
Timing of Screening
Screening Centers
Physicians' Responsibility for Abnormal Results
Diseases Warranting Screening
METABOLIC SCREENING
Tandem mass spectrometry can diagnose the following:
Aminoacidopathy
Fatty acid oxidation defects:
Carnitine cycle-Defect:
Organicaciduria:
Molecular Testing (DNA) Analysis
SCREENING FOR CRITICAL CONGENITAL HEART DISEASES
HEARING SCREENING
Initial Hearing Screening
Re-screening
Referrals for Diagnostic Audio Logical Evaluation
VISION SCREENING
Screening for Red Reflex
Procedure
SCREENING FOR RETINOPATHY OF PREMATURITY (ROP)
ROP Screening Process
Whom to screen:
Follow-up Examinations
Discontinuation of the ROP examination
Treatment indications
SCREENING FOR NEONATAL HYPERBILIRUBINEMIA
NEONATAL SCREENING FOR MALFORMATION
SCREENING FOR DEVELOPMENTAL DYSPLASIA OF HIP
DEVELOPMENTAL SCREENING
BRIEF DESCRIPTION OF THE COMMONLY SCREENED DISORDERS
Phenylketonuria
Congenital Hypothyroidism
Cystic Fibrosis
Galactosemia
Congenital Adrenal Hyperplasia
15:
Respiratory Distress in the Newborns
INTRODUCTION
NORMAL LUNG DEVELOPMENT
TRANSITION AT DELIVERY
BREATHING PATTERNS IN NEWBORNS
ACUTE RESPIRATORY DISORDERS
ETIOLOGICAL CONSIDERATIONS IN NEONATAL RESPIRATORY DISTRESS
TRANSIENT TACHYPNEA OF THE NEWBORN
RESPIRATORY DISTRESS SYNDROME
MECONIUM ASPIRATION SYNDROME
INFECTIONS
LESS COMMON CAUSES
DIAGNOSTIC APPROACH
History
Physical Examination
Laboratory Assessment
TREATMENT
Transient Tachypnea of the Newborn
Respiratory Distress Syndrome
Meconium Aspiration Syndrome
a. Oxygen Therapy34
b. Continuous Positive Airway Pressure (CPAP)
C. Surfactant Replacement Therapy (SRT)
Timing of Surfactant Therapy
16:
Persistent Pulmonary Hypertension of the Newborns—Newer Insights
INTRODUCTION
TRANSITION FROM FETAL TO NEONATAL CIRCULATION
PATHOPHYSIOLOGY OF PULMONARY HYPERTENSION
PHARMACOTHERAPY
Nitric Oxide (NO)
Sildenafil
Prostacyclin
Milrinone
Bosentan
Superoxide Dismutase
Magnesium Sulfate
17:
Neonatal Hyperbilirubinemia—What is New?
INTRODUCTION
Kernicterus
RISK FACTORS FOR BILIRUBIN NEUROTOXICITY
INDIAN CONTEXT
CLINICAL SPECTRUM OF BILIRUBIN INDUCED NEUROTOXICITY
GUIDELINES FOR MANAGEMENT OF HYPERBILIRUBINEMIA
Germany
India
Israel
Norway
Sweden
Switzerland
The Netherlands
UK
US
AAP and NICE Guidelines
BILIRUBIN ESTIMATION FOR RISK STRATIFICATION
PREDISCHARGE RISK STRATIFICATION
PHOTOTHERAPY (PT)
Initiation
Administration of Phototherapy
Device
Improving Efficacy of PT
Role of Eye Masks and Diapers
Stopping Phototherapy
Monitoring and Care Under PT
BLOOD EXCHANGE TRANSFUSION (BET)
G6PD Deficiency
ROLE OF ADDITIONAL THERAPIES
IVIg
Phenobarbital
FLUID SUPPLEMENTATION
OTHER AVAILABLE MODALITIES
18:
Neonatal Hypotension and Shock
INTRODUCTION
MEASURING BLOOD PRESSURE IN NEONATES
DEFINING HYPOTENSION IN NEONATES
SHOCK
Phases of Shock
PATHOPHYSIOLOGY OF HYPOTENSION IN NEWBORNS
ETIOLOGY
CLINICAL EVALUATION
MANAGEMENT
1. Volume Support
2. Vasopressors and Inotropes
Neonatal Cardiovascular System and Response to Catecholamine Agents
Vasopressors and Inotropes Used in Cardiovascular Support in Neonates
3. Role of Steroids
COMMON CLINICAL SCENARIOS OF SHOCK IN THE NEONATE AND THEIR MANAGEMENT
19:
Neonatal Sepsis: Role of Genomics in the Diagnosis and Management
INTRODUCTION
HUMAN GENOME PROJECT
HAPMAP PROJECT
SINGLE NUCLEOTIDE POLYMORPHISMS
Tagging SNPs
Haplogroups
Tandem Repeats
Microsatellites
Copy Number Variations
Epigenomics
Histone Modification
DNA Methylation
miRNA
Nutrigenomics
CLINICAL APPLICATIONS
LIMITATIONS OF GENOMIC MARKERS
20:
Neonatal Acute Kidney Injury (AKI)
INTRODUCTION
DEFINITION
CRITERIA FOR DIAGNOSIS
INCIDENCE
PHYSIOLOGICAL CONSIDERATIONS
ETIOLOGY
EVALUATION
CLINICAL FEATURES
MANAGEMENT
Fluid and Electrolytes Management in AKI
Hyperkalemia
Acid-Base and Mineral Disturbances
Nutrition
Hematologic Disturbances
Hypertension
Renal Adjustment of Medications
Renal Replacement Therapy
PROGNOSIS
21:
Perinatal Stroke
INTRODUCTION
INCIDENCE
PATHOLOGY
PATHOPHYSIOLOGY AND RISK FACTORS
CEREBRAL SINOVENOUS THROMBOSIS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION (TABLE 21.1)
Ancillary Studies to Identify the Underlying Cause
Acute Phase
Chronic Phase
Constraint-Induced Movement Therapy
Regenerative Interventions
LONG-TERM OUTCOME
22:
Necrotizing Enterocolitis
INTRODUCTION
INCIDENCE
RISK FACTORS
Microbial Mucosal Interaction and NEC
Hypoxic Ischemic Mechanism
Infectious Agent
Transfusion and NEC
Antibiotics
Feeding
Continuous Versus Intermittent Feeds
Aggressive Feeding
CLINICAL PRESENTATION
INVESTIGATIONS
Laboratory
Imaging
X-ray findings include:
PATHOLOGY
TREATMENT PROTOCOL
Bowel Rest and Nutrition
Intravenous Antibiotics
Fluids and Cardiovascular Support
Respiratory Support
Correction of Acidosis
Analgesia
Surgery
Stoma Care
MORTALITY
SEQUELAE
Intestinal Sequelae
Neurodevelopmental Sequelae and Growth
INTERVENTIONS AND DIRECTIONS FOR FUTURE RESEARCH
Prediction
23:
Community Care of the Newborns
INTRODUCTION
CONTINUUM OF CARE1, 2
Models of Home-based Care
Integrated Management of Neonatal and Childhood Illnesses3, 4
The Gadchiroli Field Trial5–7
The Ghana Newborn Home Visits Neonatal Mortality Trial8, 9
EVIDENCE FROM AROUND THE WORLD10
Policy of Home-based Newborn Care1
WHO AND UNICEF RECOMMENDATIONS1
Program Components Required for the Implementation of Home Visits for Newborn Care Strategy
Recommendations for the Countries
UNICEF, WHO and Partners will Support These Actions by:
SITUATION IN INDIA2, 11
RATIONALE FOR HOME-BASED NEWBORN CARE (HBNC)2
OBJECTIVE OF HBNC2
KEY ACTIVITIES IN HBNC2
INDICATORS TO MEASURE PROGRAM OUTCOME2
PRESENT STATUS OF HBNC12
24:
Managing Pain in the Neonates
INTRODUCTION
ADVERSE CONSEQUENCES
PAINFUL SITUATIONS IN A NEONATE
RESPONSE OF NEONATES TO PAINFUL STIMULI
ASSESSMENT OF PAIN IN NEONATES
MANAGEMENT OF PAIN IN NEONATES
Pharmacological Measures to Reduce Pain
Topical Analgesia
Systemic Analgesia
Analgesia in Ventilated Neonates
Analgesia during Endotracheal Intubation
Nonopioid Analgesics
SURGERY IN NEONATES AND PAIN MANAGEMENT
PAIN MANAGEMENT IN NEONATAL PERIOD: THE WAY AHEAD
25:
Dysmorphic Neonates
INTRODUCTION
INCIDENCE OF CONGENITAL ANOMALIES
DEFINITIONS
DIAGNOSTIC CLUES
APPROACH TO THE DYSMORPHIC NEONATE
Problem Analysis
CLINICAL INTERPRETATION
CONFIRMATION
Imaging
Laboratory Investigations
Cytogenetics
Indications for Routine Karyotyping
Fluorescence in situ hybridization
CHROMOSOMAL MICROARRAY ANALYSIS (CMA)
INTERVENTION
26:
Antibacterial Drugs in Neonatology Practice
INTRODUCTION
AMIKACIN
Brand Name: Amicin (Biochem), Mikicin (Aristo)
AMPICILLIN
Brand Name: Roscillin (Ranbaxy), Campicillin (Cadila Pharma), Synthocilin (PCI)
Semisynthetic aminopenicillin
AMPICILLIN-SULBACTAM
Brand Name: Sulbacin (Unichem)
AZTREONAM
Brand Name: Azenam (Aristo)
CEFTAZIDIME
Brand Name: Fortum (GSK)
CEFTOBIPROLE
Brand Names: Zeftera, Zevtera
MOA
CEFTRIAXONE
Brand Name: Monocef (Aristo)
CEFOTAXIME
Brand Name: Claforan (Aventis), Omnatax (Nicholas-Piramal)
CLINDAMYCIN
Brand Name: Dalacin Inj (Pfizer), Dalcap (Unichem)
GENTAMICIN
Brand Name: Garamycin (Fulford), Genticyn (Nicholas-Piramal)
METRONIDAZOLE
Brand Name: Flagyl (Nicholas), Metrogyl (Unique)
IMIPENEM-CILASTATIN
Brand Name: Cilanem-500 (Ranbaxy)
LINEZOLID
Brand Name: Linox (Unichem)
MEROPENEM
Brand Name: Meronem (Astra-Zeneca), Meroza (Zydus Alidac)
NETILMICIN
Brand Name: Netromycin (Fulford)
PENICILLIN G (CRYSTALLINE PENICILLIN, BENZYL PENICILLIN)
PIPERACILLIN
Brand Name: Pipracil
PIPERACILLIN WITH TAZOBACTAM
Brand Name: Zosyn (Wyeth)
RIFAMPIN (RIFAMPICIN)
Brand Name: Rifadin
TICARCILLIN
Brand Name: Ticar (Wolters Kluwer)
TICARCILLIN WITH CLAVULANIC ACID
Brand Name: Timentin (GSK)
TOBRAMYCIN
Brand Name: Tobraneg (Elder)
VANCOMYCIN
Brand Name: Vancocin (Astra-Zeneca)
INDEX
TOC
Index
×
Chapter Notes
Save
Clear