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Neonatal fluid management

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https://www.readbyqxmd.com/read/28800397/association-between-the-7-day-moving-average-for-nutrition-and-growth-in-very-low-birth-weight-infants
#1
Gustave H Falciglia, Karna Murthy, Jane Holl, Hannah L Palac, Yuliya Oumarbaeva, Pratyusha Yadavalli, Donna Woods, Daniel T Robinson
BACKGROUND: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). METHODS: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011-2014)...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28762235/fluid-supplementation-for-neonatal-unconjugated-hyperbilirubinaemia
#2
REVIEW
Nai Ming Lai, Azanna Ahmad Kamar, Yao Mun Choo, Juin Yee Kong, Chin Fang Ngim
BACKGROUND: Neonatal hyperbilirubinaemia is a common problem which carries a risk of neurotoxicity. Certain infants who have hyperbilirubinaemia develop bilirubin encephalopathy and kernicterus which may lead to long-term disability. Phototherapy is currently the mainstay of treatment for neonatal hyperbilirubinaemia. Among the adjunctive measures to compliment the effects of phototherapy, fluid supplementation has been proposed to reduce serum bilirubin levels. The mechanism of action proposed includes direct dilutional effects of intravenous (IV) fluids, or enhancement of peristalsis to reduce enterohepatic circulation by oral fluid supplementation...
August 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28742677/committee-opinion-no-712-intrapartum-management-of-intraamniotic-infection
#3
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742671/committee-opinion-no-712-summary-intrapartum-management-of-intraamniotic-infection
#4
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28739260/uses-and-misuses-of-albumin-during-resuscitation-and-in-the-neonatal-intensive-care-unit
#5
REVIEW
Wissam Shalish, Francois Olivier, Hany Aly, Guilherme Sant'Anna
Albumin is one of the most abundant proteins in plasma and serves many vital functions. Neonatal concentrations vary greatly with gestational and postnatal age. In critically ill neonates, hypoalbuminemia occurs due to decreased synthesis, increased losses or redistribution of albumin into the extravascular space, and has been associated with increased morbidities and mortality. For that reason, infusion of exogenous albumin as a volume expander has been proposed for various clinical settings including hypotension, delivery room resuscitation, sepsis and postoperative fluid management...
July 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28730376/lower-urinary-tract-obstruction-fetal-intervention-based-on-prenatal-staging
#6
Rodrigo Ruano, Timothy Dunn, Michael C Braun, Joseph R Angelo, Adnan Safdar
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28724193/saline-irrigation-for-the-management-of-skin-extravasation-injury-in-neonates
#7
REVIEW
P N Gopalakrishnan, Nitin Goel, Sujoy Banerjee
BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#8
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28695637/prenatal-management-of-fetal-intrapericardial-teratoma-a-systematic-review
#9
REVIEW
Ahmed A Nassr, Sherif A Shazly, Shaine A Morris, Nancy Ayres, Jimmy Espinoza, Hadi Erfani, Olutoyin A Olutoye, Sara K Sexson, Oluyinka O Olutoye, Charles D Fraser, Michael A Belfort, Alireza A Shamshirsaz
OBJECTIVES: The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome, and effectiveness of prenatal management options for pericardial teratoma. METHODS: A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the prenatal course of pericardial teratoma in singleton or twin gestations were considered eligible. Standardized forms were used for data abstraction by two independent reviewers...
July 10, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28693123/clinical-chorioamnionitis-at-term-viii-a-rapid-mmp-8-test-for-the-identification-of-intra-amniotic-inflammation
#10
Noppadol Chaiyasit, Roberto Romero, Piya Chaemsaithong, Nikolina Docheva, Gaurav Bhatti, Juan Pedro Kusanovic, Zhong Dong, Lami Yeo, Percy Pacora, Sonia S Hassan, Offer Erez
OBJECTIVE: Clinical chorioamnionitis is the most common infection/inflammatory process diagnosed in labor and delivery units worldwide. The condition is a syndrome that can be caused by (1) intra-amniotic infection, (2) intra-amniotic inflammation without demonstrable microorganisms (i.e. sterile intra-amniotic inflammation), and (3) maternal systemic inflammation that is not associated with intra-amniotic inflammation. The presence of intra-amniotic inflammation is a risk factor for adverse maternal and neonatal outcomes in a broad range of obstetrical syndromes that includes clinical chorioamnionitis at term...
June 24, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28691556/fluid-management-during-the-first-postnatal-day-in-very-low-birth-weight-neonates-and-rates-of-patent-ductus-arteriosus-requiring-treatment
#11
Michelle B Levinson, Catherine Messina, Jonathan P Mintzer
PURPOSE: Previous studies have suggested an association between high maintenance fluid volumes during the first several postnatal days and patent ductus arteriosus (PDA) requiring treatment in very low birth weight (VLBW) neonates. However, no studies have specifically examined fluid administration during the first postnatal day with regard to PDA-related outcomes. We seek to determine whether additional intravenous fluid administration beyond prescribed goals during the first postnatal day is associated with PDA requiring treatment...
July 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#12
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28675983/fluid-supplementation-in-management-of-neonatal-hyperbilirubinemia-a-randomized-controlled-trial
#13
Prachi Goyal, Akshay Mehta, Jasbinder Kaur, Suksham Jain, Vishal Guglani, Deepak Chawla
OBJECTIVE: To evaluate the efficacy of oral or intravenous fluid supplementation in accelerating the decline of serum bilirubin with intensive phototherapy among healthy term and late preterm neonates with hyperbilirubinemia. STUDY DESIGN: This open-label randomized controlled trial randomized neonates with severe hyperbilirubinemia (serum total bilirubin ≥18 mg/dL or within 2 mg/dL of threshold for exchange transfusion) to receive 50 mL/kg of intravenous fluid over 8 h (IVF group, n = 51), 50 mL of oral rehydration solution over 8 h (oral rehydration solution (ORS) group, n = 50) or only standard therapy (control group, n = 49)...
July 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28672752/clinical-chorioamnionitis-at-term-viii-a-rapid-mmp-8-test-for-the-identification-of-intra-amniotic-inflammation
#14
Noppadol Chaiyasit, Roberto Romero, Piya Chaemsaithong, Nikolina Docheva, Gaurav Bhatti, Juan Pedro Kusanovic, Zhong Dong, Lami Yeo, Percy Pacora, Sonia S Hassan, Offer Erez
OBJECTIVE: Clinical chorioamnionitis is the most common infection/inflammatory process diagnosed in labor and delivery units worldwide. The condition is a syndrome that can be caused by (1) intra-amniotic infection, (2) intra-amniotic inflammation without demonstrable microorganisms (i.e. sterile intra-amniotic inflammation), and (3) maternal systemic inflammation that is not associated with intra-amniotic inflammation. The presence of intra-amniotic inflammation is a risk factor for adverse maternal and neonatal outcomes in a broad range of obstetrical syndromes that includes clinical chorioamnionitis at term...
July 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28647738/outcome-and-treatment-of-antenatally-diagnosed-nonimmune-hydrops-fetalis
#15
Ahmed A Nassr, Amen Ness, Pardis Hosseinzadeh, Bahram Salmanian, Jimmy Espinoza, Victoria Berger, Eleonore Werner, Hadi Erfani, Stephen Welty, Zhoobin H Bateni, Amir A Shamshirsaz, Edwina Popek, Rodrigo Ruano, Alexis S Davis, Timothy C Lee, Sundeep Keswani, Darrell L Cass, Oluyinka O Olutoye, Michael A Belfort, Alireza A Shamshirsaz
INTRODUCTION: The objectives of this study were to evaluate the outcome of nonimmune hydrops fetalis in an attempt to identify independent predictors of perinatal mortality. MATERIAL AND METHODS: A retrospective cohort study was conducted including all cases of nonimmune hydrops from two tertiary care centers. Perinatal outcome was evaluated after classifying nonimmune hydrops into ten etiological groups. We examined the effect of etiology, site of fluid accumulation, and gestational age at delivery on postnatal survival...
June 24, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#16
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#17
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28625306/spinal-induced-hypotension-incidence-mechanisms-prophylaxis-and-management-summarizing-20-years-of-research
#18
REVIEW
Jennifer E Lee, Ronald B George, Ashraf S Habib
Hypotension commonly occurs in parturients undergoing cesarean delivery under spinal anesthesia. This leads to maternal and neonatal adverse outcomes, including maternal nausea and vomiting and fetal acidosis, and might even lead to cardiovascular collapse if not treated. Arterial dilatation and reduction in systemic vascular resistance are the major contributors to spinal-induced hypotension. Therefore, strategies aimed at expanding the intravascular volume with fluid loading or increasing venous return with lower extremities mechanical compression and lateral tilt have had limited effectiveness in the management of spinal-induced hypotension...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28620499/intrauterine-death-following-intraamniotic-triiodothyronine-and-thyroxine-therapy-for-fetal-goitrous-hypothyroidism-associated-with-polyhydramnios-and-caused-by-a-thyroglobulin-mutation
#19
Pradeep Vasudevan, Corrina Powell, Adeline K Nicholas, Ian Scudamore, James Greening, Soo-Mi Park, Nadia Schoenmakers
In the absence of maternal thyroid disease or iodine deficiency, fetal goitre is rare and usually attributable to dyshormonogenesis, for which genetic ascertainment is not always undertaken in the UK. Mechanical complications include tracheal and oesophageal compression with resultant polyhydramnios, malpresentation at delivery and neonatal respiratory distress. We report an Indian kindred in which the proband (first-born son) had congenital hypothyroidism (CH) without obvious neonatal goitre. His mother's second pregnancy was complicated by fetal hypothyroid goitre and polyhydramnios, prompting amniotic fluid drainage and intraamniotic therapy (with liothyronine, T3 and levothyroxine, T4)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28554938/term-admissions-to-neonatal-units-in-england-a-role-for-transitional-care-a-retrospective-cohort-study
#20
Cheryl Battersby, Stephanie Michaelides, Michele Upton, Janet M Rennie
OBJECTIVE: To identify the primary reasons for term admissions to neonatal units in England, to determine risk factors for admissions for jaundice and to estimate the proportion who can be cared for in a transitional setting without separation of mother and baby. DESIGN: Retrospective observational study using neonatal unit admission data from the National Neonatal Research Database and data of live births in England from the Office for National Statistics. SETTING: All 163 neonatal units in England 2011-2013...
May 29, 2017: BMJ Open
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