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Managment of neonatal shock

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https://www.readbyqxmd.com/read/28211488/differences-in-the-clinical-characteristics-of-early-and-late-onset-necrotizing-enterocolitis-in-full-term-infants-a-retrospective-case-control-study
#1
Qiu-Yu Li, Yao An, Li Liu, Xue-Qiu Wang, Shi Chen, Zheng-Li Wang, Lu-Quan Li
Information regarding the influence of age at onset on prognosis in full-term infants with necrotizing enterocolitis (NEC) is limited, and identifying differences between the clinical characteristics of early-onset NEC (EO-NEC) and late-onset NEC (LO-NEC) may be helpful in the determination of effective management strategies. In the present study, the medical records of 253 full-term infants with NEC were reviewed, and the clinical characteristics of the EO-NEC group (n = 150) and the LO-NEC group (n = 103) were compared...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28148323/primary-care-management-of-patients-with-coarctation-of-the-aorta
#2
REVIEW
Jeffrey R Boris
Coarctation of the aorta is a congenital cardiac defect that results in a variable degree of obstruction to the left side of the heart. It can present with either acute shock in the neonatal period as a critical lesion or it can appear more insidiously with hypertension or other findings later in life. This article summarises aspects of outpatient care of patients with this lesion, including clinical history and physical examination, ancillary testing, and issues associated with long-term follow-up and management...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28137353/management-of-neonatal-hypotension
#3
Brian T Kalish
Hypotension is a common problem in neonates with complex underlying pathophysiology. Although treatment of low blood pressure is common, clinicians must use all available information to target neonates with compromised perfusion. Pharmacotherapy should be tailored to the specific physiologic perturbations of the individual neonate. Dopamine is the most commonly utilized agent and may be the most appropriate agent for septic shock with low diastolic blood pressure. However, alternative therapies should be considered for other etiologies of hypotension, including milrinone and vasopressin for persistent pulmonary hypertension of the newborn and dobutamine for patent ductus arteriosus...
January 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28009331/a-study-of-acute-kidney-injury-in%C3%A2-hospitalized-preterm-neonates-in-nicu
#4
N Nagaraj, P K Berwal, A Srinivas, A Berwal
OBJECTIVES: This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates. METHODS: This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed. RESULTS: The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28005910/melioidosis-in-malaysia-a-review-of-case-reports
#5
Paul Vijay Kingsley, Mark Leader, Nandika Suranjith Nagodawithana, Meghan Tipre, Nalini Sathiakumar
BACKGROUND: Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. OBJECTIVE: We sought to review case reports of melioidosis from Malaysia. METHODS: We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27986330/making-the-quick-diagnosis-a-case-of-neonatal-shock
#6
Mike Gardiner, Timothy K Ruttan, Andrew J Kienstra, Matthew Wilkinson
BACKGROUND: The work-up and initial management of a critically ill neonate is challenging and anxiety provoking for the Emergency Physician. While sepsis and critical congenital heart disease represent a large proportion of neonates presenting to the Emergency Department (ED) in shock, there are several additional etiologies to consider. Underlying metabolic, endocrinologic, gastrointestinal, neurologic, and traumatic disorders must be considered in a critically ill infant. Several potential etiologies will present with nonspecific and overlapping signs and symptoms, and the diagnosis often is not evident at the time of ED assessment...
December 13, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27777295/single-ventricle-outcomes-after-neonatal-palliation-of-severe-ebstein-anomaly-with-modified-starnes-procedure
#7
S Ram Kumar, Grace Kung, Nathan Noh, Novel Castillo, Brian Fagan, Winfield J Wells, Vaughn A Starnes
BACKGROUND: We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known. METHODS: We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27747129/delayed-diagnosis-of-iatrogenic-bladder-perforation-in-a-neonate
#8
Antoinette S Birs, Jose A Perez, Mark A Rich, Hubert S Swana
Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates...
2016: Case Reports in Urology
https://www.readbyqxmd.com/read/27468829/ebola-virus-disease-and-critical-illness
#9
REVIEW
Aleksandra Leligdowicz, William A Fischer, Timothy M Uyeki, Thomas E Fletcher, Neill K J Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S Schieffelin, David Brett-Major, Daniel G Bausch, Nikki Shindo, Adrienne K Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G Marshall Lyon, Robert A Fowler
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury...
July 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27459146/successful-delivery-after-surgical-repair-of-uterine-rupture-at-15-weeks-of-gestation-case-report-and-brief-review
#10
REVIEW
D Surico, R Amadori, A Vigone, C D'Agostino, M Dessole, N Surico
OBJECTIVE: Second-trimester uterine rupture is a rare disorder and it is unclear if it should be managed with caesarean section, repair or hysterectomy. This article provides a case report of second-trimester uterine rupture repair, and reviews the risk factors, signs and symptoms, suturing technique and newborn outcome. METHODS: PubMed was searched using the terms 'uterine rupture', 'second trimester' and 'repair' Only cases of second-trimester uterine rupture repair that led to successful prolongation of pregnancy were included...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27434146/pulmonary-hemorrhage-due-to-coxsackievirus-b-infection-a-call-to-raise-suspicion-of-this-important-complication-as-an-end-stage-of-enterovirus-sepsis-in-preterm-twin-neonates
#11
Rotem Orbach, Dror Mandel, Ronit Lubetzky, Amit Ovental, Alon Haham, Ora Halutz, Galia Grisaru-Soen
BACKGROUND: Prematurity is an important risk factor for the fulminate form of neonatal enteroviral infection. Pulmonary hemorrhage is a morbid complication that should be anticipated and managed aggressively due to its fatal outcome. OBJECTIVE: To emphasize the significance of pulmonary hemorrhage as a complication of severe enterovirus infection in preterm neonates. STUDY DESIGN: This report is a description of the clinical history, medical management and clinical outcomes of two pairs of preterm twin newborns (30 weeks and 36 weeks) with fulminant infection due to Coxsackievirus B (CBV) infection...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/27381702/year-in-review-2015-extracorporeal-membrane-oxygenation
#12
REVIEW
Lakshmi Raman, Heidi J Dalton
Extracorporeal membrane oxygenation (ECMO) is a modified form of cardiopulmonary bypass. Although early trials were plagued by severe bleeding and high rates of death, subsequent experience with neonates found good survival, and ECMO became an important tool in the care of critically ill infants with respiratory failure. Since the 1980s, expansion to other groups (children, patients with cardiac disease, etc) followed as experience was obtained. Today, there is a rapid growth of ECMO, especially in the adult population...
July 2016: Respiratory Care
https://www.readbyqxmd.com/read/27206637/near-infrared-spectroscopy-the-new-must-have-tool-in-the-intensive-care-unit
#13
REVIEW
Michael Stuart Green, Sankalp Sehgal, Rayhan Tariq
Standard hemodynamic monitoring such as blood pressure and pulse oximetry may only provide a crude estimation of organ perfusion in the critical care setting. Near-infrared spectroscopy (NIRS) is based on the same principle as a pulse oximeter and allows continuous noninvasive monitoring of hemoglobin oxygenation and deoxygenation and thus tissue saturation "StO2" This review aims to provide an overview of NIRS technology principles and discuss its current clinical use in the critical care setting. The study selection was performed using the PubMed database to find studies that investigated the use of NIRS in both the critical care setting and in the intensive care unit...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27147768/training-of-midwives-in-advanced-obstetrics-in-liberia
#14
Obed Dolo, Alice Clack, Hannah Gibson, Naomi Lewis, David P Southall
PROBLEM: The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. APPROACH: In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. LOCAL SETTING: The training took place in CB Dunbar Maternity Hospital...
May 1, 2016: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/27133548/-cardiogenic-shock-due-to-spontaneous-neonatal-thrombosis-of-the-abdominal-aorta
#15
J Brice, P Venot, M Colinart-Thomas, P Morville
Neonatal arterial thrombosis is unusual and generally associated with an arterial umbilical catheter. Spontaneous aortic thrombosis is exceptional but its severity is related to high mortality rate and renovascular morbidity. We report here the observation of a 10-day-old term infant showing a large abdominal aortic thrombosis revealed by cardiogenic shock induced by systemic arterial hypertension. The resolution was fast following anticoagulant and antihypertensive therapy. Etiologic investigations showed renal failure and moderate hyperhomocysteinemia controlled by a vitamin supplement...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27096879/congenital-heart-disease-in-pediatric-patients-recognizing-the-undiagnosed-and-managing-complications-in-the-emergency-department
#16
REVIEW
Pavan Judge, Garth Meckler Mshs
Congenital heart disease is the most common form of all congenital malformations and, despite advances in prenatal and newborn screening, it may present undiagnosed to the emergency department. Signs and symptoms of congenital heart disease are variable and often nonspecific, making recognition and treatment challenging. Patient presentations can range from life-threatening shock or cyanosis in a neonate to respiratory distress or failure to thrive in infants. Advances in surgical techniques have improved short- and long-term survival of infants and children with congenital heart disease, but these children are at risk for a variety of complications related to the underlying or surgical anatomy and physiology...
May 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/27069349/spectrum-of-maternofetal-outcomes-during-dengue-infection-in-pregnancy-an-insight
#17
Swati Sharma, Sandhya Jain, Shalini Rajaram
Dengue is a vector transmitted viral infection; tropical and subtropical countries see outbreaks of dengue each year. There is a paucity of literature on effects of dengue infection on pregnancy outcome and this prompted us to undertake a study for better understanding of pregnancy implications with dengue infection. Pregnant women admitted during the seasonal outbreak of dengue between September 2015 and October 2015 were studied and maternal and fetal outcomes in sixteen NS1Ag positive women were analysed...
2016: Infectious Diseases in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26848884/role-of-extracorporeal-membrane-oxygenation-in-adult-respiratory-failure-an-overview
#18
REVIEW
Suneesh Anand, Divya Jayakumar, Wilbert S Aronow, Dipak Chandy
Extracorporeal membrane oxygenation (ECMO) provides complete or partial support of the heart and lungs. Ever since its inception in the 1960s, it has been used across all age groups in the management of refractory respiratory failure and cardiogenic shock. While it has gained widespread acceptance in the neonatal and pediatric physician community, ECMO remains a controversial therapy for Acute Respiratory Distress Syndrome (ARDS) in adults. Its popularity was revived during the swine flu (H1N1) pandemic and advancements in technology have contributed to its increasing usage...
2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/26612744/sepsis-and-septic-shock-in-the-equine-neonate
#19
REVIEW
Christopher Langdon Fielding, Kiragos Gary Magdesian
Sepsis and septic shock represent a major cause of morbidity and mortality in equine neonates and in all species. Early recognition of the condition is important, but definitive examination and laboratory variables to predict equine neonatal sepsis are lacking. Early and aggressive treatment should include broad-spectrum antimicrobial coverage, source control, and hemodynamic support. Field practitioners and intensive care clinicians work together in the management of this condition because the recognition and initial treatment should begin as early as possible...
December 2015: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/26232159/soluble-cd14-subtype-scd14-st-presepsin-in-premature-and-full-term-critically-ill-newborns-with-sepsis-and-sirs
#20
Michele Mussap, Elisabetta Puxeddu, Melania Puddu, Giovanni Ottonello, Ferdinando Coghe, Paola Comite, Francesco Cibecchini, Vassilios Fanos
Neonatal sepsis still remains a major cause of morbidity and mortality in neonatal intensive care unit (NICU). Recently, soluble CD14 subtype (sDC14-ST) also named presepsin, was proposed as an effective biomarker for diagnosing, monitoring, and assessing the risk of neonatal sepsis and septic shock. The aim of this study was to investigate the diagnostic accuracy of sCD14-ST presepsin in diagnosing neonatal bacterial sepsis and in discriminating non-bacterial systemic inflammatory response syndrome (SIRS) from bacterial sepsis...
December 7, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
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