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Intravenous fluids for neonates

Cinzia Auriti, Marco Falcone, Maria Paola Ronchetti, Bianca Maria Goffredo, Sara Cairoli, Rosamaria Crisafulli, Fiammetta Piersigilli, Tiziana Corsetti, Andrea Dotta, Manjunath P Pai
High doses of micafungin are advocated in neonates with systemic candidiasis but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, 3 with meningitis, were treated for at least 14 days with 8 to 15 mg/kg/day of intravenous micafungin. Plasma concentrations (4 measurements) were determined after the third dose and cerebrospinal-fluid (CSF) concentrations were also obtained in three patients. Population PK analyses were used to identify the optimal model and further validated using external data (n=5)...
October 3, 2016: Antimicrobial Agents and Chemotherapy
Frank H Morriss, Julie B Lindower, Heather L Bartlett, Dianne L Atkins, Jean O Kim, Jonathan M Klein, Bradley A Ford
Objective We describe five neonates with enteroviral (EV) infection to demonstrate central nervous system (CNS) and cardiac complications and report successful treatment of myocarditis with immunoglobulin intravenous (IVIG) in two. Study Design Case series identified during three enteroviral seasons in one neonatal intensive care unit (NICU) by cerebral spinal fluid (CSF) reverse transcriptase polymerase chain reaction (PCR) testing for EV in neonates suspected to have sepsis, but with sterile bacterial cultures...
July 2016: American Journal of Perinatology Reports
Annie Janvier, Barbara Farlow, Keith J Barrington
Trisomy 13 and 18 are life-limiting conditions for which a palliative approach is frequently recommended. The objective of this study was to examine parental goals/decisions, the length of life of their child and factors associated with survival. Parents of children who lived with trisomy 13 or 18 that were part of English-speaking social networks were invited to participate in a questionnaire study. Participants answered questions about their hopes/goals, decisions regarding neonatal interventions, and the duration of their children's lives...
September 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Joanne Perkins, Virginia Aguado-Lorenzo, Sara Arenas-Lopez
: The use of standard concentrations of intravenous infusions has been advocated by international organisations to increase intravenous medication safety in paediatric and neonatal critical care. However, there is no guidance on how to identify and implement these infusions leading to great interunit variability. OBJECTIVE: To identify the most appropriate clinical concentrations required by our paediatric intensive care unit (PICU) population with regard to accuracy of delivery and overall fluid allowance...
August 14, 2016: Journal of Pharmacy and Pharmacology
M Petrea Cober
To accommodate small fluid volumes, repackaging of intravenous fat emulsions (IVFEs) is frequently performed in institutions providing parenteral nutrition to neonates and smaller pediatric patients. However, some consider this an unsafe practice. Concerns for potential administration errors leading to an overdose of IVFEs are weighed against the potential for microbial contamination from the repackaging process. The clinician providing pediatric nutrition support should tailor repackaging practices to ensure patient safety and quality...
October 2016: Nutrition in Clinical Practice
Michael Sgro, Douglas M Campbell, Neil Gandhi
The case presented advocates for prolonged resuscitation, and aggressive rewarming in neonates with severe hypothermia (core temperature <32.0°C). The importance of rewarming has not been extensively studied in current guidelines, whereas the importance of cardiopulmonary resuscitation is well established. This abandoned, severely hypothermic (found with temperature of 27.9°C) newborn had an excellent neurological outcome at two years of age with aggressive resuscitation and rewarming techniques initiated at the time of presentation...
May 2016: Paediatrics & Child Health
Tugce Tural Kara, Tugba Erat, Halil Ozdemir, Aysun Yahsi, Suat Fitoz, Ergin Ciftci, Erdal Ince
Calcaneus osteomyelitis is a rare infection in newborns. Invasive procedures, prematurity and low birth wight are some causative factors. The clinical signs may be mild. We report a neonate with calcaneous osteomyelitis which was secondary to a Guthrie test sample. She was admitted to hospital with swelling, redness and increased temperature on her heel. Superficial tissue ultrasound showed fluid collection with heavy content was observed on the posterior of the right foot. Puncture and drainage was performed and methicillin-susceptible Staphylococcus aureus was isolated from the drainage culture...
August 1, 2016: Archivos Argentinos de Pediatría
Tinisha M Lambeth, Mario A Rojas, Amy P Holmes, Robin B Dail
BACKGROUND: Very low birth-weight (<1500 g) infants are vulnerable to their environment during the first hour after birth. We designed an evidence-based golden hour protocol (GHP) with a goal to stabilize and perform admission procedures within 1 hour of birth at a level IIIB neonatal intensive care unit (NICU). PURPOSE: The aim of this quality improvement project was to ascertain whether an evidence-based GHP would improve care efficiency and short-term outcomes...
August 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Rupsa C Boelig, Samantha J Barton, Gabriele Saccone, Anthony J Kelly, Steve J Edwards, Vincenzo Berghella
BACKGROUND: Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy affecting 0.3% to 1.0% of pregnancies, and is one of the most common indications for hospitalization during pregnancy. While a previous Cochrane review examined interventions for nausea and vomiting in pregnancy, there has not yet been a review examining the interventions for the more severe condition of hyperemesis gravidarum. OBJECTIVES: To assess the effectiveness and safety, of all interventions for hyperemesis gravidarum in pregnancy up to 20 weeks' gestation...
2016: Cochrane Database of Systematic Reviews
Nata Pratama Hardjo Lugito, Cucunawangsih, Andree Kurniawan
Sphingomonas paucimobilis is a yellow-pigmented, glucose nonfermenting, aerobic, Gram negative bacillus of low pathogenicity. This organism was found in the implantation of indwelling catheters, sterile intravenous fluid, or contaminated hospital environment such as tap and distilled water, nebulizer, ventilator, and hemodialysis device. A 55-year-old female was hospitalized for diabetic foot ulcer in the presence of multiple comorbidities: diabetes mellitus, colonic tuberculosis, end-stage renal disease, and indwelling catheters for central venous catheter and hemodialysis...
2016: Case Reports in Infectious Diseases
Michael D Staudt, Daniel Etarsky, Adrianna Ranger
BACKGROUND: Cephalohematomas are relatively common sub-periosteal collections of blood that tend to resolve spontaneously without treatment. Rarely, they become infected and can be associated with underlying osteomyelitis, meningitis, or sepsis. Common pathogens include Escherichia coli and Staphylococcus species. ILLUSTRATIVE CASE: This report describes the first case of a neonate developing an infected right parietal cephalohematoma and underlying osteomyelitis caused by Morganella morganii, which was cultured in blood and cephalohematoma aspirate...
August 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Monika Lachowska, Krzysztof Lachowski, Barbara Królak-Olejnik
INTRODUCTION: Percutaneously inserted central venous catheters (epicutaneo-cava-catheter - ECC) are widely used in neonatal intensive care, facilitating the parenteral nutrition and the treatment of critically ill newborns. This invasive procedure is regarded as safe and associated with low complication rate. Possible life-threatening complications may result from malpositioning of ECC. Paraspinal misplacement of ECC is one of the most serious complications. CASE PRESENTATION: The authors report a case of misplacement of ECC inserted via left saphenous vein for intravenous feeding...
2016: Journal of Vascular Access
Megan Doty, Christine Wade, Julie Farr, Vanessa Celleri Gomezcoello, Gregory Martin, Tala Nasr
Objective The aim of this study was to determine whether very low-birth-weight (VLBW) infants who had feedings withheld during all blood transfusions had a lower incidence of necrotizing enterocolitis (NEC) compared with infants who were fed during transfusions. Study Design A retrospective chart review over a 3-year period in a level-3 neonatal intensive care unit was conducted. A total of 108 inborn VLBW infants (weight range: 500-1,500 g) who had received a transfusion before 36 weeks were reviewed. Diagnosis of NEC (≥ Bell stage II), demographics, feeds, transfusions, outcomes, and variables associated with NEC were collected...
July 2016: American Journal of Perinatology
Jessica Rankin, Vincent J Wang, Fariba Goodarzian, Hollie A Lai
IMPORTANCE: Neonatal and infant lumbar puncture is a commonly performed procedure in emergency departments, yet traumatic and unsuccessful lumbar punctures occur 30% to 50% of the time. Dehydration may be a risk factor for unsuccessful lumbar punctures, but to our knowledge, no studies have investigated the use of intravenous (IV) fluid bolus prior to lumbar puncture. OBJECTIVE: To investigate the association of IV fluid bolus administration with the sonographic measure of the neonatal and infant lumbar subarachnoid space...
March 2016: JAMA Pediatrics
Hakki Unlugenc, Mediha Turktan, Ismail Cuneyt Evruke, Murat Gunduz, Refik Burgut, Hacer Yapicioglu-Yildizdas, Geylan Isik
PURPOSE: Spinal anesthesia for caesarean delivery is often associated with hypotension. This study was conducted to evaluate the effects of rapid crystalloid (Lactated Ringer's solution; LRS) or colloid (hydroxyethyl starch; HES) cohydration with a second intravenous access line on the incidence of hypotension and ephedrine requirement during spinal anesthesia for cesarean section. METHODS: We studied 90 women with uncomplicated pregnancies undergoing elective cesarean section under spinal anesthesia...
October 2015: Middle East Journal of Anesthesiology
Iris J Grooten, Ben W Mol, Joris A M van der Post, Carrie Ris-Stalpers, Marjolein Kok, Joke M J Bais, Caroline J Bax, Johannes J Duvekot, Henk A Bremer, Martina M Porath, Wieteke M Heidema, Kitty W M Bloemenkamp, Hubertina C J Scheepers, Maureen T M Franssen, Martijn A Oudijk, Tessa J Roseboom, Rebecca C Painter
BACKGROUND: Hyperemesis gravidarum (HG), or intractable vomiting during pregnancy, is the single most frequent cause of hospital admission in early pregnancy. HG has a major impact on maternal quality of life and has repeatedly been associated with poor pregnancy outcome such as low birth weight. Currently, women with HG are admitted to hospital for intravenous fluid replacement, without receiving specific nutritional attention. Nasogastric tube feeding is sometimes used as last resort treatment...
2016: BMC Pregnancy and Childbirth
Christopher Sawyer, Dimitrios Angelis, Robert Bennett
We report a case of Eikenella corrodens sepsis associated with CSF pleocytosis in a very low birth weight neonate. A 1000-gram male neonate was born at 27-week gestation due to preterm labor. The patient presented with signs and symptoms of sepsis and was treated for suspected meningitis with intravenous ampicillin and gentamicin for 7 days, with cefotaxime added for three weeks. He had a normal brain MRI at discharge and normal development at 6 months of life. To our knowledge, this is the first case of E...
2015: Case Reports in Pediatrics
Jamie K Overbey, Alexander A Kon
BACKGROUND: In 2007, an update was released to the pediatric and neonatal septic shock guidelines, which emphasized early use of therapies, specifically, first-hour fluid resuscitation and inotrope therapy. This has led to increased use of intraosseous (IO) access as a source of vascular access. Previously, IO access could be obtained only via a manual IO placement. New semi-automatic devices, such as EZ-IO(®) (Vidacare, Shavano Park, TX), allow for safer and quicker IO access. Data support the use of semi-automatic devices during the acute resuscitation period...
January 2016: Journal of Emergency Medicine
Maria Lorella Giannì, Paola Roggero, Pasqua Piemontese, Nadia Liotto, Anna Orsi, Orsola Amato, Francesca Taroni, Laura Morlacchi, Dario Consonni, Fabio Mosca
BACKGROUND: Late preterm birth accounts for 70 % of all preterm births. While the impact of feeding problems in very preterm infants has been widely investigated, data on late preterm infants' feeding issues are scarce. The aim of the present study was to investigate the need of nutritional support during hospital stay in a cohort of late preterm infants and to identify the factors that most contribute to its occurrence. METHODS: We analyzed the medical records of late preterm infants, born 2011-2013, admitted to a single institution...
2015: BMC Pediatrics
Vidya V Pai, Laura A Vella, Evan S Fieldston
No abstract text is available yet for this article.
November 2015: Hospital Pediatrics
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