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https://www.readbyqxmd.com/read/25220130/evaluation-and-management-of-thrombocytopenic-neonates-in-the-intensive-care-unit
#1
REVIEW
Antonio Del Vecchio
Thrombocytopenia is a very frequent problem among sick neonates, affecting up to 35% of all infants admitted to the neonatal intensive care unit (NICU), and serves as an important indicator of multiple clinical conditions. The cause of the thrombocytopenia is unclear in up to 60% of affected neonates. A clinical classification of thrombocytopenia is based on the time of presentation, early (≤72 hours of life) vs. late (>72 hours of life). Early thrombocytopenia is commonly associated with feto-maternal conditions, is most commonly caused by disorders associated with placental insufficiency, and is generally mild to moderate and resolves spontaneously within 7-10 days without any intervention...
September 2014: Early Human Development
https://www.readbyqxmd.com/read/25301082/neonatal-thrombocytopenia-and-platelet-transfusion-a-uk-perspective
#2
REVIEW
Robert Carr, Anne M Kelly, Lorna M Williamson
Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused platelets. This review summarises the common causes and mechanisms of thrombocytopenia in the newborn. Relevant evidence relating the platelet count to the risk of haemorrhage is reviewed, and current UK guidance on transfusion thresholds outlined. The UK policy for the provision of platelets for transfusion to neonates is described, including the particular requirements for neonatal allo-immune thrombocytopenia...
2015: Neonatology
https://www.readbyqxmd.com/read/21950766/how-i-manage-neonatal-thrombocytopenia
#3
REVIEW
Subarna Chakravorty, Irene Roberts
Although neonatal thrombocytopenia (platelet count < 150×10(9) /l) is a common finding in hospital practice, a careful clinical history and examination of the blood film is often sufficient to establish the diagnosis and guide management without the need for further investigations. In preterm neonates, early-onset thrombocytopenia (<72h) is usually secondary to antenatal causes, has a characteristic pattern and resolves without complications or the need for treatment. By contrast, late-onset thrombocytopenia in preterm neonates (>72h) is nearly always due to post-natally acquired bacterial infection and/or necrotizing enterocolitis, which rapidly leads to severe thrombocytopenia (platelet count<50×10(9) /l)...
January 2012: British Journal of Haematology
https://www.readbyqxmd.com/read/18433954/thrombocytopenia-in-the-neonate
#4
REVIEW
Irene Roberts, Simon Stanworth, Neil A Murray
Thrombocytopenia is one of the commonest haematological problems in neonates, affecting at least 25% of all admissions to neonatal intensive care units (NICUs) [Murray NA, Howarth LJ, McCloy MP et al. Platelet transfusion in the management of severe thrombocytopenia in neonatal intensive care unit patients. Transfus Med 2002;12:35-41; Garcia MG, Duenas E, Sola MC et al. Epidemiologic and outcome studies of patients who received platelet transfusions in the neonatal intensive care unit. J Perinatol 2001;21:415-20; Del Vecchio A, Sola MC, Theriaque DW et al...
July 2008: Blood Reviews
https://www.readbyqxmd.com/read/26216323/thrombocytopenia-in-small-for-gestational-age-infants
#5
Robert D Christensen, Vickie L Baer, Erick Henry, Gregory L Snow, Allison Butler, Martha C Sola-Visner
BACKGROUND: Thrombocytopenia is common among small-for-gestational-age (SGA) neonates (birth weight <10th percentile reference range), but several aspects of this thrombocytopenia are unclear, including the incidence, typical nadir, duration, association with preeclampsia, mechanism, and risk of death. METHODS: Using 9 years of multihospital records, we studied SGA neonates with ≥2 platelet counts <150,000/μL in their first week. RESULTS: We found first-week thrombocytopenia in 31% (905 of 2891) of SGA neonates versus 10% of non-SGA matched controls (P < ...
August 2015: Pediatrics
https://www.readbyqxmd.com/read/27150977/higher-or-lower-oxygen-for-delivery-room-resuscitation-of-preterm-infants-below-28-completed-weeks-gestation-a-meta-analysis
#6
REVIEW
Ju Lee Oei, Maximo Vento, Yacov Rabi, Ian Wright, Neil Finer, Wade Rich, Vishal Kapadia, Dagfinn Aune, Denise Rook, William Tarnow-Mordi, Ola D Saugstad
OBJECTIVE: To systematically review outcomes of infants ≤28+6 weeks gestation randomised to resuscitation with low (≤0.3) vs high (≥0.6) fraction of inspired oxygen (FiO2) at delivery. DESIGN: Systematic review of randomised controlled trials of low (≤0.3) vs high (≥0.6) FiO2 resuscitation. Information was obtained from databases (Medline/Pub Med, EMBASE, ClinicalTrials.gov, Cochrane) and meeting abstracts between 1990 to 2015. Search index terms: preterm/ resuscitation/oxygen...
January 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28196933/can-i-stop-phototherapy-for-this-baby
#7
Ian M Paul, M Jeffrey Maisels
No abstract text is available yet for this article.
February 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28196365/the-golden-age-of-probiotics-a-systematic-review-and-meta-analysis-of-randomized-and-observational-studies-in-preterm-infants
#8
Elda Dermyshi, Yizhong Wang, Chongbin Yan, Wenchao Hong, Gang Qiu, Xiaohui Gong, Ting Zhang
BACKGROUND: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. OBJECTIVES: The aim of this work was to analyse all studies (randomized controlled trials, RCTs, and observational studies) assessing the use of probiotics in very low birth weight (VLBW) preterm infants. SEARCH METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, and Web of Science...
February 15, 2017: Neonatology
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#9
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/27940508/persistent-pulmonary-hypertension-of-the-newborn-in-late-preterm-and-term-infants-in-california
#10
Martina A Steurer, Laura L Jelliffe-Pawlowski, Rebecca J Baer, J Colin Partridge, Elizabeth E Rogers, Roberta L Keller
BACKGROUND AND OBJECTIVES: There are limited epidemiologic data on persistent pulmonary hypertension of the newborn (PPHN). We sought to describe the incidence and 1-year mortality of PPHN by its underlying cause, and to identify risk factors for PPHN in a contemporary population-based dataset. METHODS: The California Office of Statewide Health Planning and Development maintains a database linking maternal and infant hospital discharges, readmissions, and birth and death certificates from 1 year before to 1 year after birth...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28131321/neonatal-pain-management
#11
Brian S Carter, Jessica Brunkhorst
Pain management in the neonatal ICU remains challenging for many clinicians and in many complex care circumstances. The authors review general pain management principles and address the use of pain scales, non-pharmacologic management, and various agents that may be useful in general neonatal practice, procedurally, or at the end of life. Chronic pain and neonatal abstinence are also noted.
January 25, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/26960919/extubating-extremely-preterm-infants-predictors-of-success-and-outcomes-following-failure
#12
Brett J Manley, Lex W Doyle, Louise S Owen, Peter G Davis
OBJECTIVES: To identify variables that predict extubation success in extremely preterm infants born <28 weeks gestational age (GA), and to compare outcomes between those who had successful or failed extubation. STUDY DESIGN: A secondary analysis of data from a randomized trial of postextubation respiratory support that included 174 extremely preterm infants. "Extubation success" was defined as not requiring reintubation within 7 days, and "extubation failure" the converse...
June 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28125815/patent-ductus-arteriosus-treatment-in-very-preterm-infants-a-european-population-based-cohort-study-epice-on-variation-and-outcomes
#13
Anna-Karin Edstedt Bonamy, Anna Gudmundsdottir, Rolf F Maier, Liis Toome, Jennifer Zeitlin, Mercedes Bonet, Alan Fenton, Asbjørn Børch Hasselager, Arno van Heijst, Ludwig Gortner, David Milligan, Patrick Van Reempts, Elaine M Boyle, Mikael Norman
BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity...
January 26, 2017: Neonatology
https://www.readbyqxmd.com/read/28114678/revisiting-the-definition-of-bronchopulmonary-dysplasia-effect-of-changing-panoply-of-respiratory-support-for-preterm-neonates
#14
Tetsuya Isayama, Shoo K Lee, Junmin Yang, David Lee, Sibasis Daspal, Michael Dunn, Prakesh S Shah
Importance: Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units. Objective: To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants. Design, Setting, and Participants: Retrospective cohort study at tertiary neonatal intensive care units...
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28004188/comparative-study-of-the-efficacy-and-safety-of-paracetamol-ibuprofen-and-indomethacin-in-closure-of-patent-ductus-arteriosus-in-preterm-neonates
#15
Abd El-Rahman El-Mashad, Heba El-Mahdy, Doaa El Amrousy, Marwa Elgendy
In this prospective study, we compared the efficacy and side effects of indomethacin, ibuprofen, and paracetamol in patent ductus arteriosus (PDA) closure in preterm neonates. Three hundred preterm neonates with hemodynamically significant PDA (hs-PDA) admitted at our neonatal intensive care unit were enrolled in the study. They were randomized into three groups. Group I (paracetamol group) received 15 mg/kg/6 h IV paracetamol infusion for 3 days. Group II (ibuprofen group) received 10 mg/kg IV ibuprofen infusion followed by 5 mg/kg/day for 2 days...
February 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/22954268/weaning-infants-from-mechanical-ventilation
#16
REVIEW
G M Sant'Anna, Martin Keszler
Protracted mechanical ventilation is associated with increased morbidity and mortality in preterm infants and thus the earliest possible weaning from mechanical ventilation is desirable. Weaning protocols may be helpful in achieving more rapid reduction in support. There is no clear consensus regarding the level of support at which an infant is ready for extubation. An improved ability to predict when a preterm infant has a high likelihood of successful extubation is highly desirable. In this article, available evidence is reviewed and reasonable evidence-based recommendations for expeditious weaning and extubation are provided...
September 2012: Clinics in Perinatology
https://www.readbyqxmd.com/read/27942261/congenital-hypothyroidism-optimal-initial-dosage-and-time-of-initiation-of-treatment-a-systematic-review
#17
REVIEW
Khaled Rahmani, Shahin Yarahmadi, Koorosh Etemad, Ahmad Koosha, Yadollah Mehrabi, Nasrin Aghang, Hamid Soori
CONTEXT: Appropriate management of neonates, tested positive for congenital hypothyroidism (CH), in particular, the initial dosage of levothyroxine and the time of initiation of treatment is a critical issue. The aim of this study was to assess all current evidence available on the subject to ascertain the optimal initial dose and optimal initiation time of treatment for children with CH. EVIDENCE ACQUISITION: In this study, all published research related to the initiation treatment dose and the onset time of treatment in congenital hypothyroidism were reviewed...
July 2016: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/23377780/hypertrophic-cardiomyopathy-in-neonates-with-congenital-hyperinsulinism
#18
TingTing Huang, Andrea Kelly, Susan A Becker, Meryl S Cohen, Charles A Stanley
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a well-recognised complication in infants of diabetic mothers and is attributed to a compensatory increase in fetal insulin secretion. Infants with congenital hyperinsulinism have excessive prenatal and postnatal insulin secretion due to defects in pathways of insulin secretion (most commonly the KATP channel). HCM has been reported in a few neonates with hyperinsulinism, but its extent and risk factors for its development have not been evaluated...
July 2013: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27694281/interventions-to-improve-patient-safety-during-intubation-in-the-neonatal-intensive-care-unit
#19
L Dupree Hatch, Peter H Grubb, Amanda S Lea, William F Walsh, Melinda H Markham, Patrick O Maynord, Gina M Whitney, Ann R Stark, E Wesley Ely
OBJECTIVE: To improve patient safety in our NICU by decreasing the incidence of intubation-associated adverse events (AEs). METHODS: We sequentially implemented and tested 3 interventions: standardized checklist for intubation, premedication algorithm, and computerized provider order entry set for intubation. We compared baseline data collected over 10 months (period 1) with data collected over a 10-month intervention and sustainment period (period 2). Outcomes were the percentage of intubations containing any prospectively defined AE and intubations with bradycardia or hypoxemia...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/26042912/inborn-errors-of-metabolism
#20
REVIEW
Ayman W El-Hattab
Inborn errors of metabolism (IEM) are individually rare but collectively common. Approximately 25% of IEMs can have manifestations in the neonatal period. Neonates with IEM are usually healthy at birth; however, in hours to days after birth they can develop nonspecific signs that are common to several other neonatal conditions. Therefore, maintaining a high index of suspicion is extremely important for early diagnosis and the institution of appropriate therapy, which are mandatory to prevent death and ameliorate complications from many IEMs...
June 2015: Clinics in Perinatology
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