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Neonatology Questions and Controversies: Neonatal Hemodynamics
- 4th Edition - November 1, 2023
- Editors: Richard A. Polin, Martin Kluckow, Patrick McNamara
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 8 8 0 7 3 - 2
Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering… Read more
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Institutional subscription on ScienceDirect
Request a sales quoteDr. Richard Polin’s Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today’s practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient.
The thoroughly updated, full-color, 4th Edition of Neonatal Hemodynamics:
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Provides in-depth clinical overviews of the many hemodynamic conditions that are relevant for the neonatologist, offering guidance based on the most up-to-date understanding of underlying pathophysiology.
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Places emphasis on controversial areas that can entail different approaches.
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Features the most current clinical information throughout, covering everything from basic cardiovascular physiology to advanced monitoring and hemodynamic assessment. Several chapters have been revised to focus on the novel concepts of hemodynamic phenotypes, enhanced diagnostic precision, and phenotypic profiling, and are illustrated by demonstrative case presentations.
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Includes new chapters on neonatal hemodynamic pharmacology, hemodynamic management in special circumstances (twin-twin transfusion, infant of a diabetic mother, arteriovenous malformations), neonatal hemodynamic care in the resource-challenged country, chronic pulmonary hypertension assessment and management, and more.
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Utilizes a consistent chapter organization to help you find information quickly and easily, and contains numerous charts, graphs, radiographic images, and photographs throughout.
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Offers the most authoritative advice available from world-class neonatologists with expertise in neonatal hemodynamics, who share their knowledge of new trends and developments in neonatal care.
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An eBook version is included with purchase. The eBook allows you to access all of the text, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud.
Purchase each volume individually, or get the entire 7-volume Neonatology Questions and Controversies set, which includes online access that allows you to search across all titles!
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Gastroenterology and Nutrition
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Hematology and Transfusion Medicine
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Neonatal Hemodynamics
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Infectious Disease, Immunology, and Pharmacology
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Renal, Fluid, and Electrolyte Disorders
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Neurology
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The Newborn Lung
neonatologists, neonatal nurse practitioners, pediatricians
- Cover image
- Title page
- Table of Contents
- Other Volumes in the Neonatology Questions and Controversies Series
- Copyright
- Dedication
- Contributors
- Series Foreword
- Preface
- List of Tables
- List of Illustrations
- PART A. Cardiovascular Physiology, Pathophysiology, and Pharmacology
- 1. Principles of developmental cardiovascular physiology and pathophysiology
- Introduction
- Principles of developmental physiology
- Developmental cardiovascular pathophysiology: Etiology and pathophysiology of neonatal shock
- Definition and phases of shock
- Etiology of neonatal shock
- Summary
- References
- 2. Vascular regulation and assessment of blood flow to organs in the neonatal period
- The purposes of blood flow
- The physics
- Regulation of arterial tone
- Blood flow to the brain
- Blood flow to other organs
- Distribution of cardiac output in the healthy human neonate
- Mechanisms governing the redistribution of cardiac output in the fetal “diving” reflex
- Methods to assess organ blood flow in the neonate
- Methods for measurement of perfusion
- Conclusion
- References
- 3. Blood pressure and cardiovascular physiology
- Introduction
- What is blood pressure?
- Regulation of systemic arterial blood pressure
- How to measure blood pressure?
- Blood pressure ranges
- Blood pressure, cardiac output, and clinical assessment
- Interpretation of blood pressure values in clinical scenarios
- Conclusion
- References
- 4. Cardiopulmonary interactions in the mechanically ventilated neonate
- Introduction
- Physiological principles of cardiorespiratory interactions in neonates
- Management of the critically ill neonate: Implications of cardiorespiratory interactions in clinical decisions
- Cardiopulmonary interactions associated with modes of positive pressure ventilation
- Cardiopulmonary interactions in the management of structural heart disease
- Conclusion
- References
- 5. Neonatal cardiovascular drugs
- Introduction
- Cardiovascular support of heart function
- Cardiovascular support for acute and/or chronic pulmonary hypertension (Figure 5.2)
- Support for systemic hypotension
- Support for systemic hypertension
- Fluid modulation
- Modulators of heart rate
- Conclusion
- References
- PART B. Hemodynamics of Postnatal Transition
- 6. Hemodynamic significance and clinical relevance of deferred cord clamping and umbilical cord milking
- The transition to newborn life and lung liquid clearance
- The cardiovascular transition at birth: Effect of umbilical cord clamping
- Placental transfusion during delayed umbilical cord clamping
- Clinical effects of deferred umbilical cord clamping
- Less intervention at birth: Resuscitation versus transitioning
- Conclusions
- References
- 7. Transitional hemodynamics and pathophysiology of peri-/intraventricular hemorrhage
- Introduction
- Fetal and transitional circulation
- Cerebral blood flow
- Vulnerabilities of preterm infants during transition
- Conclusions
- References
- 8. The immature autonomic nervous system, hemodynamic regulation, and brain injury in the early developing brain
- Introduction
- Why focus on the developing ANS?
- ANS development and metrics
- Cerebral hemodynamic control in the developing brain
- Autonomic function and hemodynamics in labor
- Prematurity, brain injury, and systemic hemodynamic disturbances
- Congenital heart disease, autonomic function, and cerebral hemodynamics
- Resolving the relationship between systemic hemodynamics and brain injury: Obstacles to progress
- Measurement of relevant hemodynamic and metabolic indices
- Characterizing “significant” systemic hemodynamic insults and establishing a temporal relationship between hemodynamic changes and brain insults difficult in neonates
- Future directions
- Conclusion
- References
- PART C. Diagnosis of Neonatal Cardiovascular Compromise: Methods and Clinical Applications
- SECTION C1. Assessment of Hemodynamics and Cardiac Function: Ultrasound
- 9. Ultrasound-guided hemodynamic management
- Introduction
- Politics of ultrasound
- Training and accreditation in Australia/New Zealand
- Training and accreditation in North America
- Moving toward the hemodynamic consultation
- Integrating clinical and physiological information to target treatment
- Uses of CPU in the NICU
- Avoiding inappropriate therapy and weaning
- Does CPU make a difference?
- Conclusions
- References
- 10. Assessment of systemic blood flow and myocardial function in the neonatal period using ultrasound
- Introduction
- Assessment of systemic blood flow by ultrasound
- Cavity measures
- Mitral and tricuspid annular plane systolic excursion
- Conclusion
- References
- 11. Advanced cardiac imaging in the newborn: Tissue doppler imaging and speckle tracking echocardiography
- Introduction
- Principles of cardiac function
- Tissue doppler velocity imaging
- Pulsed wave tissue doppler velocity measurements
- Color tissue doppler velocity
- Measurement of TDI velocities
- Clinical application of TDI velocity measurements
- Derived deformation measurements
- Image acquisition
- Sending and storage of acquired images
- Image processing
- Interpretation of the results
- Clinical application of 2DSTE-derived deformation measurements
- Left atrium strain
- Left ventricular rotational mechanics
- Intracardiac blood flow imaging and analysis
- Conclusion
- References
- SECTION C2. Assessment of Hemodynamics and Cardiac Function: Other Methods
- 12. Assessment of cardiac output in neonates: Techniques using the fick principle, indicator dilution technology, doppler ultrasound, electrical biosensing technology, and arterial pulse contour analysis
- Introduction
- The importance of validation
- Fick principle
- Indicator dilution techniques
- Doppler ultrasound
- Electrical biosensing technology
- Arterial pulse contour analysis
- Conclusion
- References
- 13. Cardiac magnetic resonance imaging in the assessment of systemic and organ blood flow and the function of the developing heart
- Introduction
- Current understanding of neonatal hemodynamics
- Cardiac magnetic resonance in adults and newborns
- Current and emerging CMR techniques
- Role of CMR in diagnosis of structural congenital heart disease
- Role of CMR in the study of neonatal hemodynamics
- Conclusion
- References
- 14. Comprehensive, real-time hemodynamic monitoring and data acquisition: An essential component of the development of individualized neonatal intensive care
- Introduction
- Limitations of conventional monitoring
- Assessment of systemic and regional blood flow
- From research to individualized neonatal intensive care
- Conclusion
- References
- 15. Clinical applications of near-infrared spectroscopy in neonates
- Introduction
- Principles of near-infrared spectroscopy
- Near-infrared spectroscopy in clinical care
- Feasibility of NIRS-monitored cerebral oxygenation and extraction in neonatal clinical care
- Clinical applications
- Conclusion
- References
- PART D. Common Hemodynamic Dilemmas in the Neonate
- SECTION D1. Pathophysiology and Treatment of Patent Ductus Arteriosus
- 16. Diagnosis, evaluation, and monitoring of patent ductus arteriosus in the very preterm infant
- Introduction
- Developmental role of the ductus arteriosus
- Regulation of ductal tone and constriction
- Myocardial adaptation in preterm infants to patent ductus arteriosus
- Effects of patent ductus arteriosus on blood pressure
- Effects of a hemodynamically significant patent ductus arteriosus on organ perfusion
- Clinical and radiologic diagnosis of patent ductus arteriosus
- Echocardiographic diagnosis and assessment of a patent ductus arteriosus
- The use of biomarkers in patent ductus arteriosus assessment: Brain natriuretic peptide and N-terminal pro–brain natriuretic peptide
- Near-infrared spectroscopy and patent ductus arteriosus assessment
- Comprehensive appraisal of the hemodynamic significance of the patent ductus arteriosus
- Summary
- References
- 17. Pharmacological management of patent ductus arteriosus in the very preterm neonate
- Introduction
- Epidemiology of PDA treatment
- Pharmacological interventions
- Comparison of the three pharmacological agents
- Conclusions and implications for practice and research
- References
- 18. Interventional management of the patent ductus arterios us
- Introduction
- Definitive PDA closure: Timing, patient selection, and staging
- Impact of definitive PDA closure
- PDA closure periprocedural management
- Care of the preterm infant after definitive PDA closure
- Post-closure cardiorespiratory instability and milrinone prophylaxis
- Isolated post-closure respiratory instability
- Hypothalamic-pituitary-adrenal (HPA) gland axis and post-closure cardiovascular instability
- Surgical and percutaneous closure complications
- Immediate post-procedural management
- Future directions
- Summary: The PDA closure decision and post-procedural management
- Appendix 18A
- Percutaneous pda closure
- References
- 19. Pathophysiology-based management of the hemodynamically significant patent ductus arteriosus in the very preterm neonate
- Introduction
- Pathophysiology of patent ductus arteriosus
- Factors to consider in PDA clinical decision-making
- Consequences of a patent ductus arteriosus
- Spontaneous closure
- Role of conservative management
- Treatment approaches for hsPDA
- Risk-benefit assessment and individualized therapy
- Assessing response to treatment and outcomes
- Conclusions
- References
- SECTION D2. Pathophysiology and Treatment of Neonatal Shock
- 20. Cardiovascular compromise in the preterm infant during the first postnatal day
- Introduction
- Definition of hypotension and its relationship to low systemic perfusion
- The transitional circulation in the VLBW infant
- Physiologic determinants of the blood pressure in the VLBW infant
- Clinical determinants of blood pressure in the VLBW infant
- Assessment of cardiovascular compromise in the shocked VLBW infant
- Short- and long-term effects of cardiovascular compromise/shock in the VLBW infant
- Treatment options in the management of cardiovascular compromise/shock in the VLBW infant
- Conclusion
- References
- 21. Assessment and management of septic shock and hypovolemia
- Introduction
- Hemodynamics in sepsis
- Management of neonates with bacterial sepsis
- Hemodynamic compromise in viral infections
- Hypovolemic shock in neonates
- Summary
- References
- 22. Hemodynamics of the neonate following perinatal hypoxic-ischemia and the effects of therapeutic hypothermia
- Introduction
- Fetal cardiovascular adaptation to hypoxia-ischemia
- The role of cerebral autoregulation
- Cardiovascular effects of hypoxemia-ischemia
- Cardiovascular effects of therapeutic hypothermia/rewarming
- Cardiovascular assessment of neonates with hypoxic-ischemic encephalopathy
- Approach to management of cardiovascular dysfunction
- Conclusions
- References
- 23. Glucocorticoids and adrenal function in neonates with hypotension
- Introduction
- Recognition of potential patients for the administration of corticosteroids
- Corticosteroid administration
- Outcomes
- Summary
- References
- 24. Hemodynamically based management of circulatory compromise in the newborn
- Introduction
- Pathophysiology
- Relevant hemodynamic information
- Patterns of abnormal neonatal hemodynamics
- Circulatory support interventions
- Targeting treatment to the defined individual hemodynamic
- Conclusions
- References
- SECTION D3. Pathophysiology and Treatment of Pulmonary Hypertension of the Newborn
- 25. Pathophysiology and assessment of acute pulmonary hypertension of the newborn
- Introduction
- Classification of aPH
- Pathophysiology of acute pulmonary hypertension in the newborn
- Mechanisms of pulmonary vascular remodeling
- Clinical presentation and diagnosis of acute pulmonary hypertension in the newborn
- Echocardiographic evaluation of acute pulmonary hypertension of newborn
- Role of advanced hemodynamic evaluation in management of acute pulmonary hypertension
- Controversies and clinical dilemmas and physiology-based management of acute pulmonary hypertension in the newborn
- Conclusions
- References
- 26. Chronic pulmonary hypertension
- Introduction
- Epidemiology and risk factors
- Neonatal right ventricle in cPH: Main determinant of symptoms and outcome
- Clinical symptoms and signs
- Diagnostic assessment for cPH in preterm neonates
- Management of cPH in preterm neonates
- Conclusion
- References
- 27. Pathophysiologically based management of pulmonary hypertension of the newborn
- Introduction
- Clinical presentation
- Pathophysiology
- Chronic pulmonary hypertension (cPH)
- Delineation of PH phenotype
- Echocardiography-based assessment in aPH
- Treatment principles
- Cardiovascular management in specific disease states associated with aPH
- Chronic pulmonary hypertension
- Case studies
- Conclusion
- References
- SECTION D4. Pathophysiology and Treatment in Other Hemodynamic Situations
- 28. Hemodynamic management in resource-challenged countries
- Introduction
- Hemodynamic monitoring in neonates
- Approach to clinical diagnosis in neonates requiring hemodynamic monitoring
- Hemodynamic assessment tools in resource-challenged settings
- Hemodynamic management of a critically ill neonate with hypoxic respiratory failure and acute pulmonary hypertension in LMIC countries
- Hemodynamic management of perinatal asphyxia in LMIC countries
- Hemodynamic management of gram-negative sepsis in LMIC countries
- Case 1: Neonate with perinatal asphyxia with hypoxic respiratory failure
- Case 2: Preterm neonate with sepsis
- Training and accreditation for clinician-performed ultrasound or echocardiography in LMIC countries
- Status of pediatric cardiac care in LMIC countries
- Conclusion
- References
- 29. Hemodynamic management in special circumstances
- Introduction
- Infants of diabetic mothers and hemodynamic management
- Hemodynamic management of IDM with obstructive hypertrophic cardiomyopathy
- Pre-ductal arteriovenous malformation and hemodynamic management
- Hemodynamic management of infants with pre-ductal AVM
- Preterm acute PH and hemodynamic management
- Congenital diaphragmatic hernia and hemodynamic management
- Hemodynamic stabilization and treatment in CDH
- Twin-to-twin transfusion syndrome
- Hemodynamic stabilization and treatment in TTTS
- Conclusion
- References
- 30. Critical congenital heart disease: What should the neonatologist know?
- Introduction
- Clinical presentation of CCHD
- Ductal-dependent pulmonary circulation
- Ductal-dependent systemic circulation
- Non-ductal-dependent CCHD
- Clinical presentation of CCHD
- Postnatal transition and instability with CCHD
- Perinatal management strategies to optimize postnatal transition
- Delivery room management
- Postnatal monitoring
- Multidisciplinary care of the neonate with CCHD
- Summary
- References
- Index
- No. of pages: 500
- Language: English
- Edition: 4
- Published: November 1, 2023
- Imprint: Elsevier
- Paperback ISBN: 9780323880732
RP
Richard A. Polin
***
Affiliations and expertise
Director, Division of Neonatology and Perinatology, Professor of Pediatrics, Columbia University Medical CollegeMK
Martin Kluckow
Affiliations and expertise
Professor of Neonatology, University of Sydney, Sydney; Senior Staff Specialist in Neonatology, Royal North Shore Hospital, St. Leonards, AustraliaPM
Patrick McNamara
Affiliations and expertise
Professor of Pediatrics-Neonatology, Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa