Principles of Neonatology

1st Edition - September 8, 2023
Editor: Akhil Maheshwari
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 4 1 5 - 5
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 4 1 6 - 2
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 4 1 7 - 9

Written by leading global experts in the field, Principles of Neonatology provides those on the NICU team with clinically focused, evidence-based guidance in an easy-to-access… Read more

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Written by leading global experts in the field, Principles of Neonatology provides those on the NICU team with clinically focused, evidence-based guidance in an easy-to-access format. Chapters cover the key topics of greatest and most frequent concern to clinicians treating newborns, delivering current, data-driven management and treatment advice in a single source relevant to the seasoned practitioner, fellow, or trainee.

Cover Image
Title Page
Copyright
Dedication
List of Contributors
Preface
Acknowledgments
Table of Contents
Section 1 Care of the Premature and Critically-Ill Neonate
Chapter 1 Design of Neonatal Intensive Care Units
Introduction
Patient Safety
Decrease Stressful Stimuli and Increase Positive Stimuli
Infection
Family-Centered Care and Improved Parent-Infant Interactions
Staffing Patterns, Nursing Workload, and Communication
Growth and Weight Gain
Neurodevelopment Outcome
Hybrid Model
Impact of the COVID-19 Pandemic
Summary
References
Chapter 2 NICU Environment for Parents and Staff
NICU Parents
Opportunities in the NICU for Reducing Distress
Recommendations to Medical Institutions and Organizations
References
Chapter 3 Safe Use of Health Information Technology
Introduction
The Need to ACT: A Focus on Access, Communication, and Tracking
Shared Responsibility in EHR Safety
EHR Security
Actions Suggested by The Joint Commission
Conclusions
References
Chapter 4 Pharmacologic Management of Neonatal Pain and Agitation
Introduction
Pathophysiology
Clinical Features
Evaluation
Management
Sucrose
Premedication for Endotracheal Intubation
Analgesia and Sedation for Other Major Procedures
Continuous Analgesia and Sedation During Mechanical Ventilation
Long-Term Outcomes
References
Chapter 5 Neonatal Transport
Introduction
Evaluation
Consultation/Medical Director’s Role
Safety
Types of Transport and Other Considerations
Decompensation
Unique Challenges
Education and Training
Quality
References
Chapter 6 Radiation Safety in Premature and Critically-Ill Neonates
Introduction
Quantifying Radiation Exposure
Image Acquisition to Optimize Dose and Adhere to the ALARA Principle
Appendix 6.1
References
Section 2 Neonatal Resuscitation and Respiratory Care
Chapter 7 Placental Transfusion in the Newborn
Introduction
Pathophysiology of Placental Transfusion
Factors That Determine Placental Transfusion
Methods of Cord Management After Birth
Placental Transfusion
How to Set Up a Quality Improvement Project on Implementation of Placental Transfusion Protocol
Long-Term Outcomes
Conclusions
References
Chapter 8 Neonatal Resuscitation
Introduction
The Transition From Fetal to Neonatal Life
Pathophysiology of Perinatal Asphyxia
Preparation
Initial Assessment and Management
Ventilation
Support of Circulation
Telemedicine
Postresuscitation Care (Fig. 8.11)
Withholding Aggressive Resuscitation
References
Chapter 9 Golden Hour and Thermoregulation
The Golden Hour of the Preterm or High-Risk Neonate
Delayed Cord Clamping
Hypothermia
Respiratory Support in the Golden Hour
Fluid Management and Prevention of Hypoglycemia During the Golden Hour
Prevention of Sepsis in the Golden Hour
Optimizing Outcomes by Minimizing Interventions
Future Directions for the Golden Hour
FURTHER READING
References
Chapter 10 Oxygen During Postnatal Stabilization
Introduction
Oxygen in Utero and During Fetal-to-Neonatal Transition
Evolving Arterial Oxygen Saturation in the First Minutes After Birth
Initial FiO2 for Resuscitation in the Delivery Room
Higher Initial FiO2: Critical Appraisal of Recent Evidence
Final Considerations
References
Chapter 11 Respiratory Distress Syndrome
Introduction
Pathophysiology
Diagnosis
Management
Types of Surfactants
Indications for Surfactant Administration
Timing of Surfactant Administration
Techniques of Surfactant Administration: INSURE, INSURE, and INRecSURE
Other Respiratory Approaches
Nonrespiratory Strategies
Complications of Treatment
Summary
References
Chapter 12 Invasive and Noninvasive Ventilation Strategies
Introduction
Invasive Ventilation
Conventional Mechanical Ventilation
High-Frequency Ventilation
Noninvasive Ventilation
Nasal Intermittent Positive Pressure Ventilation
High-Flow Nasal Canula
Noninvasive High Frequency Ventilation
Noninvasive Neurally Adjusted Ventilatory Assist
Conclusions
References
Chapter 13 Pulmonary Hypertension of the Newborn
Introduction
Pathophysiology
Clinical Conditions Presenting With PPHN
Diagnostic Features
Severity of Hypoxemia in PPHN
Evidence-Based Management of PPHN
Outcomes in Neonates With PPHN
Conclusion
References
Chapter 14 Bronchopulmonary Dysplasia
Introduction
Management
Long-Term Outcomes
Conclusion
References
Chapter 15 Treatment of Apnea of Prematurity
Introduction
Pathophysiology
Clinical Features and Evaluations
More Evidence-Based (Direct) Management Approaches
Less Evidence-Based (Indirect) Management Approaches
Long-Term Outcomes
References
Section 3 Feeding
Chapter 16 Human Milk
Introduction
Preparation of the Mother for Breastfeeding
Information That We Have Found Useful to Encourage Mothers
Appropriate Postures for the Mother and Good Latch-on for the Baby
Milk Expression
Milk Storage at Home
Nutritional Components in Human Milk
Nutritional Implications for the Premature Infant
Immunologic Benefits
Neonatal Morbidity
Chronic Disorders
Obesity and Related Cardiovascular Changes
Cognitive Ability
Benefits of Breastfeeding for Both the Mother and the Infant
Global Impact
Breastfeeding Goals
Prelacteal Feeding
Contraindications to Breastfeeding
References
Chapter 17 Storage and Use of Human Milk in Neonatal Intensive Care Units
Introduction
Definition
Infrastructure of Human Milk Storage Units in NICUs
Components and Process of a Human Milk Bank
Documentation
Staff Training
Myths and Doubts About Pasteurized Donor Human Milk
Summary
References
Chapter 18 Possible Benefits and Risks of Using Probiotics in Neonates
Types of Probiotics
Effect of Probiotics on Composite Outcomes Including NEC, LOS, and All-Cause Mortality
Effect of Probiotics on the Risk of NEC
Effect of Probiotics on the Risk of Late-Onset Sepsis and Other Conditions (Table 18.5)
Mechanisms of Probiotic Effects
Biologic Plausibility for Effects of Probiotics in Preterm Infants
Efficacy of Individual Probiotic Strains
Follow-Up Studies
Alternative Options With Prebiotics and Synbiotics: Quality and Safety
Probiotics During Other Diseases Seen in Neonates and Young Infants
Conclusions
References
Section 4 Nutrition
Chapter 19 Enteral Nutrition
Introduction
Preterm Infant Gastrointestinal Tract
Human Milk Production and Delivery
Early Enteral Nutrition
Nutrition Requirements
Preterm Infant Enteral Nutrition Management
Long-Term Outcomes
Conclusion
References
Chapter 20 Parenteral Nutrition in Neonates
Indications for Parenteral Nutrition
Nutrition Requirements in Parenteral Nutrition
Macronutrients
Electrolytes and Macrominerals
Vitamins
Trace Elements
Compatibilities in Parenteral Nutrition
Practical Calculations for Parenteral Nutrition Administration
Complications of Parenteral Nutrition
References
Chapter 21 Nutrition in Short Bowel Syndrome
Introduction
Development of the Gastrointestinal System and Relevance to Short Bowel Syndrome
Nutritional Challenges in Short Bowel Syndrome
Intestinal Adaptation/Rehabilitation
Goals of Intestinal Rehabilitation
Nutritional Strategies in Short Bowel Syndrome
Nonnutritional Strategies in the Management of Short Bowel Syndrome
Cycling of Parenteral Nutrition
Multidisciplinary Care
Medications
Dietary Fibers
Enteral Fish Oil and Lipid Supplements
Probiotics
Predictors of Successful Outcomes
Future Directions
References
Chapter 22 Neonatal Nutrition Assessment
Introduction
Classification of the Newborn
Birth Weight Classification
Anthropometric and Growth Assessment
Body Mass Index
Body Composition Modalities
Evidence of Healthy Body Composition
Biochemical Assessment
Clinical Assessment
Short Bowel Syndrome
Bronchopulmonary Dysplasia
Metabolic Bone Disease
Nutrition-Focused Physical Exam
Diagnosing Malnutrition in the Newborn
Conclusion
References
Section 5 Endocrine Disorders
Chapter 23 Neonatal Hypoglycemia
Introduction
Transitional Neonatal Hypoglycemia
Screening Neonates at Risk for Hypoglycemia
Neonates at Risk for Persistent Hypoglycemia and Indications for Evaluation
Initial Treatment and Stabilization
Evaluation of Persistent Hypoglycemia: The Diagnostic Fast
Hyperinsulinism
Conclusion
References
Chapter 24 Infants of Diabetic Mothers
Epidemiology
Pathophysiology
Clinical Features
Management
Prognosis
Conclusion
References
Chapter 25 Evidence-Based Neonatology: Neonatal Pituitary Hormone Deficiencies
Introduction
Genetics of Pituitary Disease
Syndromes Associated With Pituitary Deficiency
Growth Hormone Deficiency
Central Hypothyroidism
Gonadotropin Deficiency
Adrenal Insufficiency
Posterior Pituitary Hormone Deficiencies
Conclusion
References
Chapter 26 Neonatal Thyroid Disease
Introduction
Pathophysiology
Clinical Features
Evaluation
Management
Conclusion
References
Chapter 27 Hypothalamic-Pituitary-Adrenal Axis in Neonates
Introduction
Embryology and Development of the HPA Axis
Clinical Features of Adrenal Insufficiency
Causes of Adrenal Insufficiency
Evaluation
Management
References
Chapter 28 Disorders of Neonatal Mineral Metabolism and Metabolic Bone Disease
Background
Fetal Bone Development
Postnatal Mineral and Hormone Physiology
Hypercalcemia
PTH-Dependent Hypercalcemia
Neonatal Severe Hyperparathyroidism and Familial Hypocalciuric Hypercalcemia
PTH-Independent Hypercalcemia
Hypocalcemia
Early Neonatal Hypocalcemia
Late Neonatal Hypocalcemia
Hypocalcemia Management
Biochemical Changes in Metabolic Bone Disease of Prematurity
Risk Factors for Metabolic Bone Disease
Biochemical Screening for MBD
Role of Radiographic Screening for MBD
Prevention of MBD
Treatment of MBD
Postdischarge Management
Long-Term Outlook for Growth and Bone Mineralization
Conclusion
References
Chapter 29 Disorders of Sex Development for Neonatologists
Definition
Epidemiology
Embryology
Endocrinology of the Fetal Testis
Embryology of the Internal Ducts and External Genitalia
Genetic Regulation of Sex Determination and Sex Development
Nomenclature and Etiologies of Disorders of Sex Development
Evaluation of the Infant With a Disorder of Sex Development
Management of Disorders of Sex Development in the Neonatal Period
Conclusion
References
Section 6 Infections
Chapter 30 Early-Onset Sepsis
Introduction
Epidemiology
Pathophysiology
Risk Factors
Microbiology
Clinical Features
Risk Assessment
Diagnostic Evaluation
Empiric Therapy
References
Chapter 31 Late-Onset Sepsis
Introduction
Epidemiology
Pathophysiology
Risk Factors
Microbiology
Clinical Features
Evaluation
Prevention
Empiric Therapy
Targeted Therapy
Adjunctive Therapy
Long-Term Outcomes
References
Chapter 32 Neonatal Herpes Simplex Virus Infections
Background
Virus
Epidemiology
Clinical Manifestation
Diagnosis
Management and Prevention
Outcomes
Vaccine
Management of the Asymptomatic Exposed Infant
Conclusions
References
Chapter 33 Postnatal Cytomegalovirus Infection Among Preterm Infants
Introduction
Viral Pathogenesis
Disease Pathogenesis
Perinatal Epidemiology
Preterm pCMV
Clinical Features of CMV Infection
Diagnostic Testing
Disease Management
Infection Prevention
References
Chapter 34 Congenital Syphilis
Introduction
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Treatment
Follow-Up
Prevention
References
Chapter 35 Invasive Fungal Infections in theNICU: Candida, Aspergillosis, and Mucormycosis
Introduction
Candida
Aspergillosis and Mucormycosis
References
Section 7 Cardiac Defects and Dysfunction
Chapter 36 Congenital Heart Defects
Overview
Clinical Features
Timing of Presentation
History and Physical Examination
Evaluation
Screening for CHD
Management
Long-Term Considerations
References
Chapter 37 Cardiac Defects—Anatomy and Physiology
Septal Defects
Outflow Septation and Conal Defects
Outflow Tract Pathology
Arch Anomalies and Ductus Arteriosus
Inflow Tract Anomalies
Single Ventricles
Abnormal Venous Connections
References
Chapter 38 Medical and Surgical Management of Critical Congenital Heart Disease
Inadequate Pulmonary Blood Flow
Inadequate Systemic Blood Flow
Inadequate Intracardiac Shunts
Ventricular Dysfunction
Conclusion
References
Chapter 39 Neonatal Arrhythmia and Conduction Abnormalities
Normal Atrioventricular Conduction
Atrioventricular Block
Intraventricular Conduction Delays
Long QT Syndrome
Tachyarrhythmias
Summary
References
Chapter 40 Pulmonary Hypertension in Chronic Lung Disease
Introduction
Pathophysiology
Evaluation
Management
General Care
Conclusion
References
Chapter 41 Hemodynamic Assessment and Management of a Critically Ill Infant
Introduction
Fluid Dynamics: Understanding the Relationship Between Pressure and Flow
Determinants of Cardiac Output
Determinants of Systemic Vascular Resistance
Pathophysiology of Shock
Role of Near-Infrared Spectroscopy in Neonatal Shock
References
Section 8 Jaundice, Blood Disorders, and Transfusions
Chapter 42 A Practical Guide to Evaluating and Treating Severe Neonatal Indirect Hyperbilirubinemia
Overview
Determining Causes of Severe Hyperbilirubinemia
Hemolytic Causes of Hyperbilirubinemia
Nonhemolytic Causes of Indirect Hyperbilirubinemia
Treatment of Severe Hyperbilirubinemia
References
Chapter 43 Neonatal Anemia
Introduction
Fetal and Neonatal Erythropoiesis
Identifying Anemia Using Reference Intervals
When the Cause of Neonatal Anemia Is Not Obvious
Hyporegenerative Anemia
Hemorrhagic Anemia
Hemolytic Anemia
Immune-Mediated Hemolytic Disease of the Fetus/Neonate
Hemolytic Disease of the Fetus/Neonate Associated With Infectious Diseases
References
Chapter 44 Evidence-Based Neonatal Transfusion Guidelines
Introduction and Pathophysiology
Clinical Studies
Evaluation and Management
References
Chapter 45 Neonatal Thrombocytopenia
Platelet Counts in Newborn Infants
Fetal and Neonatal Platelet Production
Evaluation of Neonatal Thrombocytopenia
Management
Altered Platelet Function
References
Section 9 Neurological Disorders
Chapter 46 Management of Hypoxic-Ischemic Encephalopathy Using Therapeutic Hypothermia
Introduction
The Pathogenesis of Brain Cell Death
The Determinants of Neuroprotection With Therapeutic Hypothermia
Clinical Evidence for Therapeutic Hypothermia
Is It Possible to Further Optimize Therapeutic Hypothermia?
Conclusion
Acknowledgments
References
Chapter 47 Management of Hypoxic-Ischemic Encephalopathy Using Measures Other Than Therapeutic Hypothermia
Definition, Diagnosis, and Differential
Pathophysiology
Stratification of Patients by Risk
Transport
Supportive Management
Neuroprotective Strategies
Future Adjuvant Therapies
Postacute Care Follow-Up
References
Chapter 48 Management of Encephalopathy of Prematurity
Introduction
Pathophysiology
Clinical Features and Evaluation
Management
Outcome
References
Chapter 49 Neonatal Seizures
Introduction
Pathophysiology
Differential Diagnosis
Evaluation
Management
Long-Term Outcomes
References
Chapter 50 Stroke in Neonates
Introduction
Epidemiology
Pathogenesis
Presentation
Evaluation and Management
Outcomes
References
Chapter 51 Using Biomarkers for Management of Perinatal Brain Injury
REFERENCES
Chapter 52 Intraventricular Hemorrhage and Posthemorrhage Hydrocephalus
Introduction
Incidence and Timing of GM-IVH
Neuropathology
Pathogenesis of Periventricular Hemorrhagic Infarction
Posthemorrhagic Ventricular Dilatation and Posthemorrhagic Hydrocephalus
Clinical Features
Diagnosis
Posthemorrhagic Hydrocephalus (PHH)
Conclusions
References
Chapter 53 Management of Neurotrauma
Introduction
Epidemiology
Neonatal Neurotrauma Anatomical Classification
Head Injuries
Intracranial Hematomas
Spine and Spinal Cord Injuries
REFERENCES
Chapter 54 Management of Myelomeningocele and Related Disorders of the Newborn
Introduction
Pathophysiology
Clinical Features
Diagnosis
Management
Long-Term Outcomes
REFERENCES
Chapter 55 Treating Neonatal Abstinence Syndrome in the Newborn
Introduction
Opioids
Stimulants
Kratom Tea
Depressants
Selective Serotonin Reuptake Inhibitors
Conclusions
REFERENCES
Section 10 Immunology
Chapter 56 Neonatal Immunity
Leukocyte Populations in the Fetus and the Neonate
Innate Immune System
Adaptive Immune System
REFERENCES
Chapter 57 Immunodeficiency Syndromes Seen During the Neonatal Period
Introduction
Innate Immune System
Adaptive Immune System
Immune Deficiency Affecting Multiple Cell Lineages
REFERENCES
Section 11 Kidney
Chapter 58 Neonatal Acute Kidney Injury
Introduction
Developmental Considerations
Definitions of Neonatal AKI
Epidemiology and Risk Factors for Neonatal AKI
Evaluation: Prevention and Mitigation of Neonatal AKI
Novel Approaches to Determining AKI Risk and Kidney Function
Management of Neonatal AKI
Long-Term Outcomes After Neonatal AKI
Summary
REFERENCES
Chapter 59 Renal Replacement Therapy
Renal Replacement Therapy in Infants With Acute and Chronic Renal Failure
Peritoneal Dialysis
Hemodialysis
CRRT
RRT is Changing the Prognosis of Acute AKI in Neonates
The Impact of RRT on CAKUTs and Inherited Cystic Kidney Diseases
References
Chapter 60 Neonatal Hypertension
Introduction
Proper Blood Pressure Measurement
Physiology of Blood Pressure in Neonates
Incidence of Hypertension
Etiology of Hypertension
Clinical Presentation
Evaluation of Hypertension
Management of Hypertension
Long-Term Outcomes
References
Chapter 61 Altered Development of the Kidneys and the Urinary Tract
Altered Development of the Kidneys and the Urinary Tract
Congenital Abnormalities of the Kidney and the Urinary Tract
Evaluation
Functional Disorders
Low Nephron Counts and Glomerular Volume
Inherited Renal Cystic Disorders
Medical Management of Renal Anomalies
References
Section 12 Eye Disorders
Chapter 62 Retinopathy of Prematurity
Introduction
Pathophysiology
Role of Growth Hormone and IGF-1 in ROP
Other Factors With Possible Roles in Pathogenesis of ROP
Clinical Features of ROP
Management
Screening for ROP
Timing of Screening
Treatment of ROP
Surgery
Sequelae of Treated ROP
Future Direction
REFERENCES
Chapter 63 Developmental Anomalies of the Globe and Ocular Adnexa in Neonates
Introduction to the Eye and Adnexal Structures
Abnormal Eye Structure
Abnormal Eyelid Structure/Function
REFERENCES
Chapter 64 Developmental Anomalies of the Cornea and Iris in Neonates
Cornea: Abnormal Appearance or Size
Iris and Pupil: Congenital Abnormalities
REFERENCES
Chapter 65 Cataract and Glaucoma
Congenital Cataract
Glaucoma
References
Section 13 ENT and Auditory Conditions
Chapter 66 Neonatal Tracheostomy
Introduction
Pathophysiology
Clinical Features and Indications
Management
Summary
REFERENCES
Chapter 67 Stridor and Laryngotracheal Airway Obstruction in Newborns
Introduction
Pathophysiology and Clinical Features
Evaluation (Clinical, Laboratory, and/or Imaging)
Management and Long-Term Outcomes
REFERENCES
Chapter 68 Pierre-Robin Sequence/Cleft Palate-Related Airway Obstruction Seen in Neonates
Introduction
Pathophysiology
Clinical Features
Evaluation
Management
Feeding Management
Long-Term Outcomes
Summary
References
Chapter 69 Congenital Hearing Loss Seen in Neonates
Introduction
Etiology and Pathophysiology of Sensorineural Hearing Loss
Newborn Hearing Screen (NHS)
Definitive Diagnosis
Management of Newborns With SNHL
Conclusion
References
Chapter 70 Nasal Obstruction in Newborn Infants
Introduction
General Clinical Features and Recommended Evaluations for Neonatal Nasal Obstruction
Considerations for Initial Management of Neonatal Nasal Obstruction
Epidemiology, Pathophysiology, Clinical Features, Evaluation, and Management of More Common Causes of Neonatal Nasal Obstruction
Conclusions
References
Section 14 Orthopedic Conditions
Chapter 71 Upper Extremity Conditionsin the Neonate
Introduction
Embryology
Pathophysiology
Clinical Features, Evaluation, Management, Long-Term Outcomes, and Conditions
Radial, Ulnar, and Central Longitudinal Deficiencies
References
Chapter 72 Newborn Spine Deformities
Introduction
Pathophysiology
Clinical Features
Evaluation
Management
Growth Preservation Strategies
References
Chapter 73 Hip and Lower Extremity Deformities
Developmental Dysplasia of the Hip
Talipes Equinovarus
Calcaneovalgus
Congenital Hyperextension of the Knee and Congenital Knee Dislocation
Fibular Hemimelia
Congenital Femoral Deficiency
Tibial Hemimelia
Tibial Bowing
Congenital Vertical Talus
References
Chapter 74 Fractures and Musculoskeletal Infections in the Neonate
Clavicular Fractures
Congenital Pseudarthrosis of the Clavicle
Humerus Fractures
Femoral Fractures
Congenital Pseudarthrosis of the Tibia
Bone and Joint Infections
Conclusion
REFERENCES
Section 15 Inborn Errors of Metabolism and Newborn Screening
Chapter 75 Most Frequently Encountered Inborn Errors of Metabolism
Diagnosis of Conditions With Early Neonatal Onset or Those Not Included in Screening Programs
Clinical Approach to IEMs Detected in NBS Programs
Congenital Adrenal Hyperplasia
REFERENCES
Chapter 76 Screening Programs for EarlyDetection of Inborn Errors ofMetabolism in Neonates
Introduction
Background
Selection of Disorders
Description of the Process
Abnormal Newborn Screen Results
False-Positive/False-Negative Results
References
Section 16 Genetic Conditions (Including Microarrays, Exome Sequencing)
Chapter 77 An Overview of GeneticTesting
Diagnostic Techniques in Clinical Genetics
Chromosomal Disorders and Karyotyping
Mosaicism
Aneuploidy
Fluorescence In Situ Hybridization
Chromosomal Microarray
Sanger Sequencing
Next-generation Sequencing Technology
Gene Panel Testing
Exome Sequencing
Genome Sequencing
References
Chapter 78 Genetics of Common Birth Defects in Newborns
Summary
Introduction
Congenital Heart Disease
Chromosomal Aneuploidies
Copy Number Variations
Single-Gene Defects
Heterotaxy and Ciliopathies
GDF1 and Founder Ashkenazi Mutation
Monogenic Causes of Isolated CHD
Common Variants and CHD
Recommendations for Clinical Genetic Testing
Conclusion
References
Chapter 79 Common Monogenetic Conditions in Newborns
Autosomal Recessive Polycystic Kidney Disease
Achondroplasia
Rasopathies
Tuberous Sclerosis Complex
Spinal Muscular Atrophy
Congenital Myotonic Dystrophy Type 1
References
Chapter 80 Common Chromosomal Conditions in Newborns
Introduction
Turner Syndrome (Monosomy X) and Triple X Syndrome (Trisomy X)
Klinefelter Syndrome
Jacobs Syndrome
Trisomy 13 and Trisomy 18
Trisomy 21
Microdeletion/Microduplication Syndromes
References
Section 17 Neonatal Surgical Conditions
Chapter 81 Necrotizing Enterocolitis
Introduction
Risk Factors
The Five Clinical Presentations of NEC in Infants
Differential Diagnoses
Diagnosis
Management
Medical Management
Operative Management
Complications From NEC
Outcomes and Prevention in Patients Undergoing Surgery for NEC
Summary
References
Chapter 82 Extracorporeal Membrane Oxygenation in Neonates
Introduction
ECMO—Respiratory
Congenital Diaphragmatic Hernia
Persistent Pulmonary Hypertension of the Newborn
Meconium Aspiration Syndrome
ECMO—Cardiac
ECMO—ECPR
Neurologic Outcomes
Controversies and Ethical Considerations
References
Chapter 83 Intestinal Surgery in the Newborn—Atresias, Volvulus, and Everything Else
Introduction
Intestinal Atresia
Malrotation and Volvulus
Meconium Ileus
Duplication Cysts
Abdominal Wall Defects
References
Chapter 84 Pulmonary Surgery inthe Newborn
Upper Respiratory Airway Disease
Laryngomalacia
Laryngeal Stenosis
Laryngeal Webs and Laryngeal Atresia
Tracheomalacia
Tracheal Stenosis
Vascular Compression of the Airway
Congenital Lung Lesions
Congenital Pulmonary Airway Malformation
Bronchopulmonary Sequestration
Congenital Lobar Emphysema
Bronchogenic Cysts
Congenital Diaphragmatic Hernia
Diaphragmatic Eventration
References
Chapter 85 Congenital Anorectal Malformations and Hirschsprung Disease in the Neonate
Introduction
Anorectal Malformations
Hirschprung Disease
Conclusions
References
Chapter 86 Esophageal Surgery in Neonates: Esophageal Atresia, Gastroesophageal Reflux, and Other Congenital Anomalies
Introduction
EA and TEF
Surgery for Other Esophageal Pathology in Neonates
Summary
References
Section 18 Current State of Neonatal Palliative Care
Chapter 87 Caring for Families Who Have Previously Endured Multiple Perinatal Losses
Reproductive Story
Ontological Death
Complexity of the Loss of Young Infants
Impact of Previous Losses During Pregnancy or Early Infancy
Grief
Role of the Healthcare Professional
References
Chapter 88 Current State of Perinatal Palliative Care: Clinical Practice, Training, and Research
Introduction
The Clinical Practice of Perinatal Palliative Care
Progress in Perinatal Palliative Care Research
References
Chapter 89 Serious Communication in the Neonatal Intensive Care Unit: Evidence for Strategies and Training
Communication in the Neonatal Intensive Care Unit
Conclusion
References
Chapter 90 Pain and Symptom Management in Newborns Receiving Palliative and End-of-Life Care
Introduction
Pain
Opioids
Additional Medications for Pain Control
Nonpain Symptoms
Nonpharmacologic Interventions
Symptom Management in the Actively Dying Neonate
Conclusion
References
Chapter 91 Palliative Care Family Support in Neonatology
Prenatal Phase
Acute Neonatal Intensive Care Phase
Chronic Critical Illness Phase
Bereavement Phase
References
Section 19 Follow-Up
Chapter 92 Early Diagnosis and Intervention in Neonatal Intensive Care Units
Days 1 to 3 of Life
Days 3 to 7 of Life in the NICU
Prior to Discharge From the NICU
References
Chapter 93 Early Diagnosis and Intervention—On Neonatal Follow-Up
Ensuring Continuity and Compliance After Discharge From the NICU
Role of Developmental Follow-Up Services
Developmental Surveillance—After Discharge From the NICU
Beyond Early Infancy
Referral: Timely Specific Interventions and Interprofessional Integration
Audits and Process of Improvement
References
Chapter 94 Early Detection of Cerebral Palsy
Introduction
Pathophysiology
Clinical Features and Evaluation of Cerebral Palsy
Long-Term Outcomes
Management
Conclusion
References
Chapter 95 Use of Neuroimaging to Predict Adverse Developmental Outcomes in High-Risk Infants
Introduction
Imaging of the Neonatal Central Nervous System
Types of Brain Injury in the Neonatal Period
Comparison of TE-cUS and TE-MRI for Predicting Neurodevelopmental Outcomes
Advanced MRI Techniques
Conclusions
References
Chapter 96 Neurodevelopmental Impairment in Specific Neonatal Disorders
Introduction
Pathophysiology
Hypoxic-Ischemic Encephalopathy
Intraventricular Hemorrhage
Bronchopulmonary Dysplasia
Necrotizing Enterocolitis
Neonatal Sepsis
References
Section 20 Designing Clinical Trials in Neonatology
Chapter 97 Quality Improvement in Neonatal Care
General Considerations
Methodology
Quality Networks
Professional Expectations for QI
Research Versus Quality Improvement
References
Chapter 98 Neonatal Randomized Controlled Trials
Introduction
Clinical Trial Designs
Informed Consent
Recruitment and Retention of Trial Participants
Long-Term Follow-Up in Neonatal RCTs
Stakeholder Engagement in Neonatal RCT Design
Summary Conclusions
Acknowledgment
References
Chapter 99 Designing Clinical Trials in Neonatology—International Trials
Introduction
Building a Shared Vision of the Purpose of the Study
How to Encourage Local Buy-in and Participation
Regulatory and Ethical Considerations
Guidelines for the Conduct of International Clinical Trials
Potential Sources of Funding
Conclusion
References
Section 21 Healthcare Leadership
Chapter 100 Organization of Neonatal Intensive Care
Neonatal Intensive Care Units
Leadership Structure
Medical Staff
Nursing and Ancillary Staff
Data, Quality, and Safety Staff
NICU Provider Workforce Shortages and Strategies
Transition to Home
References
Chapter 101 Leadership and Organizational Culture in Healthcare
Leadership
Leadership Types
Significance of Specific Leadership Styles
Organizational Culture
Further Reading
References
Section 22 Neonatal Dermatology
Chapter 102 Skin Disorders in Newborn Infants
Immaturity of the Skin in Newborn Infants
Transient Cutaneous Changes Seen in Newborn Infants
Minor Congenital Anomalies That Predominantly Involve the Skin
Complications Associated With Neonatal Intensive Care
Congenital Disorders of Skin Structure Seen in Newborn Infants
Vascular Malformations
Inflammatory Disorders of the Neonatal Skin
Scaling Disorders
Cutaneous Infections
Cutaneous Neoplasms
References
Index

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Principles of Neonatology

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