Neonatology at a Glance

 

Description:

Written by a team of leading international experts, Neonatology at a Glance provides a concise and easy-to-read overview of neonatal medicine. Each topic is clearly explained over a two-page spread, aided by numerous diagrams and illustrations. It has been extensively updated to include recent advances in perinatal medicine, genetics, respiratory support, therapeutic hypothermia, antimicrobial stewardship, and family integrated care. The book covers the wide range of problems encountered in looking after newborn babies, from normal newborn infants to the complexities of neonatal intensive care.

Neonatology at a Glance:

Provides up-to-date coverage of the important conditions you will encounter, including neonatal resuscitation and care of preterm infants

Covers challenging topics including pain, ethical issues, patient safety, evidence-based medicine, and palliative and end of life care

Includes details of a wide range of practical procedures, including less invasive surfactant administration, cranial ultrasound, brain monitoring and neuroimaging, and neonatal transport

Neonatology at a Glance is the perfect guide for all health professionals looking after newborn infants, including pediatric trainees, medical students, neonatal nurse practitioners and neonatal nurses, therapists, and midwives. For neonatologists, pediatricians, and neonatal lecturers, it is a valuable resource to assist with teaching.

 

 

Table of Contents:

 

1 Milestones in neonatology

Thermal regulation

Nutrition

Rhesus hemolytic disease

Antibiotics

Respiratory distress syndrome (RDS)

Development of neonatal intensive care

Challenges for the future

2 Epidemiology

Births

Maternal mortality

Perinatal mortality

Neonatal mortality

Epidemiologic data collection

Infant mortality

3 Perinatal medicine overview

Neonatal involvement in perinatal care

Neonatal networks

4 Prepregnancy care, prenatal screening, and fetal medicine

Fetal medicine

5 Maternal medical conditions

Diabetes mellitus

Type 2 and gestational diabetes

Maternal red blood cell alloimmunization

Perinatal alloimmune thrombocytopenia

6 Intrauterine growth restriction

Definition

Etiology

Pathophysiology

Management

7 Multiple births

Fetal complications

Neonatal complications

8 Preterm delivery

Causes

Risk factors

Prevention

Management

Timing of delivery

9 Maternal drugs affecting the fetus and newborn infant

Neonatal abstinence (withdrawal) syndrome (NAS)

Clinical assessment

Management

Cocaine

Teratogenic medicines

10 Congenital infection

Diagnosis

Clinical features

Congenital cytomegalovirus (CMV) infection

Congenital toxoplasmosis

Congenital rubella

Congenital syphilis

Varicella: chickenpox, varicella zoster virus (VZV) infection

Congenital parvovirus B19

Congenital zika virus

11 Genetics

Congenital anomalies

Specific genetic disorders

Genetic testing

12 Adaption to extra‐uterine life

Physiologic changes in fetal–neonatal transition

Abnormal transition from fetal to extrauterine life

The Apgar score

Asphyxia

13 Neonatal resuscitation and post‐resuscitation care

Preparation

Cord clamping

Temperature control

Initial assessment at birth

A – Airway

B – Breathing

Endotracheal intubation

C – Circulation

Drugs

Withholding and discontinuing resuscitation

Post‐resuscitation care in the delivery room

14 Birth injuries

Injuries to the head

Injuries to the face

Injury to the neck, shoulders and limbs

15 Routine care of the newborn infant

Screening

Health promotion

Discharge

16 Routine examination of the newborn infant

Preparation

The infant

Routine examination of newborn infants

17 Neurology examination

States of alertness

Tone and posture

Reflexes

Spontaneous movements

Abnormal signs

Behavior

18 Feeding

Nutritional characteristics of human milk compared with unmodified cow's milk

Formula

Feeding advice resources

19 Parental attachment

Communicating with parents

Antenatal identification of fetal abnormality or potential abnormality

Admission of the infant to the neonatal unit

Infants with serious congenital malformations

20 Minor abnormalities in the first few days

21 Overview of common problems of term infants

Anticipation based on history

Overview of common medical problems

22 Admission to the neonatal unit

Welcoming parents and families

Open access

Explanation and facilitating communication

Assisting attachment

Providing a family‐friendly environment

23 Stabilizing the sick newborn infant

Airway – see chapters 13, 41 and 77

Breathing – see chapters 13 and 24

Circulation

Shock

Disability and Dextrose (Neurologic system) – see Chapter 16 and 51

Environment and systematic examination

Family

24 Respiratory support

Forms of respiratory support

Supplemental oxygen therapy

Continuous positive airway pressure (CPAP)

Conventional mechanical ventilation (via a tracheal tube)

Synchronized ventilation modes

High‐frequency oscillatory ventilation (HFOV)

High frequency jet ventilation (HFJV)

Inhaled nitric oxide (iNO)

Respiratory failure

Extracorporeal membrane oxygenation (ECMO)

25 Developmental care

Observing newborn behavior

The nursery environment

Adapting care

26 Family integrated care

27 Preterm infants and their complications

Short term complications

28 Lung development and surfactant

Structural development

Surfactant

Clinical implications of surfactant deficiency

Antenatal corticosteroids

Surfactant therapy

29 Respiratory distress syndrome

Risk factors

Pathology

Pathogenesis

Clinical features

Natural course

Management

Complications

30 Temperature control

Hypothermia

Evaporative heat loss in preterm infants

Keeping neonates warm

31 Growth and nutrition

Growth

Nutrition

Enteral feeding

Parenteral nutrition (PN)

Supplements

Osteopenia of prematurity

32 Intraventricular hemorrhage and periventricular leukomalacia

Diagnosis

Clinical features

Laboratory findings

Management

Prognosis

Prevention

33 Patent ductus arteriosus (PDA)

Ductal closure

Risk factors

Clinical features

Investigations

Management

34 Apnea, infection, anemia, and jaundice

Apnea, bradycardia and desaturations

Infection

Anemia

Jaundice

35 Retinopathy of prematurity

Pathogenesis

Screening

Treatment of ROP

36 Necrotizing enterocolitis

Risk factors

Clinical features

Laboratory findings

Radiologic abnormalities

Management

37 Bronchopulmonary dysplasia

Definition

Predisposing factors

Clinical features

Investigations

Management

Strategies for prevention

38 Discharge of preterm infants from hospital

Discharge planning

39 Outcome of preterm infants

Survival

Outcome

Growth

Medical complications

Disability and impairment

Neurosensory impairment

Cognitive impairment

Behavioral outcomes

School performance

Adult outcomes

40 Respiratory distress in term infants

Common causes

Less common causes

Rare causes

41 Upper airway disorders

Cleft lip and palate

Choanal atresia

Pierre Robin sequence

Laryngomalacia

Subglottic Stenosis

42 Jaundice

Significance of severe hyperbilrubinemia

Causes of early‐onset jaundice (

Causes of jaundice 24 hours to 2 weeks

Clinical examination and assessment

Investigations

Management

Prolonged jaundice (>14 days)

43 Neonatal infection

Bacterial sepsis

Risk factors

Clinical presentation

Investigations

Interpretation

44 Antimicrobial stewardship

Global neonatal antibiotic use and resistance

45 Specific bacterial infections

Group B streptococcal (GBS) infection

Listeria monocytogenes

Gram‐negative infection (e.g. E. Coli, Pseudomonas, Klebsiella)

Conjunctivitis

Skin

46 Viral infections

Herpes simplex virus (HSV)

Hepatitis B (HBV)

Hepatitis C

HIV

47 Hypoglycemia and hyperglycemia

Hypoglycemia

Hyperglycemia

48 Gastrointestinal disorders

Vomiting

Gastroesophageal reflux

Esophageal atresia and tracheoesophageal fistula

Abdominal masses

Abdominal wall defects

Imperforate anus

49 Gastrointestinal obstruction

Causes (See Figure 49.1)

Diagnostic clues

Clinical presentation

Diagnosis

Management

Some specific conditions

50 Cardiac disorders

Risk factors

Presentation

Heart murmur

Heart failure

Selected causes of cyanotic congenital heart disease

Oxygen saturation screening for critical congenital heart defects

Investigations

Management of congenital heart disease

51 Hypoxic–ischemic encephalopathy

Pathogenic mechanisms of HIE

Compensatory mechanisms

Primary and delayed injury

Clinical staging

Clinical features, investigations, and management

Therapeutic hypothermia

Cerebral function tests and neuroimaging

Outcome

52 Seizures and perinatal strokes

53 Neural tube defects and hydrocephalus

Neural tube defects

Anencephaly

Encephalocele

Spina bifida

Hydrocephalus

54 The hypotonic infant

Clues from the history

Causes, clinical features, and investigations

Some specific conditions

55 Renal and urinary tract anomalies diagnosed prenatally

Embryology

Structural abnormalities of the kidneys

56 Renal and urinary tract disorders

Electrolyte problems

Urinary tract infection (UTI)

Acute kidney injury, AKI

57 Genital disorders

Inguinal hernia

Hydrocele

Undescended testis

Torsion of the testis

Hypospadias

Circumcision

58 Disorders of sex development

Sex development

Congenital adrenal hyperplasia

59 Anemia and polycythemia

Anemia

Polycythemia

60 White cell disorders

White blood cells in the newborn

Neutrophilia

Neutropenia

Blood abnormalities in infants with Down syndrome (trisomy 21)

61 Coagulation and thrombotic disorders

Thrombocytopenia

Abnormal coagulation

Thrombotic disorders (thrombophilia)

62 Dermatological disorders

Goals of neonatal skin care

Diaper (nappy) dermatitis

Infection

Vascular skin lesions

63 Bone and joint disorders

Congenital abnormalities of the hip and feets

Infection

Skeletal dysplasias

64 Inborn errors of metabolism

Age of presentation

When to suspect an inborn error of metabolism

Management

65 Hearing and vision

Hearing

Vision

66 Pain

Development of pain pathways in the fetus and preterm infant

Factors that modify pain responses

Assessment of pain

Pain assessment scales

Minimizing pain

67 Pharmacology

Drug dosing

Drug monitoring

Drugs in breast milk

Drug licensing and neonatology

68 Quality improvement

Identifying areas of improvement

Improvement science

69 Patient safety

Briefing

Hand‐off (hand‐overs)

Simulation

Modes of simulation

Critical incidents

Hospital associated infections

Extravasation of intravenous infusions

Excessive fluid volume infused

Unplanned extubation

Giving wrong breast milk to wrong patient

Complications of umbilical arterial catheters (UAC)

Thrombosis/emboli/vasoconstriction

Blood loss from arterial catheters

Ischemic damage from peripheral artery catheters

Portal vein thrombosis from umbilical venous catheters

Extravasation of parenteral nutrition (PN) from central venous lines

Burns and scalds

Scarring of skin

Nasal damage from tracheal tube

Nasal damage from nasal CPAP

Tracheal stenosis

Aspiration pneumonia from misplaced gavage (nasogastric) feeding tubes

70 Evidence‐based practice

What is evidence‐based practice (EBP)?

Steps in evidence‐based practice

Examples of evidence‐based practice in neonatology

71 Ethics

72 Research and consent

Research

Practical difficulties in conducting research in infants

Consent

Consent issues in clinical practice

73 Palliative and end‐of‐life care

Care plans

Place of care

Support for the parents, siblings, and family

Care after death

Caring for staff

Organ donation

Autopsy

74 Follow‐up of high‐risk infants

Goals

Criteria

Organization and timing

Who should conduct neonatal follow‐up?

Components

Outcome measures

75 Global neonatology

Geography of newborn deaths

Causes of newborn deaths

Timing of newborn deaths

Reducing neonatal mortality in low‐income countries

76 Transport of the sick newborn infant

Infrastructure

Why transfer?

Equipment

Documentation

77 Intubation

Endotracheal intubation

INSURE

Less Invasive Surfactant Administration (LISA)

Video laryngoscopy

78 Chest tubes

Needle thoracotomy (chest needling)

Chest tubes (chest drain)

Pleural tap

79 Common practical procedures

80 Umbilical catheters and intraosseous cannulation

Umbilical catheters

Intraosseous cannulation

81 Central venous catheters and exchange transfusions

Central venous catheters (CVC)

Exchange transfusion

82 Cranial ultrasound

Limitations of ultrasound

Lesions that can be identified

Practical issues

Lesions detectable on cranial ultrasound (Figures 82.4–82.11)

Germinal matrix hemorrhage, GMH (Grade I) (Figure 82.3)

Intraventricular hemorrhage, GMH‐IVH (Grade II – no ventricular dilatation) (Figure 82.4)

Intraventricular hemorrhage, GMH‐IVH with dilatation (Grade III – ventricular dilatation) (Figure 82.5)

Hemorrhagic parenchymal infarct (Grade IV) (Figure 82.6)

Porencephalic cyst (Figure 82.7)

Post‐hemorrhagic ventricular dilatation (PHVD) (Figure 82.8)

Ventricular index (Figure 82.9)

Echodensities (Figure 82.10)

Cystic periventricular leukomalacia (PVL) (Figure 82.11)

View from additional window (Figure 82.12)

Color Doppler flow velocity measurements

Additional windows

83 Brain monitoring

Electroencephalography (EEG) and amplitude‐integrated electroencephalography (aEEG)

Use of aEEG and EEG in neonates

Electroencephalography (EEG)

Amplitude integrated EEG (aEEG)

Near infrared spectroscopy (NIRS)

Reference values for NIRS

84 Perinatal neuroimaging with MRI

Functional MRI

The connectome and network theory

Practical and safety considerations of MRI

Prognostic information

85 Echocardiography for the neonatologist

Standard views

Assessment of the PDA

Assessment of left ventricular function in critically ill neonates

Assessment of pulmonary hypertension (PH)

Assessment of neonatal hypotension or shock

Identify the position of umbilical and central venous lines

Appendix Gestational age assessment, BP, Newborn Early Warning Trigger and Track (NEWTT) chart, Jaundice, Hypoglycemia, Growth charts

Gestational age assessment: Ballard exam

Calculating an estimated gestational age

Blood pressure charts

Jaundice indications for phototherapy and exchange transfusion

Newborn early warning trigger and track (NEWTT)

Hypoglycemia prevention and treatment and persistent or symptomatic hypoglycemia screening tests

Growth charts

Further reading

Chapter 9

Chapter 10

Chapter 17

Chapter 18

Chapter 26

Chapter 32

Chapter 35

Chapter 44

Chapter 45

Chapter 46

Chapter 47

Chapter 54

Chapter 60

Chapter 62

Chapter 65

Chapter 69

Chapter 75

Chapter 79

Index

End User License Agreement

 

An aparitie	11 May 2020
Autor	Avroy A. Fanaroff , Lawrence Miall, Jonathan Fanaroff , Tom Lissauer
Dimensiuni	21.59 x 1.27 x 27.43 cm
Editura	Wiley-Blackwell
Format	Paperback
ISBN	9781119513193
Limba	Engleza
Nr pag	256