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Clinical and molecular markers to assist decision-making in neonatal sepsis
Key points Early detection followed by rapid initiation of antimicrobial treatment and measures to prevent and treat organ dysfunction are key to optimizing the outcome of sepsis. Due to the non-specific presentation, the dynamic and heterogeneous nature of sepsis, and…
Recent advances and controversies in inborn errors of immunity presenting in the newborn period
Key points Inborn errors of immunity (IEI) presenting in the newborn period include immune deficiencies affecting cellular and humoral immunity, diseases of immune dysregulation, congenital defects in phagocyte function, defects in intrinsic and innate immunity, and autoinflammatory disorders. There are…
Drug-associated acute kidney injury in neonates
Key points Drug-associated acute kidney injury is common in neonates and has important implications for therapeutic decisions and patient clinical outcomes. This chapter reviews the mechanisms of nephrotoxin-induced acute kidney injury and the various medications that are widely used in…
Vasodilator drugs for pulmonary hypertension in bronchopulmonary dysplasia
Key points Pulmonary hypertension (PH) is an important comorbidity associated with bronchopulmonary dysplasia that increases risk of right ventricular failure and death in premature infants. First-line treatment is aimed at correction of the respiratory status by optimizing lung volumes, oxygenation,…
Pharmacological therapy of neonatal abstinence syndrome
Key points Neonatal abstinence syndrome (NAS) secondary to maternal use of opioids during pregnancy continues to remain a major problem in neonates. Nonpharmacological measures are the first-line treatment in the management of NAS. Morphine remains the most popular medication in…
Neuroprotective therapies in newborns
Key points Preterm and term infants are at risk of acquiring brain injury with lasting neurodevelopmental sequelae. Mechanisms of brain injury in the developing brain are related to unique vulnerabilities due to the maturational stage of the various types of…
Antiseizure medications and treatments in neonates
Key points Initial/emergent management of neonatal seizures includes stabilization of the neonate, assessment and correction of reversible causes of seizures, and evaluation for sepsis/meningitis at the same time as antiseizure medications (ASMs) are initiated. Despite limited efficacy data and concern…
Antibiotic considerations for necrotizing enterocolitis
Key points Necrotizing enterocolitis (NEC) results in an intra-abdominal infection, and treatment includes antimicrobial therapy, bowel rest, parenteral nutrition, and surgery, if clinically or radiologically indicated. In the absence of evidence-based guidelines, many antibiotic combinations are used for NEC treatment…
Organ dysfunction in sepsis and necrotizing enterocolitis
Key points Sepsis and necrotizing enterocolitis are common sources of morbidity and mortality in the premature infant population. There is a lack of consensus on the definition of neonatal sepsis, confounded by the overlap between pathologic and non-pathologic variability in…