Case 1 You are taking care of a 4-day-old male infant, born at 32 weeks’ gestation and weighing 1750 g. He was recently transitioned from mechanical ventilation to nasal cannula. He was doing well until this morning, when you noticed…
Introduction Bronchopulmonary dysplasia (BPD) is the most prevalent and prognostically one of the most important complications associated with prematurity. In the United States, it affects 10,000 to 15,000 newborns each year, including upwards of half of all babies born weighing…
Safe and effective respiratory support of newborn infants requires a good understanding of pulmonary physiology, familiarity with the available evidence regarding management of respiratory failure and knowledge of the capabilities of the ventilators at one’s disposal. The clinician must also…
Introduction Respiratory distress syndrome (RDS) is a developmental lung disease of preterm infants primarily caused by inadequate production of surfactant. Infants with RDS have difficulty maintaining adequate functional residual capacity (FRC), leading to alveolar atelectasis, hypoventilation, and ventilation-perfusion mismatch. Affected…
Introduction Anemia is a term typically used to describe either a low hemoglobin (Hb) or hematocrit (Hct). Although the word anemia is loosely used in clinical medicine, the exact meaning is difficult to define as it is not binary. Instead,…
Evidence is increasingly accumulating that nutritional inadequacies in the early neonatal period have both short- and long-term consequences. Nonetheless, provision of adequate nutritional support to the high-risk premature infant remains a significant clinical challenge. Among extremely premature infants, duplicating rates…
Indications Parenteral nutrition (PN) is used to provide nutrients to newborn infants who cannot tolerate full enteral nutrition or who have contraindications to enteral nutrition ( Table 6.1 ). TABLE 6.1 Indications for Parenteral Nutrition Prematurity <32 weeks and <1800…
Introduction Neonatal jaundice is the most common physiologic variant encountered in the newborn. More than 60% of healthy term neonates, and even a greater percentage of breastfed infants, display some degree of visible jaundice during the first week of life.…
Introduction Cornblath and Reisner established nearly 60 years ago that neonatal hypoglycemia was a significant cause of neonatal morbidity and mortality, yet the definition and management of neonatal hypoglycemia have remained unclear. The management of low blood glucose levels is…
Fluid and electrolyte management is an important and challenging part of the initial care of any very premature or critically ill newborn. The transition from fetal to neonatal life is associated with major changes in fluid and electrolyte homeostasis and…