Multiple pathophysiologic mechanisms can present with pulmonary manifestations in term and preterm infants. The clinical picture is most commonly dominated by respiratory distress, which presents as tachypnea, grunting, flaring, retractions, cyanosis, and hypoxemia. However, apnea and hypoventilation are also common.…
Mechanical ventilation has been used to treat neonatal respiratory failure for more than a half century. The earliest applications began as modifications of adult ventilators, treating babies of modest size and prematurity by today's standards. Most devices were time-cycled, pressure-limited…
Enormous strides have been made in understanding the pathophysiology of respiratory distress syndrome (RDS) and the role of surfactant in its cause and treatment (see Chapter 62 ). Nevertheless, RDS, formerly referred to as hyaline membrane disease, remains a dominant…
Most neonates requiring intensive care present with respiratory symptoms. Although standard techniques for assessing pulmonary function can be applied in a healthy infant, special limitations and problems are encountered in very small or sick neonates. Methods have been developed to…
A Brief History An understanding of lung development and maturation is central to the care of preterm infants, because lung function is so critical to survival of the preterm. Pattle and Clements first noted surface-active substances in pulmonary edema foam…
Cranial Ultrasound Cranial ultrasound (CUS) is the most widely used neuroimaging method for preterm infants. Cranial ultrasound uses high-frequency sound waves, transmitted through open fontanelles, to detect differences in echogenicity between tissues and allow identification of anatomic structures, hemorrhage, and…
Advances in obstetric and neonatal care, which have been responsible for the improved survival of high-risk neonates, have not resulted in decreased morbidity. Since perinatal interventions can alter later growth and development, long-term follow-up is essential to ensure therapies such…
Background Tremendous progress has been made during the past 25 years in the identification of hearing loss (HL) in newborns. The National Institutes of Health issued a “Consensus Statement on Early Identification of Hearing Impairment in Infants and Young Children”…
Summary This chapter reviews open and closed neural tube defects. We discuss imaging evaluation as well as physical exam findings. Finally, we discuss current trends in treatment and perinatal care. Introduction Neural tube defects (NTD) are the second-most common birth…
Summary This chapter explores those conditions that cause abnormal head shape or head size in the newborn infant. The underlying causes, clinical presentation, diagnosis, and available interventions will be presented. Examination of the Head Abnormalities are first identified by observation…