Key Points Prompt diagnosis and early intervention are key in salvaging infants with life-threatening surgical disorders of the airway and chest. Improved prenatal ultrasound has shifted the diagnosis and management of disorders of the chest and airways into the fetal…
Key Points Bronchopulmonary dysplasia (BPD), as determined near term corrected age in former preterm newborns < 32 weeks’ gestational age is a marker for chronic respiratory morbidity. Newborns that are most immature and those born from an adverse intrauterine environment,…
Key Points Marked hypoxemia in the newborn can be caused by parenchymal lung disease, pulmonary vascular disease, or congenital heart defects. Events occurring at delivery, as well as the response to supplemental oxygen and to continuous positive airway pressure, can…
Key Points Apnea of prematurity is universal in preterm infants and a manifestation of greater inhibitory (rather than excitatory) influences on the central respiratory network. In premature infants, excitation of peripheral arterial chemoreceptors by hypoxia predisposes to periodic breathing and…
Key Points Most neonatal lung diseases are characterized by increased alveolar surface tension causing atelectasis. To offset this, pressure is applied to the upper airway through either noninvasive or invasive techniques. Regardless of the support technique applied, mean airway pressure…
Key Points Understanding the movement and maintenance of a volume of gas in and out of the lungs forms the basis of pulmonary physiology. Maintenance of functional residual capacity (FRC) is vital to adequate lung mechanics and gas exchange. There…
Key Points Lung organogenesis is organized into five stages, beginning at embryonic day 25 in humans. The mechanisms of lung organogenesis, including branching morphogenesis, stretch/mechanotransduction, alveolarization, microvascular maturation, and cellular differentiation, depend on transcriptional regulation of cell–cell and cell–extracellular matrix…
Key Points Healthcare-associated infections (HAIs) are important preventable causes of morbidity and death in neonates. Central line–associated bloodstream infections cause the bulk of HAIs in the neonatal intensive care unit; other HAIs include ventilator-associated pneumonias, urinary tract infections, surgical site…
Key Points Fungal infections account for approximately 12% of neonatal late-onset sepsis, with a mortality rate of approximately 32%, and the most important risk factor remains the gestational age at birth. When a lumbar puncture is performed, 10% to 50%…
Key Points Maternal transmission of Toxoplasma gondii in the first trimester causes the greatest damage to the fetus, while infections later in pregnancy are more readily transmissible to the fetus. No neonate should be discharged from a birth hospital without…