Neonatal intensive care

Human breast milk is the best nutrient for preterm infants and is often delivered via gavage feeding methods before the baby s sucking skills mature. Because sufficient quantities of the mother s fresh breast milk may not be available, milk may be frozen for later consumption or be provided by donor mothers. To protect against the risk of disease transmission, donor milk is usually pasteurized. In the present study, we assessed preterm infants responses to the odours of different categories of milk that are routinely available in neonatal intensive care nurseries. 

Each infant participated in two series of tests at 34 and 36 weeks PCA. Tests were conducted in the neonatal intensive care unit, with the baby laying face up with the head held in place by rolled cotton towels. During each of these test series,... 

Menon PA, Thach BT, Smith CH, et al. Benzyl alcohol toxicity in a neonatal intensive care unit. Incidence, symptomatology, and mortality. Am J Perinatal 1984 1(4) 288-292. 

Calafat AM, Needham EL, Silva MJ, Lambert G (2004) Exposure to di-(2-ethyUiexyl) phthalate among premature neonates in a neonatal intensive care unit. Pediatrics 113 e429-e434... 

Weuve J, Sanchez BN, Calafat AM, Schettler T, Green RA, Hu H, HauserR (2006) Exposure to phthalates in neonatal intensive care unit infants urinary concentrations of monoesters and oxidative metabolites. Environ Health Perspect 114 1424—1431... 

Spillover costs on other sectors (e.g. additional educational costs related to the proportion of children who survive neonatal intensive care units with learning disabilities)... 

Giroux JD, Sizun J, Rubio S, Metz C, Montaud N, Guillois B, Alix D. Hypothyroldie transitoire apres opacification iodees des catheters epicutaneocaves au reanimation neonatale. [Transient hypothyroidism after iodine opacification of epicutaneo-caval catheters in neonatal intensive care.] Arch Fr Pediatr 1993 50 (3) 273. 

LaPointe DR, Arnold AD, Eichelberger WJ, 2002. Quality improvement projects to enhance safety and efficacy of gentamicin in a neonatal intensive care unit. ASHP Midyear Clinical Meeting, Adanta, GA. 

The potential for the use of neonatal MS/MS evaluation is exceptional, and this technology is likely to emerge as a valuable adjunct to care in the next decade. Several areas of neonatal intensive care would seem to benefit the most from proteomic assessment of the newborn infant. These include (but are not limited to) the following ... 

One needs to keep in mind that the use of drugs by the mother will sometimes lead to impairment of the activity of bilirubin-UDP-glucuronyltransferase. Phenothiazines are an example of this kind of interaction. The use of drugs in the neonatal intensive care unit also can contribute to hyperbilirubinemia. Usually, the medications that compete for binding sites on albumin are the culprits in this case (see section on Bilburin Transport). An example of this type of interaction is the use of furosimide, which is a diuretic used to decrease fluid retention and improve cardiac function and renal output. 

S. C., Pinsky, P.P., Jarvis, W.R., Ott, C.E., Mai olis, H.S. Hepatitis A outbreak in a neonatal intensive care unit risk factors for transmission and evidence of prolonged viral excretion among preterm infants. J. Infect. Dis. 1991 164 476 - 482... 

Brown, W.J. Buist, N.R.M. Gipson, H.T.C. Huston, R.K. Kennaway, N.G. Fatal benzyl alcohol poisoning in a neonatal intensive care unit. Lancet 1982, 1, 1250, Letter... 

In a prospective study on the prevalence of hearing impairment in a neonatal intensive care unit population (a total of 942 neonates were screened), aminoglycoside administration did not seem to be an important risk factor for communication-related hearing impairment (148). In almost all cases, another factor was the more probable cause of the hearing loss (dysmorphism, prenatal rubella or cytomegaly, a positive family history of hearing loss, and severe perinatal and postnatal complications). 

Coudray S, Janoly A, Belkacem-Kahlouli A, Bourhis Y, Bleyzac N, Bourgeois J, Putet G, Aulagner G. Erythromycin-induced digoxin toxicity in a neonatal intensive care unit. J Pharm Chn 2001 20 129-31. 

Despite concerns that Emla cream can cause methemoglobinemia in neonates and preterm babies, a French study of 116 infants in neonatal intensive care, who were treated with small amounts of Emla once a day before skin puncture, showed that methemoglobin concentrations never exceeded 5% and were not related to... 

Case Conclusion Because of her reaction to the terbutaline, PC is placed on IV MgS04. Her contractions abate and she continues on the medication for the next 48 hours. At that time, the medication is discontinued and she remains acon-tractile. She is discharged to home, but presents 2 weeks later with stronger contractions. On her second admission, the MgSO is unable to stop her labor and she delivers a 32-week infant weighing 1400 g. She is quite concerned about her infant, but he does well in the neonatal intensive care unit and is discharged home on day of life 23. 

E510 Conrad, P.D., Sparks, J.W., Osberg, L, Abrams, L. and Hay, W.W. (1989). Clinical application of a new glucose analyzer in the neonatal intensive care unit Comparison with other methods. J. Pediatr. 114, 281-287. 

Equine Veterinary Education 8 8-12 Ecke P, Hodgson D R, Rose R J 1998 Induced diarrhoea in horses. Part 2 Response to administration of an oral rehydration solution. Veterinary Journal 155 161-170 Fanconi S, Burger R, Ghelfi D et al 1993 Hemodynamic effects of sodium bicarbonate in critically III neonates. Intensive Care Medicine 19 65-69 Fink M 1997 Cytopathic hypoxia in sepsis. Acta Anaesthesiologic Scandinavica Supplementum 110 87-95... 

Once one knows the problem and has devised a solution, then the real job begins. National Center for Health Statistics data show a decline in total US infant mortality from 1982 to 1992, but marked geographic and racial differences remain. The 1992 overall US rate of infant death was 8.5 per 1000 live births (California, 6.9 Texas, 7.7 New York, 8.5 New Jersey, 8.5 Pennsylvania, 8.6 Ohio, 8.7 Florida, 9.1 Illinois, 10.0 Georgia, 10.4 Michigan, 10.5) - a decline attributed not to reductions in the numbers of birth defects or premature births but to improved neonatal intensive care units and the introduction of synthetic pulmonary surfactants and consequent reductions in death from acute neonatal respiratory distress syndrome. Still, the years of potential life lost due to birth defects ranks fifth, just behind that of homicide and suicide (1, unintentional injury 2, cancer 3, cardiovascular disease) prematurity/low birth weight ranks sixth and sudden infant death syndrome seventh. Ethnic discrepancy remains pronounced rates of White (5.8 per 1000 live births) and Cuban Hispanic (3.7 per 1000 live births) infant death are similar, but the 2002 rate for Blacks (13.9 per 1000 live births) increased compared to the previous year. 

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