Additional Information
Book Details
Abstract
Neonatology is a new e-book in a collection of subject-themed e-books containing relevant key articles from Paediatrics & Child Health. The e-books provide a perfect source of revision for post-graduate exams in paediatrics and portfolio material for life-long learning.
As well as mapping to the requirements of post-graduate training in paediatrics, these e-books also enable anyone with a short-term interest in a specific area to buy individual articles at a price-point that will give affordable access to all readers (from medical students to GPs and practitioners in related areas). The quality of user experience on mobiles, tablets and laptops will be an added bonus for learning on the move.
About the journal
The parent journal (http://www.paediatricsandchildhealthjournal.co.uk/) is a rolling, continuously updated review of clinical medicine over a 4-year cycle covering all the important topics for post-graduate exams in paediatrics. The journal’s articles are refreshed, updated, augmented or replaced as appropriate each time the subject is due for revision to provide a concise overview of knowledge and practice core to the curriculum. Each article is written by invited experts and overseen by the relevant subject specialist on the Board. A trainee representative on the Board ensures relevance and accessibility for exam candidates.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Neonatology: Prepare for the MRCPCH | Fm-1 | ||
| Copyright Page | Fm-2 | ||
| PREFACE | Fm-4 | ||
| Table of Contents | Fm-5 | ||
| Cardiovascular support during neonatal intensive care | 1 | ||
| Introduction | 1 | ||
| Cardiovascular physiology | 1 | ||
| Management | 3 | ||
| Inotropes | 4 | ||
| Vasopressin | 5 | ||
| Summary | 6 | ||
| Financial support received | 7 | ||
| FURTHER READING | 7 | ||
| Preterm patent ductus arteriosus: are we any closer to knowing when to treat? | 8 | ||
| Introduction | 8 | ||
| Ultrasound and the ductus | 8 | ||
| Early preterm ductal behaviour | 8 | ||
| Treatment of the preterm ductus arteriosus | 9 | ||
| If you are going to treat, what to treat with? | 9 | ||
| If you’re going to treat, when to treat? | 10 | ||
| Symptomatic treatment | 10 | ||
| Pre-symptomatic treatment | 10 | ||
| Prophylactic treatment | 11 | ||
| What’s the role of surgical ligation? | 11 | ||
| How should I manage a PDA in 2014? | 11 | ||
| What next: very early ultrasound targeted treatment? | 11 | ||
| FURTHER READING | 12 | ||
| Echocardiography and the neonatologist | 13 | ||
| Part 1: Overview of practice | 13 | ||
| Part 2 | 13 | ||
| Summary | 16 | ||
| FURTHER READING | 16 | ||
| Preventing necrotising enterocolitis in very preterm infants: current evidence | 17 | ||
| Epidemiology and outcomes | 17 | ||
| Pathogenesis and risk factors | 17 | ||
| Genetic contribution | 17 | ||
| Enteral feeding | 17 | ||
| Breast milk versus formula milk | 17 | ||
| Timing of introduction and rate of advancement of enteral feeds | 18 | ||
| Competing outcomes | 18 | ||
| Intra-uterine growth-restriction | 19 | ||
| “SIFT” | 20 | ||
| Standardised feeding protocols | 20 | ||
| “Immuno-nutrition” | 20 | ||
| Immunoglobulin | 20 | ||
| Probiotics | 21 | ||
| Prebiotics | 21 | ||
| Lactoferrin supplementation | 21 | ||
| The ELFIN trial | 21 | ||
| Immuno-nutrition: glutamine and arginine | 21 | ||
| Other modifiable risk factors | 21 | ||
| Conclusion | 22 | ||
| FURTHER READING | 22 | ||
| Neonatal sepsis | 23 | ||
| Definition | 23 | ||
| Early-onset sepsis (EOS) | 23 | ||
| Late-onset sepsis | 23 | ||
| Risk factors | 23 | ||
| Presentation | 24 | ||
| Physical examination | 25 | ||
| Investigations | 25 | ||
| Haematological investigation | 25 | ||
| Polymerase chain reaction (PCR) | 26 | ||
| Treatment of neonatal sepsis | 26 | ||
| Antibiotic choices for early-onset infection | 26 | ||
| Antibiotic choices for late-onset infection | 26 | ||
| Monitoring response to therapy | 26 | ||
| Length of treatment | 26 | ||
| Potential hazards of antibiotics | 27 | ||
| Feeding and infection prevention | 27 | ||
| Summary and practice points | 27 | ||
| FURTHER READING | 27 | ||
| Management of neonatal jaundice | 28 | ||
| Introduction | 28 | ||
| Prevention | 28 | ||
| The bilirubin/albumin ratio | 28 | ||
| Assessing the level of serum bilirubin | 28 | ||
| Transcutaneous bilirubinometry | 29 | ||
| Invasive blood sampling | 29 | ||
| Diagnostic approaches | 29 | ||
| Jaundice with a pathological cause | 29 | ||
| Early-onset jaundice | 29 | ||
| Prolonged jaundice | 30 | ||
| Cholestatic or conjugated jaundice | 31 | ||
| be overstated.Clinical management of the jaundiced infant | 31 | ||
| Phototherapy | 31 | ||
| Pharmacological agents | 31 | ||
| Exchange transfusion | 31 | ||
| Guidelines for the use of phototherapy and exchange transfusion | 32 | ||
| Future monitoring and adherence to best practice | 33 | ||
| FURTHER READING | 33 | ||
| Hypoxic ischaemicencephalopathy | 34 | ||
| Introduction | 34 | ||
| Cellular effects | 34 | ||
| Neuronal injury | 34 | ||
| Biochemical cascades | 34 | ||
| Vascular effects | 36 | ||
| Genetic | 36 | ||
| Forms of cell death: necrosis and apoptosis | 36 | ||
| Neuropathology | 36 | ||
| Neuroprotective strategies | 37 | ||
| Summary | 37 | ||
| FURTHER READING | 37 | ||
| Protecting the brain of term\rinfants: from bench to\rbedside | 39 | ||
| Introduction | 39 | ||
| A brief history of hypothermia | 39 | ||
| Early clinical studies | 40 | ||
| Randomised controlled trials | 40 | ||
| Meta-analysis of trial data | 40 | ||
| Translation into clinical practice | 40 | ||
| The future of neuroprotection in the term infant | 44 | ||
| Conclusion | 44 | ||
| FURTHER READING | 44 | ||
| White matter damage in the preterm neonate | 46 | ||
| Introduction | 46 | ||
| Cells of the central nervous system | 46 | ||
| Pathophysiology | 46 | ||
| Pathology | 48 | ||
| Conclusions | 48 | ||
| FURTHER READING | 48 | ||
| Modifiable risk factors for preterm brain injury | 50 | ||
| Introduction | 50 | ||
| Types of preterm brain injury | 50 | ||
| Modifiable risk factors for preterm brain injury | 51 | ||
| Future directions | 54 | ||
| Role of the funding source | 54 | ||
| FURTHER READING | 54 | ||
| MRI brain imaging in neonates | 56 | ||
| Introduction | 56 | ||
| Normal myelination | 56 | ||
| Hypoxic-ischaemic encephalopathy | 56 | ||
| Acute profound hypoxic-ischaemic injury | 57 | ||
| Prolonged partial hypoxic-ischaemic injury | 57 | ||
| Image modification by therapeutic cooling | 57 | ||
| Advanced MRI techniques in hypoxic-ischaemic encephalopathy | 58 | ||
| Neonatal infarction | 58 | ||
| Neonatal hypoglycaemia | 58 | ||
| White matter injury of prematurity | 58 | ||
| White matter injury in term infants | 59 | ||
| Complications of preterm germinal matrix haemorrhage | 59 | ||
| Meningitis | 60 | ||
| Viral encephalitis | 61 | ||
| FURTHER READING | 61 | ||
| Neonatal brain injury: insult, injury and impact in the term infant | 62 | ||
| Introduction | 62 | ||
| Hypoxia-ischaemic encephalopathy | 62 | ||
| Perinatal stroke | 63 | ||
| Kernicterus | 64 | ||
| Hypoglycaemia | 64 | ||
| Infection | 65 | ||
| Summary | 67 | ||
| FURTHER READING | 67 | ||
| Overview of assisted ventilation in the newborn | 68 | ||
| Introduction | 68 | ||
| Physiology of ventilation | 68 | ||
| Mechanical ventilation | 68 | ||
| Methods of providing mechanical respiratory support include | 69 | ||
| Patient triggered modes include | 69 | ||
| Hybrid modes | 71 | ||
| Non tidal assisted ventilation | 71 | ||
| Current evidence | 71 | ||
| Conclusions | 72 | ||
| FURTHER READING | 73 | ||
| A review of non-invasive ventilation support in neonates | 74 | ||
| Introduction | 74 | ||
| Pathophysiology of respiratory insufficiency in preterm infants | 74 | ||
| NCPAP | 74 | ||
| Bubble CPAP | 76 | ||
| Nasal intermittent positive pressure ventilation (NIPPV) | 76 | ||
| Bilevel positive airway pressure (BiPAP) | 76 | ||
| Heated humidified high flow nasal cannula (HHFNC) | 76 | ||
| Summary | 77 | ||
| FURTHER READING | 77 | ||
| Diagnosis and management of pulmonary hypertension of the newborn | 79 | ||
| Introduction | 79 | ||
| Pathogenesis and physiology | 79 | ||
| Examination | 79 | ||
| Investigations | 80 | ||
| Other investigations to consider | 80 | ||
| Management | 81 | ||
| Extra corporeal membrane oxygenation (ECMO) | 82 | ||
| Novel therapies | 82 | ||
| Outcome | 82 | ||
| Conclusion | 82 | ||
| FURTHER READING | 82 | ||
| Management of congenital diaphragmatic hernia | 90 | ||
| Introduction | 90 | ||
| Antenatal care (fetal CDH) | 90 | ||
| Newborn management ‒ postnatal care | 91 | ||
| Stabilization | 91 | ||
| Surgery | 92 | ||
| FURTHER READING | 93 | ||
| Management of bronchopulmonary dysplasia | 94 | ||
| Introduction | 94 | ||
| Prevention of bronchopulmonary dysplasia | 94 | ||
| Treatment of evolving bronchopulmonary dysplasia | 96 | ||
| Management of established bronchopulmonary dysplasia | 97 | ||
| Management in the community | 97 | ||
| Conclusion | 98 | ||
| FURTHER READING | 98 | ||
| The pathophysiology of respiratory distress syndrome in neonates | 99 | ||
| Introduction | 99 | ||
| Risk factors for RDS | 99 | ||
| Fetal stages of lung development | 100 | ||
| Surfactant | 101 | ||
| The pathophysiology of RDS | 102 | ||
| Alternative causes for respiratory distress of the newborn | 103 | ||
| Summary | 104 | ||
| FURTHER READING | 104 | ||
| Minimizing the risk of respiratory distress syndrome | 105 | ||
| Introduction | 105 | ||
| Pathophysiology | 105 | ||
| Prevention strategies | 105 | ||
| Conclusion | 108 | ||
| FURTHER READING | 109 | ||
| Management of neonatal respiratory distress syndrome | 110 | ||
| Introduction | 110 | ||
| Prenatal care | 110 | ||
| Delivery room stabilization strategies | 110 | ||
| Respiratory support and surfactant | 111 | ||
| Mechanical ventilation strategies | 112 | ||
| Strategies to avoid or reduce mechanical ventilation | 113 | ||
| Supportive care | 113 | ||
| Respiratory distress in term babies | 113 | ||
| Summary | 114 | ||
| FURTHER READING | 114 | ||
| Causes and management of pulmonary air leaks | 115 | ||
| Introduction | 115 | ||
| Pathophysiology | 115 | ||
| Pneumothorax | 115 | ||
| Pulmonary interstitial emphysema | 117 | ||
| Pneumomediastinum | 117 | ||
| Pneumopericardium | 117 | ||
| Pneumoperitoneum | 118 | ||
| Systemic air embolism | 118 | ||
| Subcutaneous emphysema | 118 | ||
| Funding source | 118 | ||
| Role of funding source | 118 | ||
| FURTHER READING | 118 | ||
| Causes and management of pulmonary haemorrhage in the neonate | 120 | ||
| Introduction | 120 | ||
| Incidence | 120 | ||
| Pathogenesis | 120 | ||
| Aetiology | 120 | ||
| Clinical features | 121 | ||
| Investigations | 121 | ||
| Treatment | 121 | ||
| Complications | 122 | ||
| Mortality | 122 | ||
| FURTHER READING | 122 | ||
| Management of meconium aspiration syndrome | 124 | ||
| Introduction | 124 | ||
| Management | 124 | ||
| Perinatal management | 125 | ||
| Postpartum management | 125 | ||
| Outcome | 126 | ||
| Conclusions | 127 | ||
| FURTHER READING | 127 | ||
| Postnatal metabolic adaptation and neonatal hypoglycaemia | 128 | ||
| Introduction | 128 | ||
| Metabolic changes at birth | 128 | ||
| Clinical significance of impaired metabolic adaptation | 128 | ||
| Causes of impaired neonatal metabolic adaptation | 128 | ||
| Diagnosis of clinically significant hypoglycaemia | 129 | ||
| Prevention and management of neonatal hypoglycaemia | 130 | ||
| Summary | 132 | ||
| FURTHER READING | 132 | ||
| Resuscitation of the term and preterm infant | 133 | ||
| Background | 133 | ||
| Resuscitation and support of transition of term infants at birth | 133 | ||
| Breathing | 137 | ||
| Circulation | 137 | ||
| FURTHER READING | 139 | ||
| Respiratory support for preterm infants — the Cochrane evidence and beyond | 140 | ||
| Introduction | 140 | ||
| Lung development | 140 | ||
| Support strategies before birth | 140 | ||
| Respiratory support at birth | 141 | ||
| Ongoing respiratory support: mechanical ventilation | 141 | ||
| Weaning and extubation from mechanical ventilation | 143 | ||
| Non-invasive respiratory support | 143 | ||
| Weaning from respiratory support | 144 | ||
| Summary and future perspectives | 144 | ||
| FURTHER READING | 144 | ||
| Congenital brachial plexus palsy | 145 | ||
| Introduction | 145 | ||
| Pathophysiology | 145 | ||
| Diagnosis | 145 | ||
| Classification and natural history | 146 | ||
| Associations | 146 | ||
| Differential diagnosis | 146 | ||
| Initial physical examination and investigations | 147 | ||
| Further management | 147 | ||
| Electrodiagnostic studies | 147 | ||
| Radiological studies | 147 | ||
| Surgical management e primary | 148 | ||
| Surgical management e secondary | 148 | ||
| Post-operative management | 148 | ||
| Pain and brachial plexus palsy | 149 | ||
| FURTHER READING | 149 | ||
| Early care of the preterm infant — current evidence | 150 | ||
| Introduction | 150 | ||
| Before birth | 150 | ||
| Delivery suite management | 150 | ||
| Early NICU care | 153 | ||
| Conclusion | 154 | ||
| FURTHER READING | 154 | ||
| Temperature monitoring and control in the newborn baby | 155 | ||
| Introduction | 155 | ||
| Thermoregulation | 155 | ||
| Thermoregulation and outcome | 155 | ||
| Temperature measurement | 156 | ||
| Variation due to device and measurement method | 157 | ||
| How best to maintain temperature | 157 | ||
| Conclusions | 158 | ||
| FURTHER READING | 158 | ||
| Understanding blood gases/acid—base balance | 159 | ||
| Introduction & terminology | 159 | ||
| Normal acidebase regulation | 159 | ||
| Disturbances of acidebase balance | 161 | ||
| Implications of acid ‒ base disorders | 163 | ||
| Invasive & non-invasive blood gas analysis in the neonatal unit | 163 | ||
| Clinical interpretation of blood gases | 164 | ||
| FURTHER READING | 164 | ||
| Recognition and management of neonatal seizures | 166 | ||
| Introduction | 166 | ||
| Pathophysiology | 166 | ||
| Clinical features | 167 | ||
| Aetiology | 167 | ||
| Management of neonatal seizures | 168 | ||
| Prognosis | 171 | ||
| FURTHER READING | 171 | ||
| The role of brain MRI scanning in the newborn | 172 | ||
| Introduction | 172 | ||
| The newborn brain | 172 | ||
| Diseases leading to brain injuries in newborns | 172 | ||
| MRI sequences available for brain newborn imaging | 173 | ||
| Brain MRI for clinical purposes | 174 | ||
| Brain MRI for research purposes | 174 | ||
| Safety of brain MRI scanning in the newborn | 175 | ||
| Conclusions | 175 | ||
| FURTHER READING | 175 |