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Apnea
Apneas represent another important group of respiratory/ventilation dysfunctions in newborns (apart from perinatal asphyxia and respiratory distress syndrome). They are generally defined as a cessation of breathing movements and air flow for more than 20 seconds, thus often being accompanied by desaturation and bradycardia. Spontaneous breathing causes water in lungs to be resorbed into blood and…
Prematurity
Preterm birth is defined as any birth before 37 completed weeks of gestation (37+0). It has been estimated to account for up to 11 % of all births. Preterm birth is a substantial cause of neonatal and pediatric morbidity and mortality. Prematurity is the single most important cause of death in the…
Retinopathy of prematurity
Retinopathy of prematurity (ROP) is a vasoproliferative disorder (fibrovascular proliferation) of developing retina in preterm infants. It is characterised by disorganized growth of abnormal new blood vessels (=> hemorrhage) and fibrous tissue ( => contracted scar tissue causing retinal detachment). Incidence of ROP is inversely proportional to the gestational age (general ROP screening…
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) belongs to acute abdomen events (inflammatory subgroup). It is typical disease of extreme prematurity – incidence is inversely proportional to advancing gestational age (1-5% of newborns admitted to the neonatal intensive care unit). Mortality associated with NEC varies between 20-50%. Multifactorial basis of NEC makes it difficult to pinpoint single…
Oxygen Therapy
We should attempt to maintain normoxemic oxygenation in order to prevent hypoxic injury (mainly in the cerebral tissue). On the other hand, oxygen should be carefully titrated to newborns, especially preterm, due to the negative effects associated with its overuse (reactive oxygen species = ROS). Hyperoxia induces the production of oxygen radicals that subsequently trigger…
Bicarbonate
Alkalinization with 4.2% Sodium Bicarbonate (0.5 mmol/mL) combats metabolic acidosis; interventions must target the underlying cause.
