1/47. Transthoracic pacing in a very low birth weight infant with congenital complete atrioventricular block.We report our experience of pacemaker treatment in a premature infant of 830 g with congenital complete atrioventricular block due to maternal sjogren's syndrome. The infant was delivered by cesarean section at an estimated gestational age of 26 weeks because of fetal bradycardia, decreasing fetal movements, and hydrops. Immediate postnatal transesophageal ventricular pacing was not successful, whereas transthoracic pacing with self-adhesive patch electrodes adapted to body size resulted in an effective increase of the infant's heart rate until operative application of temporary epimyocardial pacing wires allowed external stimulation of the heart.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/47. Congenital complete heart block: fetal management protocol, review of the literature, and report of the smallest successful pacemaker implantation.Fetuses with complete heart block have an increased mortality with most deaths occurring in utero or during infancy. The cardiac evaluation of these fetuses is difficult since the ventricular rate is low and the heart is dilated. We have implemented a strategy that includes the biophysical profile, which assesses fetal well-being, in combination with the cardiovascular profile that assesses cardiac function and the circulation. We present two cases of fetal complete heart block in which early delivery was recommended due to worsening cardiovascular profile scores. Biophysical profile scores were normal. Both babies were successfully treated, despite having risk factors that predicted poor outcomes. We hypothesize that our management protocol initiated intervention before fetal compromise, hydrops, and myocardial damage occurred. We recommend an evaluation of heart function in addition to an assessment of fetal well-being in fetuses with complete heart block. Early delivery should be considered if there is evidence of distress and/or deteriorating cardiac function.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
3/47. Misdiagnosis of congenital chloride-losing diarrhea.Congenital chloride-losing diarrhea is a recessively inherited disorder due to the absence of chloride-bicarbonate exchange in the small bowel. Malabsorption of chloride leads to osmotic diarrhea, electrolyte abnormalities, and dehydration. If left untreated, the infants fail to thrive and have a very high mortality. Clinically, affected patients develop secretory diarrhea in utero resulting in distended bowel loops and polyhydramnios. At birth these infants have profuse watery diarrhea that may be confused with urine. Thus, the correct diagnosis is often missed, and they may be subjected to unnecessary interventions. If diagnosed early, the electrolyte abnormalities are easily corrected and the prognosis is good. We report two patients who were initially evaluated for other conditions but later proved to have congenital chloride-losing diarrhea. The cases emphasize the importance of having a high index of suspicion in patients with a history of polyhydramnios, prematurity, and watery stools.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
4/47. Management of infiltration injury in neonates using duoderm hydroactive gel.Neonates are at increased risk of injury from infiltration of intravenous fluids because of small vessel size and immature skin structure. Until recently, hyaluronidase injection was used to prevent tissue injury following the infiltration of intravenous solutions in neonates. The production of hyaluronidase injection was discontinued in 2001. The alternative, compounded hyaluronidase injection is not regulated by the U.S. food and Drug Administration and is subject to variation in quality assurance practices. Amorphous hydrogels have been used as wound dressings for sloughy or necrotic wounds in a variety of clinical settings. hydrogels facilitate autodebridement of the wound by rehydrating slough and enhancing the rate of autolysis. No adverse effects or increased infection rates have been associated with the use of hydrogel dressings. DuoDerm Hydroactive gel is a sterile, preservative-free, viscous, hydrating gel composed of natural hydrocolloids. We report our experience using DuoDerm Hydroactive gel for management of injury secondary to the infiltration of total parenteral nutrition solution and lipid emulsion in three neonates.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
5/47. Intestinal zygomycosis due to absidia corymbifera mimicking necrotizing enterocolitis in a preterm neonate.zygomycosis is a rare fungal disease that occurs in compromised human hosts, including the preterm infant. The three clinical forms of zygomycosis are cellulitis, disseminated, and gastrointestinal, and the last often mimics necrotizing enterocolitis (NEC), complicating the diagnosis. This report details a case of primary gastrointestinal zygomycosis due to absidia corymbifera, mimicking NEC, in a preterm infant, and emphasizes features that may lead to earlier diagnosis and treatment of future cases.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
6/47. Use of the LMA classic to secure the airway of a premature neonate with smith-lemli-opitz syndrome: a case report.In addition to managing the most challenging of airways within the operating room environment, anesthesia providers are frequently consulted or requested to participate in emergency airway control in various areas of the hospital, often after other providers have failed. The following is a case report of a premature infant born with multiple and life threatening congenital anomalies in a rural facility. The current recommendations of the american heart association for neonatal resuscitation were followed; however, the resuscitating team was unable to secure the airway using standard intubating techniques. Consultation with the anesthetist on duty resulted in the successful placement of the laryngeal mask airway (LMA) size 1. The pediatrician involved in the care of the patient had minimal experience with using the LMA; however, with verbal instruction was able to successfully place the LMA. With a patent airway established, the patient stabilized and was transferred to a tertiary facility for aggressive care. Although currently not part of the american heart association neonatal resuscitation algorithm, consideration of the LMA as a tool to manage an airway after failed attempts at intubation may be appropriate.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
7/47. Subcapsular hemorrhage of the liver and hemoperitoneum in premature infants: report of 4 cases.The occurrence of a subcapsular hemorrhage of the liver (SHL) with associated hemoperitoneum in four very low birth weight infants (VLBW) is described. We conclude from the analysis of these four cases and a review of the literature, that the pathogenesis of SHL is multifactorial, which emphasizes the extreme vulnerability of these infants.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
8/47. Expansion of arachnoid cysts in children: report of two cases and review of the literature.arachnoid cysts are intracranial, space-occupying lesions that typically remain stable in size on serial imaging. The authors describe two cases of rapidly enlarging arachnoid cysts, including one located in the anterior fossa. In the first case a 7-month-old boy presented with increasing head circumference and a rapidly enlarging arachnoid cyst in the left middle fossa, which had been documented by serial imaging over the preceding 6 months. In the second case a 4-year-old girl presented with an arachnoid cyst compressing the right frontal lobe. The cyst had not been present on imaging studies performed during the perinatal period. In both cases, a craniotomy for open fenestration of the cyst was performed with successful resolution of the mass effect. Rare cases of expansion of arachnoid cysts have been reported in the literature. In this article the authors report the dramatic enlargement of two arachnoid cysts, including the first description of enlargement of an arachnoid cyst located in the anterior fossa.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
9/47. breast milk as a source for acquisition of cytomegalovirus (HCMV) in a premature infant with sepsis syndrome: detection by real-time PCR.Symptomatic disease due to human cytomegalovirus (HCMV) has been increasingly recognized in low birth weight (LBW) premature infants. breast milk has been identified as a potential source for these infections. At approximately 60 days of life a LBW, premature infant was diagnosed with HCMV sepsis syndrome, prompting further investigation of the source for HCMV acquisition. The infant had received a combination of both fresh and frozen breast milk from his mother throughout his first 2 months of life. We utilized a real-time PCR assay for HCMV dna to retrospectively examine viral genome copy number in serial samples of stored, frozen breast milk. This analysis indicated an increase in breast milk viral load over the first 45 days of life, heralding the HCMV sepsis syndrome that was observed clinically. Real-time PCR may be a useful tool in the evaluation of HCMV viral load in breast milk.- - - - - - - - - - ranking = 0.55303312834755keywords = sample (Clic here for more details about this article) |
10/47. Transmission of community-associated methicillin-resistant staphylococcus aureus from breast milk in the neonatal intensive care unit.methicillin-resistant staphylococcus aureus (MRSA) has become increasingly common in neonatal intensive care units and can lead to severe outcomes. Baby C, of a set of quadruplets, died of MRSA sepsis. The surviving siblings were colonized with MRSA. Expressed breast milk was fed to all infants; tested breast milk samples were all MRSA-positive. Pulsed field gel electrophoresis results of isolates from the infants and breast milk were indistinguishable.- - - - - - - - - - ranking = 0.55303312834755keywords = sample (Clic here for more details about this article) |
| | Next -> |