Bicarbonate
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Resuscitation
Perinatal asphyxia remains one of the most common indications for postnatal resuscitation. The necessary prerequisites for successful resuscitation are properly equipped rooms (delivery suite, neonatal wards with the right and functional equipment; warmed up to the temperature of 26 °C) with properly trained personnel. Ventilation (and circulation dysfunction) are indications to initiate resuscitation…
Birth injury
Birth injury is defined physical (mechanical) trauma of tissues and organs that is associated with birth (internal or external injury). Treatment is required for birth injury itself, as well as for the associated complications (perinatal asphyxia, hemorrhage and resultant anemia, hyperbilirubinemia, paresis, fractures). Risk Factors for Birth Injury Prematurity Instrumental birth (forceps,…
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…
Neurodevelopment
The central nervous system of extremely preterm infants is highly susceptible to perinatal injuries due to the presence of immature vasculature in the germinal matrix and periventricular white matter. Furthermore, the sensitivity of cerebral tissue to hypoxia-ischemia stems from already low baseline CBF and high oxygen consumption with increased oxygen extraction. In…
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…
Late onset sepsis
Late onset sepsis (LOS) is an infectious complication in newborns that have clinical presentation after the first 72 hours of life. Sometimes also called nosocomial due to pathogenesis – contact with mother, breastmilk, invasive procedures, hands of healthcare personnel. LOS episodes significantly contribute to neonatal mortality and morbidity rates and can have lifelong…
