Clinical specialties
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
The paediatric resuscitation team is called to the maternity ward following delivery of a 26-week-old newborn with developed signs of infant respiratory distress syndrome (IRDS). Apart from prematurity, give two risk factors for IRDS. (2)What substance is deficient in the lungs of premature babies, giving rise to IRDS? (1)What cells in the lungs produce this substance? (1)What prenatal medication can be given to prevent respiratory distress syndrome? (1)Give two signs of IRDS. (2)What is seen on a chest X-ray in a baby with IRDS? (1)Despite maximal therapy, the baby continues to deteriorate, and the resuscitation team recognises the baby is dying.When breaking bad news, give two things a doctor can do to ensure a good consultation. (2)
Pharmacology and Toxicology of Loop Diuretics in Pediatrics
Sam Kacew in Drug Toxicity and Metabolism in Pediatrics, 1990
Disturbances in fluid balance can result in pathologic increases in fluid volume leading to edema and congestion. In neonatology a primary site for fluid accumulation is the lungs with a consequential development of pulmonary edema and congestive heart failure. Various factors can facilitate the accumulation of fluids in pulmonary tissue (Table 1). In association with pulmonary edema, there is an impairment in lung functions as outlined in Table 2. Pulmonary edema and lymphangiectasis are characteristic pathological alterations believed to play a role in the early stages of infant respiratory distress syndrome (RDS).25,26 In addition the presence of a patent ductus arteriosus (PDA) was found to contribute to the development of RDS.27 It has been suggested that a common sequela to RDS is the development of chronic lung disease or bronchopulmonary dysplasia (BPD).28 Pulmonary edema has also been implicated in the disease transient tachypnea of the newborn (TTNB).1 Clearly, there are a number of neonatal diseases associated with fluid imbalance which provide a basis for the therapeutic use of diuretics.
Preterm Labor
Vincenzo Berghella in Obstetric Evidence Based Guidelines, 2022
A meta-analysis examining the use of oral nifedipine for maintenance tocolysis found no difference in the incidence of perinatal death (RR 1.36; 95%, 95% CI 0.35–5.33), IVH ≥grade II (RR 0.65; 95% CI 0.16–2.67), NEC (RR 1.15; 95% CI 0.50–2.65), infant respiratory distress syndrome (IRDS) (RR 0.98;95% CI 0.51–1.85), and prolongation of pregnancy (hazard ratio 0.74; 95% CI 0.55–1.01) [71]. Therefore, maintenance tocolysis with nifedipine is not recommended.
Hypercalcemic crisis in third trimenon: evaluating the optimal treatment strategy
Published in Gynecological Endocrinology, 2018
Julie Refardt, Patricia Farina, Irene Hoesli, Christian Meier
The growth retarded male preterm (weight 1470 g (<10th percentile), length 42 cm (10–50th percentile), head circumference 30.5 cm (25–50th percentile), umbilical cord blood pH 7.37, Apgar score 6/6/8) was transferred immediately to the neonate intensive care due to infant respiratory distress syndrome (IRDS). He also suffered from apnea and bradycardia, insufficient drinking, hyponatremia and hyperbilirubinemia – which were all due to the prematurity. He did not suffer from hypocalcemia induced tetany and had normal calcium levels at all times. He was discharged after one month in good condition (weight 2590 g (5th–10th percentile), length 50 cm (10th–50th percentile), head circumference 33.5 cm (10th–25th percentile).
Safety of ambroxol in the treatment of airway diseases in adult patients
Published in Expert Opinion on Drug Safety, 2018
Dorotheea Cazan, Ludger Klimek, Annette Sperl, Manuel Plomer, Stephan Kölsch
Finally, with regards to the concerns around an increased reporting of anaphylactic reactions, the PRAC retrieved from the database of the marketing authorization holders 119 cases for ambroxol-containing products indicated in secretolytic therapy, infant respiratory distress syndrome and in the prophylaxis of postoperative complications, of which nearly half originated from China. However, the PRAC deemed that the observed increase in reporting of anaphylactic reactions for ambroxol-containing products was likely an artefact resulting from the implementation of a new pharmacovigilance regulation in China and did not constitute a new safety concern [2].
Ethics Considerations Regarding Artificial Womb Technology for the Fetonate
Published in The American Journal of Bioethics, 2023
Felix R. De Bie, Sarah D. Kim, Sourav K. Bose, Pamela Nathanson, Emily A. Partridge, Alan W. Flake, Chris Feudtner
Infants born prematurely before 35weeks estimated gestational age are at substantially increased risk of infant respiratory distress syndrome (IRDS), also known as hyaline membrane disease. Fifty years ago, IRDS was essentially uniformly fatal. Since then, with advances of neonatal mechanical ventilation technology beginning in the 1970s and the advent of surfactant replacement therapy in the 1980s, expectations of survival for infants born at earlier EGA rose, such that currently an infant born in the United States at an EGA of 26weeks has an 85% chance of surviving (Stoll et al. 2015).
Related Knowledge Centers
- Pulmonary Hypoplasia
- Pulmonary Surfactant
- Syndrome
- Tachycardia
- Lung
- Preterm Birth
- Gestational Age
- Neonatal Infection
- Caesarean Section
- Tachypnea