Download Cloherty and Stark’s Manual of Neonatal Care PDF

TitleCloherty and Stark’s Manual of Neonatal Care
Author
LanguageEnglish
File Size17.0 MB
Total Pages1073
Table of Contents
                            0.Cover
0.1.Editors
1.Fetal Assessment and Prenatal Diagnosis
2.Maternal Diabetes Mellitus
3.Preeclampsia and Related Conditions
4.Resuscitation in the Delivery Room
5.Nonimmune Hydrops Fetalis
6.Birth Trauma
7.The High-Risk Newborn  Anticipation, Evaluation, Management, and Outcome
8.Assessment of the Newborn History and Physical Examination of the Newborn
9.Care of the Well Newborn
10.Genetic Issues Presenting in the Nursery
11.Multiple Births
12.Maternal Drug Use, Infant Exposure, and Neonatal Abstinence Syndrome
13.Care of the Extremely Low Birth Weight Infant
14.Developmentally Supportive Care
15.Temperature Control
16.Follow-up Care of Very Preterm and Very Low Birth Weight Infants
17.Neonatal Transport
18.Neonatal Intensive Care Unit Discharge Planning
19.Decision-Making and Ethical Dilemmas
20.Management of Neonatal End-of-Life Care and Bereavement Follow-up
21.Nutrition
22.Breastfeeding and Maternal Medications
23.Fluid and Electrolyte Management
24.Hypoglycemia and Hyperglycemia
25.Abnormalities of Serum Calcium and Magnesium
26.Neonatal Hyperbilirubinemia
27.Necrotizing Enterocolitis
28.Neonatal Kidney Conditions
29.Mechanical Ventilation
30.Blood Gas and Pulmonary Function Monitoring
31.Apnea
32.Transient Tachypnea of the Newborn
33.Respiratory Distress Syndrome
34.Bronchopulmonary DysplasiaChronic Lung Disease
35.Meconium Aspiration
36.Persistent Pulmonary Hypertension of the Newborn
37.Pulmonary Hemorrhage
38.Pulmonary Air Leak
39.Extracorporeal Membrane Oxygenation
40.Shock
41.Cardiac Disorders
42.Blood Products Used in the Newborn
43.Bleeding
44.,Neonatal Thrombosis
45.Anemia
46.Polycythemia
47.Thrombocytopenia
48.Viral Infections
49.Bacterial and Fungal Infections
50.Congenital Toxoplasmosis
51.Syphilis
52.Tuberculosis
53.Lyme Disease
54.Intracranial Hemorrhage and White Matter InjuryPeriventricular Leukomalacia
55.Perinatal Asphyxia and Hypoxic-Ischemic Encephalopathy
56.Neonatal Seizures
57.Neural Tube Defects
58.Orthopedic Problems
59.Osteopenia (Metabolic Bone Disease) of Prematurity
60.Inborn Errors of Metabolism
61.Thyroid Disorders
62.Neonatal Effects of Maternal Diabetes
63.Disorders of Sex Development
64.Surgical Emergencies in the Newborn
65.Skin Care
66.Vascular Anomalies
67.Retinopathy of Prematurity
68.Hearing Loss in Neonatal Intensive Care Unit Graduates
69.Common Neonatal Procedures
70.Preventing and Treating Pain and Stress Among Infants in the Newborn Intensive Care Unit
71.Appendix A,B
72.Index-A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Z
                        
Document Text Contents
Page 2

Editors
Eric C. Eichenwald MD

Anne R. Hansen MD, MPH

Camilia R. Martin MD, MS

Ann R. Stark MD

Contributors
Elisa Abdulhayoglu, MD, MS, FAAP

Page 536

Rashish G, Paes BA, Nagel K, et al. Spontaneous neonatal arterial thromboembolism: infants at risk,
diagnosis, treatment, and outcomes. 2013;24:787-797.

Saxonhouse MA. Thrombosis in the neonatal intensive care unit. 2015;42:651-673.

Saxonhouse MA, Manco-Johnson MJ. The evaluation and management of neonatal coagulation disorders.
2009;33:52-65.

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P.614

45
Anemia

Asimenia I. Angelidou

Helen A. Christou

KEY POINTS
A postnatal fall in hemoglobin is physiologically expected in all infants due to suppression of
erythropoietin production in the relatively hyperoxic extrauterine environment reaching nadir between 8
and 12 weeks of age. The degree of anemia, as well as the nadir period, is more dramatic in preterm
infants.

Infant growth and development are likely affected by hemoglobin levels, but current evidence is
inconclusive regarding optimal hematocrit (Hct)/hemoglobin target levels.

Enteral iron supplementation of 2 to 4 mg/kg/day in the preterm infant leads to higher hemoglobin levels,
improves iron stores, and lowers the risk of iron deficiency anemia, but its effect on neurodevelopment
remains unclear. Erythropoiesis-stimulating agents are not routinely recommended because they are of
limited benefit in reducing the number and volume of transfusions in preterm infants once strict
transfusion criteria are used. However, their use may be associated with improved neurodevelopmental
outcomes, and this is being addressed in ongoing clinical trials in preterm infants.

An association between red blood cell (RBC) transfusions and necrotizing enterocolitis (NEC) has been
reported in observational studies, but randomized controlled trials do not support a causal relationship.

I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN. Significant changes occur in the red blood cell
(RBC) mass of an infant during the neonatal period and ensuing months. The evaluation of anemia must take
into account this developmental process as well as the infant's physiologic needs.

A. Normal development: The physiologic anemia of infancy

1. , the fetal aortic oxygen saturation is 45%, erythropoietin levels are high, and RBC production is rapid.
The fetal liver is the major site of erythropoietin production.

2. After birth, the oxygen saturation is 95%, and erythropoietin is undetectable. RBC production by day 7 is
<1/10th the level . Reticulocyte counts are low, and the hemoglobin level falls (Table 45.1).

3. Despite dropping hemoglobin levels, the ratio of hemoglobin A to hemoglobin F increases, and the levels of
2,3-diphosphoglycerate (2,3-DPG)

(which interacts with hemoglobin A to decrease its affinity for oxygen, thereby enhancing oxygen release to the
tissues) are high. As a result, oxygen delivery to the tissues actually increases. This physiologic “anemia” is not
a functional anemia in that oxygen delivery to the tissues is adequate. Iron from degraded RBCs is stored.

Table 45.1. Hemoglobin Changes in Babies in the First Year of Life

Hemoglobin Level

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