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Signa Vitae

A Journal In Intensive Care And Emergency Medicine

Tag: newborn (Page 1 of 2)

Clonidine for neonatal abstinence syndrome: a single neonatology department’s experience

Abstract

Clonidine has been shown effective in reducing sympathetic hyperactivity in neonatal abstinence syndrome (NAS). The aim of this study was to analyze clinical and laboratory characteristics of a group of newborns treated with clonidine for NAS due to maternal drug addiction and due to withdrawal from opioid analgesic therapy. Only one full–term newborn presented with metabolic acidosis and hyperkalemia; in others no clinical or laboratory adverse effects were detected. This report emphasizes the importance of alertness to potential adverse effects of clonidine therapy, and discusses possible pathophysiological aspects of hyperkalemia and metabolic acidosis during treatment for NAS.

Key words: newborn, sympathetic hyperactivity, metabolic acidosis, hyperkalemia

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Uncommon manifestations of neonatal group b Streptococcus infection: case report and literature review

Abstract

Streptococcus agalactiae, also called Group B Streptococcus (GBS), is a common pathogen in the neonatal period that can cause early- and late-onset infections. The most common manifestations are bacteremia without an apparent focus of infection, pneumonia and meningitis. Additionally, GBS can rarely cause early- and late-onset infections with uncommon manifestations. If they go unrecognized, they may lead to inappropriate treatment and increased neonatal morbidity and mortality. In this article, a case report of an infant with early-onset GBS bullous impetigo is presented together with a short review of other uncommon manifestations of GBS infection.

Key words: Streptococcus agalactiae, infection, newborn

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Neonatal early onset sepsis due to Moraxella osloensis: Case-report and revision of the literature

Abstract

We report the first case of early-onset systemic neonatal infection associated with Moraxella osloensis bacteriemia in a full term baby. The genus Moraxella is constituted by a group of pleomorphic bacteria obligate aerobes, Gram-negative, oxidase positive and indole negative infrequently isolated from clinical specimens. The organism is rarely reported in the literature as the causative agent of infection in humans, mostly in immunocompromised patients. Only 12 cases of M. osloensis-related infections during childhood have been reported in the literature so far. This unique report of M. osloensis infection, during the neonatal period, concerns the isolation of the bacteria in purulent secretions from the eyes of a 3-week-old baby with opthalmia. In our patient, the precocity of the onset of symptoms allows us to hypothesize a vertical transmission of the bacteria.

Key words: Moraxella, newborn, sepsis

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Umbilical Vein Catheterization – When Complications Occur A Case Report

Abstract

Although umbilical venous catheterization is a routine procedure in premature newborns, it is associated with various, potentially life threatening, complications. We present a case of a premature baby diagnosed with a hepatic parenchymal liquid collection as a complication of umbilical vein catheterization in our Neonatal Intensive Care Unit.

The child was born in the 25th gestational week (GW) and was doing well until the12th day of life when his general condition deteriorated. He appeared anxious and his oxygen saturation (SaO2) decreased. There was slight abdominal distension and tenderness over the abdominal wall, with weak bowel movements, and a palpable liver. Abdominal ultrasound (US) showed an enlarged liver with a well-defined hypoechoic area, with inhomogeneous echogenicity. Such findings were suggestive of fluid extravasation to the liver through a malpositioned umbilical venous catheter. The umbilical catheter was withdrawn, antimicrobial treatment initiated, and eventual complete regression of the collection was seen eleven days after extravasation. Rapid, unexplained clinical deterioration of a newborn with an umbilical vein catheter should always raise the suspicion of a complication due to catheterization. Such a catheter should be carefully revised and, if there is any doubt, removed. Timely diagnosis and adequate treatment is essential, and potentially life-saving.

Key words: newborn, umbilical vein catheterization, complication, malposition, liver

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Thrombosis in newborns: experience from 31 cases

Abstract

Thrombosis is the result of congenital or acquired prothrombotic risk factors. The incidence of thrombosis in the paediatric population is highest in newborns, as about 10% of thrombotic events occur in the first four weeks of life. Haemostasis in a newborn, though still developing, is a well balanced mechanism. About 90% of all thrombotic events are due to acquired and the rest to congenital risk factors.
The aim of our study was to estimate the incidence of thrombosis in a population of Slovenian newborns and to study risk factors, location and treatment of thrombotic events.
Inpatient charts of newborns with thrombosis, admitted to a tertiary neonatology centre and paediatric intensive care unit between 2004 and 2011, were studied retrospectively. Family history, location, aetiology and treatment of thrombosis were analysed.
Thirty one newborns, 17 boys (54.8%) and 14 girls (45.2%), with 31 thrombotic events were found. There were 17 cases (54.8%) of arterial and 14 cases (45.2%) of venous thrombosis. A  family history of thrombophilia was found in two cases (6.5%). Twenty six cases (83.9%) were contributed to acquired risk factors and five (16.1%) to congenital aetiology. Four cases (12.8%) were treated, two with anticoagulation, one with thrombolysis and one with both. The estimated incidence of thrombosis was 0.17 per 1000 live births. Our data showed a higher incidence of thrombosis in Slovenian newborns and a higher incidence of congenital prothrombotic risk factors than in the data published so far.

 

Key words: newborn, thrombosis, incidence, risk factor, treatment

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