Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality.

Background: Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI).

Methods: Retrospective chart review of the neonates born at a gestational age of ≤28 weeks admitted to the neonatal intensive care unit (NICU) between January 2014 and December 2018.

Use of serum citrulline concentrations from routine newborn screen as a biomarker for necrotizing enterocolitis.

Purpose: Necrotizing enterocolitis (NEC), a leading cause of mortality and morbidity in preterm neonates, lacks a reliable biomarker. Citrulline is primarily produced by enterocytes and correlates with intestinal function. Serum citrulline concentration (CIT) is routinely measured in routine newborn screening (NBS).

c-KIT-Positive Fatal Diffuse Cutaneous Mastocytosis With Systemic Manifestations in a Neonate.

Diffuse cutaneous mastocytosis is a rare variant of mastocytosis in the neonatal period. We describe a case of c-KIT (DV) mutation-positive fatal diffuse cutaneous mastocytosis with systemic involvement of the gastrointestinal tract and associated malabsorption and hepatosplenomegaly associated with mast cell mediator release symptoms.

A Unique Preparation and Delivery Method for Acitretin for Neonatal Harlequin Ichthyosis.

Harlequin ichthyosis is a rare form of congenital ichthyosis with a distinct phenotypic appearance. We describe a case of a newborn baby with harlequin ichthyosis who was treated with an oral formulation of acitretin. The treatment resulted in a satisfactory improvement in the skin condition of the patient.

Extravasation of total parenteral nutrition into the liver from an upper extremity peripherally inserted central venous catheter.

Peripherally inserted central catheters (PICC) are the mainstay of central venous access in preterm infants, and one of the common procedures performed in neonatal intensive care unit (NICU). Complications of PICC include infection, mechanical dysfunction, thrombosis, migration, and extravasation of the infusate. In this report, we describe a case of PICC inserted from an upper extremity with migration into the inferior vena cava (IVC) and the hepatic vein associated with extravasation of the total parenteral nutrition (TPN) into the peritoneum and the liver.

Antenatal Escitalopram Use and Necrotizing Enterocolitis in a Newborn: A Case Report.

The increased use of antidepressants during pregnancy has been associated with adverse effects in the newborn. We report a case of antenatal escitalopram use associated with necrotizing enterocolitis in a healthy term baby. We further discuss possible mechanisms that may explain this association.

Topical Iodine-Induced Thyrotoxicosis in a Newborn with a Giant Omphalocele.

Introduction: Neonatal thyrotoxicosis is a life-threatening condition with potentially irreversible neurologic sequelae. Most cases are seen in neonates born to mothers with Graves' disease. Topical iodine-induced hypothyroidism has been reported in neonates, but iodine-induced neonatal hyperthyroidism has not been described; albeit a familiar entity in adults.

Transitioning Preterm Infants From Parenteral Nutrition: A Comparison of 2 Protocols.

Background: Growth in preterm infants is compromised during the transition phase of nutrition, when parenteral nutrition (PN) volumes are weaned with advancing enteral nutrition (EN) feeds, likely due to suboptimal nutrient intakes during this time. We implemented new PN guidelines designed to maintain optimal nutrient intakes during the transition phase and compared growth outcomes of this cohort with a control group.

Materials And Methods: A chart review was conducted on infants born <32 weeks' gestation, before (control group) and after (study group) a new transition PN protocol was implemented in the neonatal intensive care unit.

Randomized control trial comparing physiologic effects in preterm infants during treatment with nasal continuous positive airway pressure (NCPAP) generated by Bubble NCPAP and Ventilator NCPAP: a pilot study.

Objectives: Nasal continuous positive airway pressure (NCPAP) is an accepted form of non-invasive ventilation in preterm infants. Few, if any, studies have shown an advantage of one type of NCPAP over another. It has been theorized that bubble-generated NCPAP may be advantageous for the preterm neonate versus traditionally used ventilator-generated NCPAP.

A Multidisciplinary Approach to Anesthetic Management of a Parturient with Severe Aortic Stenosis.

In order to optimize anesthetic management and avoid adverse maternal and fetal outcomes, a clear understanding of the changes in cardiovascular physiology that occur during pregnancy is paramount. The effects of normal gestation on the cardiovascular system are particularly significant in a parturient with cardiac valvular pathology. We present a case of a 27-year-old G2P0 at 37 weeks with a past medical history of diabetes, macrosomia, congenital bicuspid aortic valve with severe stenosis (valve area 0.

Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature.

Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.

Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans.

Neonatal serum magnesium concentrations are determined by total maternal dose of magnesium sulfate administered for neuroprotection.

Background: Antenatal magnesium in preterm labor for neuroprotection decreases the incidence of cerebral palsy. However, there are no guidelines on the dose and duration of magnesium infusion for neuroprotection. As increased neonatal serum magnesium concentrations may be related to higher risk of morbidity and mortality, the role of total amount of magnesium and maternal serum magnesium concentrations associated with safe neonatal serum magnesium concentrations is not known.

From parenteral to enteral nutrition: a nutrition-based approach for evaluating postnatal growth failure in preterm infants.

Background: Nutrition practices for preterm infants include phases of parenteral nutrition (PN), full enteral nutrition (EN), and the transitional phase in between. Our aim was to identify the nutrition phases during which infants are most likely to exhibit poor growth that would affect risk for growth failure (GF) at discharge and to examine factors associated with GF.

Methods: A retrospective chart review was conducted on infants born <32 weeks' gestation.

Gradual versus sudden weaning from nasal CPAP in preterm infants: a pilot randomized controlled trial.

Background: There is paucity of information on the weaning of nasal CPAP (NCPAP) in preterm infants. As the weaning from NCPAP can be gradual or sudden, we wanted to determine which of the 2 methods was better.

Methods: A prospective randomized trial was conducted to compare the success of weaning from NCPAP when using the sudden and gradual weaning methods in infants born ≤ 32 weeks.

Pattern of bacterial colonization in a new neonatal intensive care unit and its association with infections in infants.

Background: There is paucity of information on the pattern of bacterial colonization of a new neonatal intensive care unit.

Objective: To study the pattern of bacterial colonization on the environmental surfaces in a new neonatal intensive care unit (NICU) and correlate it with infections in the infants.

Methods: Environmental cultures from the faucets and computer keyboards in the NICU were obtained prospectively every 2 weeks for 1 year.

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates.

Objective. Identification of the weight and postmenstrual age (PMA) at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean. Study Design.

Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes.

Background: Thrombocytopenia is a common finding among preterm neonates and has been associated with mortality and morbidities. In recent studies in adults, the drop in platelet numbers has been shown to be a predictor of clinical outcomes. Although drop in the platelet counts with or without thrombocytopenia has also been observed in neonates, its association with mortality and morbidity has not been investigated in the preterm population.

Immediate clinical outcomes in preterm neonates receiving antenatal magnesium for neuroprotection.

Background: Antenatal magnesium sulfate can potentially reduce the risk of cerebral palsy in neonates delivered between 24 and 32 weeks of gestational age. Some studies using high-dose magnesium sulfate for neuroprotection have reported increased perinatal mortality.

Methods: A retrospective study was conducted on 475 neonates born between 24 and 32 weeks of gestational age.

NCI classification of thrombocytopenia in extremely preterm neonates and its association with mortality and morbidity.

Background: Thrombocytopenia (TP) is a common finding among preterm neonates and has been associated with mortality and morbidities. Yet, there is no consistent classification for neonatal TP. TP in adults has recently been graded by the National Cancer Institute (NCI) Common Toxicity Criteria and has been shown to predict clinical outcomes.

Inhaled nitric oxide and gentle ventilation in the treatment of pulmonary hypertension of the newborn--a single-center, 5-year experience.

Objective: To evaluate the effect of inhaled nitric oxide (INO) in pulmonary hypertension of the newborn (PH) in a single center over 5 years using gentle ventilation (GV), without hyperventilation or induced alkalosis.

Methods: Data from 229 consecutive infants with PH of varied etiology treated with INO and GV, and from 67 infants with meconium aspiration syndrome (MAS) and primary PH (PPHN) treated with GV alone were reviewed over a 5-year period (86% outborn). INO was initiated at 25 ppm when PH and severe hypoxemia persisted despite maximal optimal ventilation.