Tip 61b: benign sleep myoclonus

The myoclonic jerks, mainly affecting the distal upper limbs, can be unilateral or bilateral, and usually last for 10–20 seconds. Sleep is not disturbed and they stop abruptly when the baby is awakened. There are no other clinical manifestations of neonatal seizures.

Reference: Panayiotopoulos, C.P., 2005. The Epilepsies: Seizures, Syndromes and Management. Chapter 5, Neonatal Seizures and Neonatal Syndromes. Oxfordshire (UK): Bladon Medical Publishing.

Advertisements
Posted in Neurology | Leave a comment

Tip 61a: benign sleep myoclonus

Neonatal benign sleep myoclonus is a common non-epileptic condition, starting between day one and three weeks of age. It normally subsides by a few months of age, with no treatment needed.

Reference: Panayiotopoulos, C.P., 2005. The Epilepsies: Seizures, Syndromes and Management. Chapter 5, Neonatal Seizures and Neonatal Syndromes. Oxfordshire (UK): Bladon Medical Publishing.

Posted in Neurology | Leave a comment

Tip 60: pneumothorax

Pneumothorax is more frequent in the neonatal period than at any other time in life, significantly more so in infants <1500g.

The risk for pneumothorax is increased in infants with:

  • respiratory distress syndrome
  • meconium aspiration syndrome
  • pulmonary hypoplasia
  • infants who need resuscitation at birth
  • CPAP and positive pressure ventilation.

References:

Litmanovitz, I., 2008. Expectant Management of Pneumothorax in Ventilated Neonates. Pediatrics; 122 (5): e975 -e979. (1992-2005, 136 infants.)

Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill.

Posted in Prematurity, Respiratory | Leave a comment

Tip 58: long line tip position

Long line tips should ideally lie in the SVC or the IVC.

If access is difficult, tip position in the subclavian or femoral veins may be sufficient but have a greater risk of extravasation.

The tip must not lie within the heart due to the risk of pericardial extravasation and tamponade and any line tip within the cardiac shadow should be pulled back and a repeat X-ray performed to confirm its position.

Reference:  BAPM (2015). Use of Central Venous Catheters in Neonates: A Framework for Practice.

Posted in Management | Leave a comment

Fun 5: meetings

The consultant tried some different faces before deciding which one to wear to handover.

Judith2

Posted in Uncategorized | Leave a comment

Tip 57: posterior urethral valves

In bilateral antenatal renal pelvis dilatation, an urgent ultrasound scan is needed after birth to look for residual significant renal pelvis dilatation (over 10mm) and any dilated ureter or thickened bladder wall that may signify posterior urethral valves. A normal stream of urine does not rule out posterior urethral valves.

Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2012. London: Churchill.

Posted in Congenital anomalies, Renal | Leave a comment

Tip 56: hyperglycaemia in prematurity

Hyperglycaemia has been estimated to occur in 45% to 80% of premature infants.

The underlying mechanisms causing hyperglycaemia are multifactorial and may be the result of high glucose concentrations in the infusion fluids or low glucose uptake rate. Other causes include sepsis, respiratory distress, pain, surgery and steroids.

Reference: Bottino M, Cowett RM, Sinclair JC. Interventions for treatment of neonatal hyperglycemia in very low birth weight infants. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007453. DOI: 10.1002/14651858.CD007453.pub3.

Posted in Metabolic, Prematurity | Leave a comment