Author Archives: neonataltips

Tip 152: hepatitis C

Hepatitis C is a single stranded RNA virus leading to hepatic fibrosis, cirrhosis and occasionally hepatocellular carcinoma. Unlike Hepatitis B, vertical transmission is rare (~5% in Hep C viraemic mothers, increasing to 15-25% from a mother co-infected with HIV), so … Continue reading

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Tip 151: CRIB score

The CRIB (Clinical Risk Index for Babies) score, and its update, CRIB II, were designed to predict mortality for infants born below 32/40. They were based on specific criteria present in the first 12 hours of the infant’s life (to minimise … Continue reading

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Tip 150: oxygen and ROP

Giving supplemental oxygen in preterm infants with incompletely vascularised retina causes hyperoxia and vasoconstriction. This in turn may lead to local hypoxia, up‐regulation of vascular endothelial growth factor, and excessive proliferation of new vessels and fibrous tissue that invades the … Continue reading

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Tip 149: preterm infant nutrition

Preterm infants <1kg require 4.0 – 4.5 g/kg/day protein compared to 2 g/kg/day for a term infant. Reference: ESPGHAN, (2010). Enteral Nutrient Supply for Preterm Infants: Commentary from European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. JPGN; 50: … Continue reading

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Tip 148: meconium ileus

Meconium ileus is due to obstruction of the terminal ileum with thick, viscid meconium. It has an incidence of 1: 1,000 – 2,000 live births. 80 – 90% of neonates with meconium ileus will have cystic fibrosis (usually the first … Continue reading

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Tip 147: hydrocortisone for hypotension

Hydrocortisone is effective in increasing blood pressure, with few other acute side-effects in the sick preterm infant. However, benefit data and long-term safety data are unknown. It is likely that it works by improving the immature neonatal stress response (due to … Continue reading

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Tip 146: NEC risk factors (2)

Other risk factors for NEC include: Hypoxic insult – especially in the more mature infant with NEC Anaemia / need for transfusion Polycythaemia Dehydration Use of non-human milk or hyperosmolar feeds (e.g. fortifier additives) Rapid introduction and escalation of enteral … Continue reading

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