Category Archives: Prematurity

Tip 78: PDA medical treatment

Treatment of a symptomatic PDA in a preterm infant is usually by fluid restriction (and waiting for spontaneous closure) or ibuprofen (indomethacin is no longer available in the UK.) The Cochrane review below included the following findings. IV ibuprofen showed a … Continue reading

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Tip 76: PDA 2

Due to an increased left (aorta) to right (pulmonary artery) shunting, a significant PDA is associated with renal impairment / failure, intestinal perforation / NEC, and severe IVH / PVL, possibly due to systemic ‘steal’. The increase pulmonary blood flow can … Continue reading

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Tip 75: patent ductus arteriosus (PDA)

The incidence of PDA in term infants is ~6: 10,000 live births. In preterm infants, especially <1500g, the incidence can be up to 33%. Over half of infants weighing <1kg are symptomatic and require medical treatment for PDA closure. Reference: … Continue reading

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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 … Continue reading

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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 … Continue reading

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Tip 55b: fluid losses in preterm babies

Babies <1.5kg commonly require: high infusion rates (80-100ml/kg/day) of 10% dextrose on day 1 diligent review of their fluid balance and clinical picture with reduction in fluids if required (e.g. hyponatraemia) delayed sodium supplementation until a significant diuresis has occurred … Continue reading

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Tip 55a: fluid requirements in preterm babies

The insensible losses in preterm babies, from evaporation and respiratory tract, can reach 40-60ml/kg/day, even when nursed in 90% humidity, and can be much larger (up to 140ml/kg/day). Reference: Hartnoll, G., 2003. Basic principles and practical steps in the management of … Continue reading

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