Category Archives: Prematurity

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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Tip 50: surfactant for RDS

Using surfactant early (<2h age vs. late) in preterm infants with RDS requiring ventilation leads to reduced: pneumothorax (RR 0.69) pulmonary interstitial emphysema (RR 0.60) neonatal mortality (RR 0.84) chronic lung disease at 36 weeks’ gestation (RR 0.69). Reference:¬†Bahadue, F.L., … Continue reading

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Tip 49: respiratory distress syndrome (RDS)

“For babies with RDS to have the best outcomes, it is essential that they have optimal supportive care,¬†including: maintenance of normal body temperature proper fluid management good nutritional support appropriate management of the ductus arteriosus support of the circulation to … Continue reading

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Tip 47: PEEP from the first breath

Studies have shown a ~50% reduction in surfactant administration in 25-28 week gestation babies who receive early PEEP during resuscitation/stabilisation. Also, less supplemental oxygen is required. However, the risk of pneumothorax is increased and there is no overall reduction in … Continue reading

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