scholarly journals Hyperekplexia, A Rare Cause of Neonatal Hypertonia: Report of Two Cases

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sudden Death ◽  
Neonatal Intensive Care Unit ◽  
Early Treatment ◽  
Neonatal Intensive Care ◽  
Low Dose ◽  
Neonatal Period ◽  
Final Diagnosis ◽  
Startle Disease

Hyperekplexia (startle disease) is a rare neurogenetic disorder, frequently misdiagnosed with the risk of choking on food, apnea and sudden death. Recognition of this disorder in the neonatal period is essential to avoid erroneous diagnoses and to start early treatment that has proven effective. We report two cases of two newborns who were initially admitted in our neonatal intensive care unit for management of suspected tetanus and epilepsy. Following clinical and paraclinical investigations, a final diagnosis of hyperekplexia was retained in both cases and a low dose of clonazepam was administered. The symptoms gradually decreased until disappearance of hypertonia and startles.

scholarly journals Neonatal admission from emergency department

2020 ◽  
Vol 7 (1) ◽  
pp. 117-120
Author(s):  
Sitaram Shrestha
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Vulnerable Period ◽  
Common Causes

Neonatal period is a vulnerable period of life. In Nepal, most common causes of newborn admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis. This study explores the diseases with which 131 neonates were admitted from emergency department. Sepsis was the main cause of admission, followed by pneumonia.

scholarly journals Fraturas Ósseas em uma Unidade de Cuidados Intensivos Neonatais

2015 ◽  
Vol 28 (2) ◽  
pp. 204 ◽  
Author(s):  
Ângela Machado ◽  
Gustavo Rocha ◽  
Ana Isabel Silva ◽  
Nuno Alegrete ◽  
Hercília Guimarães
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Bone Fractures ◽  
Clavicle Fracture ◽  
Skull Fracture ◽  
Extremely Low Birth Weight ◽  
Increased Risk

<strong>Introduction:</strong> Fractures during the neonatal period are rare. Some fractures, especially long bones, may occur during birth. Moreover, neonates hospitalized in the Neonatal Intensive Care Unit have an increased risk of fractures for several reasons.<br /><strong>Objective:</strong> To evaluate the incidence and characterize fractures in newborns admitted in a tertiary Neonatal Intensive Care Unit.<br /><strong>Material and Methods:</strong> A retrospective analysis of the newborns admitted to the Neonatal Intensive Care Unit with a diagnosis at discharge of one or more bone fractures from January 1996 to June 2013.<br /><strong>Results: </strong>Eighty neonates had one or more fractures. In 76 (95%) infants the fractures were attributed to birth injury. The most common fracture was the clavicle fracture in 60 (79%) neonates, followed by skull fracture in 6 (8%). In two (2.5%) neonates, extremely low birth weight infants, fractures were interpreted as resulting from osteopenia of prematurity. Both had multiple fractures, and one of them with several ribs.<br /><strong>Conclusion: </strong>A change in obstetric practices allied to improvement premature neonate’s care contributed to the decreased incidence of fractures in neonatal period. But in premature infants the diagnosis may be underestimated, given the high risk of fracture that these infants present.

scholarly journals Epileptic manifestations induced by midazolam in the neonatal period

2001 ◽  
Vol 59 (2A) ◽  
pp. 242-243 ◽  
Author(s):  
Maria Augusta Montenegro ◽  
Marilisa M. Guerreiro ◽  
Jamil Pedro Siqueira Caldas ◽  
Maria Valeriana L. Moura-Ribeiro ◽  
Carlos Alberto M. Guerreiro
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Intensive Care ◽  
Adverse Effects ◽  
Neonatal Intensive Care Unit ◽  
Antiepileptic Drugs ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
University Hospital ◽  
Patients At Risk

Antiepileptic drugs may cause worsening of epilepsy by aggravating pre-existing seizures or by triggering new seizure types. There are several reports of adverse effects related to midazolam, but only a few authors reported epileptic manifestations. We report four newborns seen at the Neonatal Intensive Care Unit of our University Hospital, who developed seizures a few seconds after the administration of midazolam. It is difficult to identify the patients at risk, but it is important to be aware and recognize this situation.

scholarly journals Efficacy of Low-Dose Epinephrine Continuous Infusion in Neonatal Intensive Care Unit Patients

2021 ◽  
Vol 26 (1) ◽  
pp. 51-55
Author(s):  
Gloria Lee ◽  
Jeffrey R. Kaiser ◽  
Brady S. Moffett ◽  
Emily Rodman ◽  
Cynthia Toy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Effects ◽  
Neonatal Intensive Care Unit ◽  
Continuous Infusion ◽  
Neonatal Intensive Care ◽  
Low Dose ◽  
Epinephrine Infusion ◽  
Starting Dose ◽  
Few Data

OBJECTIVES Although epinephrine is used in the neonatal intensive care unit, few data exist on efficacy of doses &lt;0.05 mcg/kg/min. This study evaluates the efficacy and safety of low-dose epinephrine continuous infusion at doses &lt;0.05 mcg/kg/min in infants. METHODS Single-center, retrospective review of hypotensive infants from 2011–2018. Charts were reviewed for initial and maximum epinephrine doses, additional vasoactive agents, short-term efficacy, and adverse effects. The primary outcome was percentage of patients initiated on low-dose epinephrine whose dose did not require titration to ≥0.05 mcg/kg/min. RESULTS A total of 115 patients met study criteria with 131 distinct occurrences of low-dose epinephrine initiation. Most patients were unresponsive to other vasopressors at the time of epinephrine initiation. The median (IQR) starting dose of low-dose epinephrine was 0.01 (0.01–0.04) mcg/kg/min and median (IQR) maximum dose was 0.04 (0.02–0.08) mcg/kg/min. Fifty-five percent were responders. Patients in this cohort demonstrated significant improvement of blood pressure and urine output (p &lt; 0.001) without adverse effects. CONCLUSIONS Low-dose epinephrine infusion may be considered as an alternative treatment to standard starting doses in hypotensive neonatal intensive care unit patients.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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