Neonatology: A Practical Approach to Neonatal Diseases

1376 Pages·2012·27.5 MB·English

by  Marcello Orzalesi

Neonatology
A Practical Approach to Neonatal Diseases
Giuseppe Buonocore • Rodolfo Bracci
Michael Weindling
Editors
Neonatology
A Practical Approach
to Neonatal Diseases
123
Editors
Giuseppe Buonocore Michael Weindling
Professor of Pediatrics and Neonatology Professor of Perinatal Medicine
Head of School of Pediatrics University of Liverpool
Department of Pediatrics, Obstetrics Director of Postgraduate Research
and Reproductive Medicine Department of Women’s and Children’s Health
Division of Neonatology Institute of Translational Medicine
University of Siena Head of School of Paediatrics Mersey Deanery
General Hospital S. Maria alle Scotte Liverpool Women’s Hospital
Azienda Ospedaliera Universitaria Senese Liverpool, United Kingdom
Siena, Italy
Rodolfo Bracci
Formerly Professor of Pediatrics and
Head of Department of Pediatrics,
Obstetrics and Reproductive Medicine
University of Siena
Siena, Italy
ISBN 978-88-470-1404-6 e-ISBN 978-88-470-1405-3
DOI 10.1007/978-88-470-1405-3
Springer Milan Dordrecht Heidelberg London New York
Library of Congress Control Number: 2011940798
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Preface
All practitioners, doctors and nurses, who care for newborn babies have an enormous
responsibility. They are entrusted with the care of approximately 130 million children
who are born each year worldwide, about 20 million of whom are of low birth weight.
Because they are born light and early, these children are at high risk of dying during
the perinatal period, have reduced survival during infancy and are at risk of survival
with cognitive impairment. Their health later in life may be adversely affected and even
the next generation may suffer. Some babies become sick because they are born small,
others because of inherited diseases, which often provide diagnostic and therapeutic
challenges. Still others, about one in every thousand, have thrived during the pregnancy
but are subjected to severe and potentially damaging hypoxic ischaemia at full-term.
We firmly believe that good care can help improve the survival of these small vulnerable
patients and this book was produced with the aim of providing healthcare practitioners
in neonatology with an up-to-date, readily available and comprehensive source of prac-
tical advice for the expert management of their patients and their diverse illnesses.
Neonatology is a science in rapid evolution and all the contributors to this new text-
book are experts in their fields, clinically active and committed to developing the best
possible care for their patients. This book brings together their expertise in a clear and
easy-to-follow manner. Although some may feel that in the age of the internet such a
textbook is an anachronism, we feel passionately that those caring for newborn babies
will be helped by the accessibility of the information, written by experts, in this single
volume. Our intention is that healthcare practitioners with responsibility for babies will
be helped by the knowledge of the contributors to this book and their collective expe-
rience acquired over many years. The evidence base for practice has been set out where
available, but there are gaps in the research-based evidence and sick babies still deserve
to be given first-class care. We firmly believe that this textbook will enable the better
delivery of such high quality care by making widely available the personal expertise
of the contributors, who have been selected because of their international reputations
and renown. We hope this textbook finds a place in the library of every neonatal unit
and on the bookshelf of every practitioner committed to the care of newborn babies.
The book has been organized in a logical manner. In the first section, relevant epi-
demiology and fetal medicine are considered. Here consideration is given to epigenetic
mechanisms and well as more traditional risk factors. Intrauterine growth restriction is
considered from obstetric, neonatal and therapeutic aspects. There are chapters devoted
to the difficult ethical problems in this area of care, how to make decisions, and how to
measure the quality of the care that our small patients receive. The vital issue of follow
up outcomes is considered, as well as the complexities of cerebral plasticity and func-
tional reorganization in children with congenital brain lesions.
The second section deals with therapeutic issues, including the organization of peri-
natal care, transport services, resuscitation and oxygen toxicity, home care after dis-
charge from hospital and the training of specialist doctors and nurses. Here legal issues
are also considered. The third section on nutrition begins with a consideration of the
VI Preface
physiology of the gastrointestinal tract and of the developing endocrine milieu. Nutri-
tion of the baby in hospital is considered in its various aspects, as is post-discharge nu-
trition, calcium and phosphorous homeostasis and micronutrients and vitamins. Section
IV provides a detailed consideration of the problems due to drugs taken during preg-
nancy and there is an expert review of developmental pharmacology and therapeutics.
Issues relating to infants born to mothers with diabetes are also considered here. Section
V deals with the respiratory system in all its complexity, ranging from its development
and physiology, through a consideration of the control of breathing and the molecular
structure of surfactant and rare lung disorders, to practical therapeutic considerations.
The following sections deal with the cardiovascular system, hyperbilirubinemia and
liver diseases. Section VIII deals with surgery, including the treatment of orofacial mal-
formations and necrotizing enterocolitis, and pre- and post- natal management. Subse-
quent sections deal with hematology, immunology and inflammation, and the rare but
important topic of neonatal malignancies. Sections on infection and endocrine and meta-
bolic disease follow. Finally there are sections on neurology, including brain develop-
ment, injury, electrophysiology and imaging, and relevant ophthalmology, orthopedics
and dermatology.
This book is comprehensive and provides an easily accessible single reference point.
It is intended for all involved in the care of newborn babies – pediatricians, neonatal
nurses, nurse practitioners, midwives, pediatric surgeons, anesthesiologists, neonatol-
ogists and those training in these various areas.
Siena and Liverpool, November 2011 Giuseppe Buonocore
Rodolfo Bracci
Michael Weindling
Editors
Acknowledgements
The Editors are grateful to the Europe Against Infant Brain Injury (EURAIBI - Onlus)
Foundation for its most generous support. Particular thanks to Barbara Marzocchi, who
gave so much energy contacting contributors and getting back manuscripts, and to
Marco Martorelli for his unfailing help in copy editing. Last, but no means least, we
are very grateful to our trainees and residents, Sara Bertrando, Sara Cornacchione, Tei
Monica, and Gemma Stazzoni, who carefully checked the index.
Contents
Section I Epidemiology and Fetal Neonatal Medicine
1 Epidemiology: Mortality and Morbidity................................. 1
Marcello Orzalesi and Carlo Corchia
2 The Development from Fetus to Newborn............................. 7
Domenico Arduini and Marianne Vendola
3 General Characteristics of Preterm and Term Newborn.......... 17
Stefano Parmigiani, Daniela Gianotti and Giulio Bevilacqua
4 Risk Factors for Gestational Diseases ..................................... 21
Maria De Bonis, Michela Torricelli and Felice Petraglia
5 Epigenetic Mechanisms ......................................................... 26
Felicia M. Low, Emilia Tng and Peter D. Gluckman
6 Congenital Malformations and Syndromes:
Early Diagnosis and Prognosis................................................ 31
Giovanni Corsello and Mario Giuffrè
7 Prenatal and Postnatal Inflammatory Mechanisms ................ 46
Christian P. Speer
8 The Fetus at Risk: Chorioamnionitis....................................... 50
Mikko Hallman and Tuula Kaukola
9 Diagnosis of Fetal Distress...................................................... 55
Felice Petraglia, Carlotta Boni, Filiberto M. Severi and Jane Norman
10 Multiple Pregnancies............................................................. 67
Maria Angela Rustico, Mariano Lanna and Enrico Ferrazzi
11 Intrauterine Growth Restriction: Obstetric Aspects................ 77
Anna Maria Marconi and Frederick C. Battaglia
12 Intrauterine Growth Restriction: Neonatal Aspects................ 82
Enrico Bertino, Luciana Occhi and Claudio Fabris
13 Intrauterine Growth Restriction: Intervention Strategies ........ 89
Victor K.M. Han, Maxim D. Seferovic, Caroline D. Albion
and Madhulika B. Gupta
VIII Contents
14 Late Preterm Infants at Risk for Short-Term and
Long-Term Morbidity and Mortality ....................................... 94
Avroy A. Fanaroff
15 Ethical Problems.................................................................... 102
Otwin Linderkamp
16 Basic Approach to the Care of Extremely Low Birth
Weight Infants: an Outline...................................................... 114
Costantino Romagnoli and Fabio Mosca
17 The Process of Decision-Making ............................................ 117
Endla K. Anday and Maria Delivoria-Papadopoulos
18 Follow-up Outcomes of High Risk Infants .............................. 122
Maureen Hack and Deanne Wilson-Costello
19 Early Markers of Poor Outcome ............................................. 130
Fabrizio Ferrari, Licia Lugli, Isotta Guidotti and Marisa Pugliese
20 Quality of Neonatal Intensive Care and Outcome
for High Risk Newborn Infants................................................ 136
Liz McKechnie, Kathryn Johnson and Malcolm Levene
21 Cerebral Plasticity and Functional Reorganization
in Children with Congenital Brain Lesions.............................. 145
Giovanni Cioni, Andrea Guzzetta and Giulia D’Acunto
Section II Perinatal and Neonatal Care
22 Organization of Perinatal Care............................................... 150
Neil Marlow
23 Training of Doctors and Nurses in Perinatology ..................... 157
Franco Macagno and Alfred Tenore
24 Neonatal Transport Services.................................................. 161
Rocco Agostino and Roberto Aufieri
25 Problems of Discharge and Home Care of Newborns............. 165
Fabio Mosca and Monica Fumagalli
26 Risk Management.................................................................. 168
Isabelle Ligi, Sophie Tardieu, Véronique Millet and Umberto Simeoni
27 Guidelines and Protocols....................................................... 173
Rinaldo Zanini
28 Physical Environment: the Thermal Environment................... 178
Gunnar Sedin
29 Information and Psychosocial Intervention
in Neonatology ..................................................................... 189
Massimo Agosti
Contents IX
30 Neonatology and the Law ..................................................... 192
Vittorio Fineschi and Emanuela Turillazzi
31 Environment and Early Developmental Care ......................... 197
Dominique Haumont
32 Neonatal Pain: Neurophysiology, Recognition
and Prevention ..................................................................... 201
Carlo Bellieni
33 Procedural Pain Management with Non-Pharmacological
Interventions ........................................................................ 206
Celeste Johnston, Ananda M. Fernandes and Marsha Campbell-Yeo
34 Neonatal Anesthesia .............................................................. 210
Nicola Disma, Maria L. Massone, Leila Mameli, Giovanni Montobbio
and Pietro Tuo
35 Neonatal Care in the Delivery Room: Initial Management...... 217
Tara M. Randis
36 Approach to Low Risk Newborns........................................... 221
Jennifer M. Duchon
37 Early Detection of Neonatal Depression and Asphyxia .......... 226
Paolo Biban and Davide Silvagni
38 Resuscitation of the Newborn ............................................... 232
Ola D. Saugstad
39 Oxygen Toxicity .................................................................... 242
Giuseppe Buonocore, Rodolfo Bracci, Serafina Perrone and Maximo Vento
40 Physical Examination of the Newborn ................................... 250
Claudio Fabris and Alessandra Coscia
41 Primary Investigations in the Term and Preterm Newborn ..... 257
Ignazio Barberi, Eloisa Gitto and Diego Gazzolo
Section III Nutrition
42 Physiology of the Gastrointestinal Tract ................................ 263
Arieh Riskin, Carlo Agostoni and Raanan Shamir
43 Hormones and Gastrointestinal Function .............................. 281
Flavia Prodam, Simonetta Bellone, Silvia Savastio, Arianna Busti,
Carla Guidi, Alice Monzani and Gianni Bona
44 Feeding the Term Infant: Human Milk and Formulas ............. 290
Silvia Fanaro and Vittorio Vigi
45 Nutritional Recommendations for the Very Low
Birth Weight Newborn ........................................................... 298
Ekhard E. Ziegler
X Contents
46 Enteral Feeding of the Very Low Birth Weight Infant.............. 304
Johannes B. (Hans) van Goudoever
47 Parenteral Nutrition............................................................... 311
Jacques Rigo and Thibault Senterre
48 Post-Discharge Nutrition in Preterm Infants .......................... 320
Richard J. Cooke
49 Calcium and Phosphorus Homeostasis: Pathophysiology ...... 333
Jacques Rigo, Catherine Pieltain, Renaud Viellevoye and Franco Bagnoli
50 Micronutrients and Vitamins ................................................. 354
Olivier Claris and Guy Putet
Section IV Pharmacology and Infants of Smoking,
Addicted and Diabetic Mother
51 Safety of Medications During Pregnancy
and Breastfeeding................................................................. 358
Nada Djokanovic and Gideon Koren
52 Developmental Pharmacology and Therapeutics .................. 364
Erika Crane, Victoria Tutag Lehr, Merene Mathew and Jacob V. Aranda
53 Infants of Drug-Addicted Mothers ......................................... 369
Eunji Kim and Gideon Koren
54 Infants of Smoking Mothers .................................................. 375
Roberto Paludetto and Francesco Raimondi
55 Infants of Diabetic Mothers ................................................... 379
Jane E. Barthell and Michael K. Georgieff
Section V Respiratory System
56 Lung Development and Pulmonary Malformations ............... 387
Corrado Moretti and Paola Papoff
57 Neonatal Pulmonary Physiology of Term
and Preterm Newborns ......................................................... 405
Corrado Moretti and Paola Papoff
58 Control of Breathing in Newborns ......................................... 415
Ruben Alvaro and Henrique Rigatto
59 Meconium Aspiration Syndrome ........................................... 423
Simone Pratesi and Carlo Dani
60 Molecular Structure of Surfactant: Biochemical Aspects........ 429
Tore Curstedt
61 Surfactant Metabolism in Neonatal Lung Diseases ................ 433
Virgilio P. Carnielli and Paola E. Cogo
Contents XI
62 Respiratory Distress Syndrome: Predisposing Factors,
Pathophysiology and Diagnosis ............................................ 441
Mikko Hallman and Timo Saarela
63 Pulmonary Hemorrhage, Transient Tachypnea
and Neonatal Pneumonia...................................................... 455
Richard J. Martin and Amitai Kohn
64 Pulmonary Air Leakage .......................................................... 460
Paola Papoff and Corrado Moretti
65 Bronchopulmonary Dysplasia/Chronic Lung Disease ............ 469
Vineet Bhandari
66 Rare Lung Diseases................................................................ 484
Paolo Tagliabue and Clotilde Farina
67 Persistent Pulmonary Hypertension of the Newborn
and Congenital Diaphragmatic Hernia .................................. 488
Steven H. Abman
68 Treatment of Respiratory Failure: Mechanical Ventilation....... 497
Colin J. Morley
69 Continuous Positive Airways Pressure and other
Non-Invasive Ventilation Techniques..................................... 509
Fabrizio Sandri and Gina Ancora
70 Lung Diseases: Surfactant Replacement Therapy................... 522
Henry L. Halliday
71 Nitric Oxide Therapy in Neonatology..................................... 529
John P. Kinsella
72 Extracorporeal Membrane Oxygenation for Neonates........... 537
Anne Greenough, Munir Agha and Adam P.R. Smith
73 Lung Diseases: Problems of Steroid Treatment of Fetus
and Newborn ........................................................................ 540
Henry L. Halliday
74 Apnea of Prematurity and Sudden Infant Death Syndrome .... 543
Christian F. Poets
Section VI Cardiovascular System
75 Cardiovascular Physiology, Pathology, and Clinical
Investigation ......................................................................... 550
Luciane Piazza, Angelo Micheletti, Diana Negura, Carmelo Arcidiacono,
Antonio Saracino and Mario Carminati
76 Early Diagnosis of Congenital Heart Disease:
When and How to Treat ......................................................... 569
Luciane Piazza, Angelo Micheletti, Diana Negura, Carmelo Arcidiacono,
Antonio Saracino and Mario Carminati