Clinics in perinatology
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Clinics in perinatology · Mar 2008
ReviewComplications of vascular catheters in the neonatal intensive care unit.
Insertion of an intravascular catheter is the most common invasive procedure in the neonatal ICU. With every passing decade, technological innovations in catheter materials and sizes have allowed vascular access in infants who are smaller and sicker for purposes of blood pressure monitoring, blood sampling, and infusion of intravenous fluids and medications. There is, however, growing recognition of potential risks to life and limb associated with the use of intravascular catheters. This article reviews complications of venous and arterial catheters in the neonatal ICU and discusses treatment approaches and methods to prevent such complications, based on current evidence.
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Clinics in perinatology · Mar 2008
ReviewAnesthesia complications in the birthplace: is the neuraxial block always to blame?
This article highlights the common and some of the very serious complications that may occur following neuraxial analgesia for labor and delivery, including headache, backache, infection, hypotension, and hematoma. Total spinal and failed block also are discussed, as are complications unique to epidural anesthesia, such as the intravascular injection of large volumes of local anesthetic (causing seizure or cardiac arrest) and accidental dural puncture.
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This article reviews the physiology of thermoregulation, hypothermia, and hyperthermia. The differential diagnosis of hypothermia and hyperthermia is discussed. The benefits of hypothermia following hypoxic-ischemic injury are discussed; however, both hypothermia and hyperthermia, in the extreme, are potentially harmful to the newborn. Recommendations for the prevention of these problems are discussed, as well as available treatments.