Journal of neonatal-perinatal medicine
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J Neonatal Perinatal Med · Jan 2013
Case ReportsUtilization of extracorporeal membrane oxygenation in congenital hypertrophic cardiomyopathy caused by maternal diabetes.
Extracorporeal membrane oxygenation (ECMO) is an advanced strategy utilized in many neonatal intensive care units for a specific list of indications. This case illustrates a rare but effective use of this therapy for a newborn infant with severe hypertrophic cardiomyopathy induced by maternal diabetes. Such infants who are unresponsive to conventional therapies may benefit from ECMO support, if it is used in conjunction with management strategies that optimize cardiac output.
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J Neonatal Perinatal Med · Jan 2013
Resuscitation at the limit of viability: trapped between a rock and a hard place.
Current professional guidelines, such as the Neonatal Resuscitation Program, specify significant roles for parents in decision-making at periviability. However, current federal regulations and some legal precedents indicate that resuscitation decisions should be made by the physician at the time of delivery, based on physical assessment of the infant. The enforcement of such approach would potentially increase the resuscitation of infants with poor prognoses. ⋯ Our findings suggest that resuscitation of premature infants at 24 weeks gestation is the standard of care in New Jersey, a socioeconomically and ethnically diverse state that may represent broader national trends. The high compliance with parental wishes at 22 or 23 weeks is probably related to physicians' expectation of poor outcomes at these gestational ages. This approach is consistent with current recommendations of the Neonatal Resuscitation Program but may not be compatible with existing federal statutes and legal precedent.
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J Neonatal Perinatal Med · Jan 2013
Risk factors for the development of necrotizing enterocolitis: a case-control study.
To determine risk or protective factors for the development of necrotizing enterocolitis in very low birth weight infants. ⋯ A greater number of transfusions of packed red blood cells are associated with an increased risk of necrotizing enterocolitis in very low birth weight infants. The other analyzed variables in this study do not identify the infants at risk. Caution is advocated in using transfusions in newborns.