K. Kim, E. Kim, Sung-Hye Park, Y. Kim, S. Shin, Han-Suk Kim
Treatment guidelines for postnatal cytomegalovirus (pCMV) infection in preterm have not been established yet. Neutropenia, thrombocytopenia, hepatitis, colitis, and sepsis-like disease are among the clinical manifestations, which range from moderate to serious. We present a case of autopsy diagnosed as pCMV infection in a premature infant delivered at gestational age of 24 weeks and 5 days. On the 7th and 14th days of birth, urinary CMV polymerase chain reaction samples were negative, ruling out congenital CMV infection. However, autopsy examination revealed that the patient had disseminated pCMV infection. CMV inclusion bodies were found in the majority of tissues, including the lung, liver, pancreas, breast, kidney, and adrenal gland, but not the placenta. The thymus exhibited significant cortical atrophy and T-cell immunodeficiency, possibly induced by dexamethasone treatment for bronchopulmonary dysplasia or by pCMV infection itself. If dexamethasone treatment is extended or high doses are considered, it may be beneficial to test the CMV infection status to prevent aggravation of infection. This case demonstrates that, de spite the low prevalence, pCMV infection should be considered a differential diag nosis in preterm if other conditions or etiology cannot justify clinical deterioration.
{"title":"Disseminated Postnatal Cytomegalovirus Infection in a Preterm Neonate: Autopsy Case Report","authors":"K. Kim, E. Kim, Sung-Hye Park, Y. Kim, S. Shin, Han-Suk Kim","doi":"10.5385/NM.2021.28.2.83","DOIUrl":"https://doi.org/10.5385/NM.2021.28.2.83","url":null,"abstract":"Treatment guidelines for postnatal cytomegalovirus (pCMV) infection in preterm have not been established yet. Neutropenia, thrombocytopenia, hepatitis, colitis, and sepsis-like disease are among the clinical manifestations, which range from moderate to serious. We present a case of autopsy diagnosed as pCMV infection in a premature infant delivered at gestational age of 24 weeks and 5 days. On the 7th and 14th days of birth, urinary CMV polymerase chain reaction samples were negative, ruling out congenital CMV infection. However, autopsy examination revealed that the patient had disseminated pCMV infection. CMV inclusion bodies were found in the majority of tissues, including the lung, liver, pancreas, breast, kidney, and adrenal gland, but not the placenta. The thymus exhibited significant cortical atrophy and T-cell immunodeficiency, possibly induced by dexamethasone treatment for bronchopulmonary dysplasia or by pCMV infection itself. If dexamethasone treatment is extended or high doses are considered, it may be beneficial to test the CMV infection status to prevent aggravation of infection. This case demonstrates that, de spite the low prevalence, pCMV infection should be considered a differential diag nosis in preterm if other conditions or etiology cannot justify clinical deterioration.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49454166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: We investigated whether consecutive levels of new emerging renal bio markers, including serum cystatin C (CysC) and urinary neutrophil gelatinaseasso ciated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in verylowbirthweight (VLBW) infants. Methods: Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association bet ween renal biomarkers and postconceptional age was assessed using Pearson’s cor relation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeatedmeasures analysis of variance. Results: For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P<0.001), and serum Cr (r=–0.311, P<0.001) were negatively correlated with postconceptional age. Compared with the mean values of the postnatal agespecific stages, serum CysC showed no significant differences in any of the four stages. However, the urinary NGAL/Cr ratio in stage IV was significantly different from those in stages I to III. Conclusion: Although urinary NGAL/Cr ratio and serum CysC were negatively cor related with postconceptional age considering renal development, serum CysC showed no significant differences in any of the four postnatal agespecific stages. Urinary NGAL/Cr ratio at >28 days postnatally seems to be more affected by post conceptional age than serum CysC in VLBW infants.
{"title":"Influence of Postconceptional Age on the Renal Biomarkers in Very-Low-Birth-Weight Infants","authors":"Robert Lee, S. Shin, W. H. Jung, Jaehyun Park","doi":"10.5385/NM.2021.28.2.65","DOIUrl":"https://doi.org/10.5385/NM.2021.28.2.65","url":null,"abstract":"Purpose: We investigated whether consecutive levels of new emerging renal bio markers, including serum cystatin C (CysC) and urinary neutrophil gelatinaseasso ciated lipocalin (NGAL)/creatinine (Cr) ratio, were affected by postconceptional age in verylowbirthweight (VLBW) infants. Methods: Repeatedly measured samples for each infant were divided into four groups according to postnatal age: at birth (stage I), 3 to 7 days postnatally (stage II), 8 to 28 days postnatally (stage III), and >28 days postnatally (stage IV). The association bet ween renal biomarkers and postconceptional age was assessed using Pearson’s cor relation coefficient, and the mean values of renal biomarkers in the four stages were compared using repeatedmeasures analysis of variance. Results: For samples measured at birth, serum CysC (r=–0.358, P=0.032) and urinary NGAL/Cr ratio (r=–0.522, P=0.001) were negatively correlated with gestational age, whereas serum Cr (r=0.148, P=0.390) was not. In addition, for all samples measured, serum CysC (r=–0.209, P=0.012), urinary NGAL/Cr ratio (r=–0.536, P<0.001), and serum Cr (r=–0.311, P<0.001) were negatively correlated with postconceptional age. Compared with the mean values of the postnatal agespecific stages, serum CysC showed no significant differences in any of the four stages. However, the urinary NGAL/Cr ratio in stage IV was significantly different from those in stages I to III. Conclusion: Although urinary NGAL/Cr ratio and serum CysC were negatively cor related with postconceptional age considering renal development, serum CysC showed no significant differences in any of the four postnatal agespecific stages. Urinary NGAL/Cr ratio at >28 days postnatally seems to be more affected by post conceptional age than serum CysC in VLBW infants.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41892386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jihyun Ha, Sun Hyang Lee, G. Park, Young-Lim Shin, Sung Shin Kim, Mi-Ae Jang
We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.
{"title":"A Neonate Diagnosed with Wolff-Parkinson-White Syndrome Presenting with Cardiogenic Shock","authors":"Jihyun Ha, Sun Hyang Lee, G. Park, Young-Lim Shin, Sung Shin Kim, Mi-Ae Jang","doi":"10.5385/NM.2021.28.2.77","DOIUrl":"https://doi.org/10.5385/NM.2021.28.2.77","url":null,"abstract":"We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44745712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han-Sol Kim, S. Lee, Song-Hee Han, Soon-Hyun Nam, Chae-Ku Jo, M. Kim
Ectopic pancreas is defined as an abnormally located pancreatic tissue not sufficiently connected with the normal pancreas, which rarely occurs in neonates. To our know ledge, only a few cases of ectopic pancreas have been reported in newborns in South Korea. We report a case of ectopic pancreas as the cause of intussusception and jejunal atresia in a newborn. This clinical association is extremely rare, and this is the first report in South Korea.
{"title":"Intussusception and Jejunal Atresia Caused by an Ectopic Pancreas in a Newborn","authors":"Han-Sol Kim, S. Lee, Song-Hee Han, Soon-Hyun Nam, Chae-Ku Jo, M. Kim","doi":"10.5385/NM.2021.28.2.72","DOIUrl":"https://doi.org/10.5385/NM.2021.28.2.72","url":null,"abstract":"Ectopic pancreas is defined as an abnormally located pancreatic tissue not sufficiently connected with the normal pancreas, which rarely occurs in neonates. To our know ledge, only a few cases of ectopic pancreas have been reported in newborns in South Korea. We report a case of ectopic pancreas as the cause of intussusception and jejunal atresia in a newborn. This clinical association is extremely rare, and this is the first report in South Korea.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"72-76"},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49484831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. Neonatal nemaline myopathy has the worst prog nosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hy potonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGSbased gene panel sequencing was performed. Compound hetero zygous pathogenic variants were detected in KLHL40: c.[1405G>T];[1582G>A] (p. [Gly469cys];[Glu528Lys]). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.
{"title":"A Korean Case of Neonatal Nemaline Myopathy Carrying KLHL40 Mutations Diagnosed Using Next Generation Sequencing","authors":"Y. Suh, Y. Sohn, M. Park, Jang Hoon Lee","doi":"10.5385/NM.2021.28.2.89","DOIUrl":"https://doi.org/10.5385/NM.2021.28.2.89","url":null,"abstract":"Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. Neonatal nemaline myopathy has the worst prog nosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hy potonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGSbased gene panel sequencing was performed. Compound hetero zygous pathogenic variants were detected in KLHL40: c.[1405G>T];[1582G>A] (p. [Gly469cys];[Glu528Lys]). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49521392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emer gency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.
{"title":"A Case of Midgut Volvulus with Gastric Perforation and Periveintricular Leukomalacia in a Term Infant","authors":"S. Park, J. Hwang","doi":"10.5385/NM.2021.28.1.53","DOIUrl":"https://doi.org/10.5385/NM.2021.28.1.53","url":null,"abstract":"Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emer gency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42041988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Oxygen Saturation Fluctuations on Retinopathy in Infants Younger than 30 Weeks’ Gestational Age","authors":"C. Jeon, Ji Su Kim, Bumhee Park, Jang Hoon Lee","doi":"10.5385/NM.2021.28.1.7","DOIUrl":"https://doi.org/10.5385/NM.2021.28.1.7","url":null,"abstract":"","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45876376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Meconium obstruction of prematurity (MOP) predisposes premature in fants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clini cally diagnosed patients with MOP whose obstructions were not relieved via conven tional sonographyguided contrast enema. We retrospectively evaluated whether oral nonionic watersoluble contrast media relieves MOP. Methods: Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followedup radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results: We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27 weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without airfluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion: Nonionic oral watersoluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.
{"title":"Oral Administration of Nonionic Water-Soluble Contrast Media to Treat Meconium Obstruction in Premature Infants: A Preliminary Study","authors":"H. Hong, Sung Shin Kim, G. Park","doi":"10.5385/NM.2021.28.1.22","DOIUrl":"https://doi.org/10.5385/NM.2021.28.1.22","url":null,"abstract":"Purpose: Meconium obstruction of prematurity (MOP) predisposes premature in fants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clini cally diagnosed patients with MOP whose obstructions were not relieved via conven tional sonographyguided contrast enema. We retrospectively evaluated whether oral nonionic watersoluble contrast media relieves MOP. Methods: Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followedup radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results: We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27 weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without airfluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion: Nonionic oral watersoluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43443110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pul monary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to fullterm newborns. This adaptation is due to the lower oxygen requirement and high oxygen carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membraneoligohydramniospulmonary hypo plasia sequence. PPHN in preterm infants, along with maximum supportive treat ment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.
{"title":"Management of Persistent Pulmonary Hypertension in Preterm Infants","authors":"B. Lee","doi":"10.5385/NM.2021.28.1.1","DOIUrl":"https://doi.org/10.5385/NM.2021.28.1.1","url":null,"abstract":"Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pul monary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to fullterm newborns. This adaptation is due to the lower oxygen requirement and high oxygen carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membraneoligohydramniospulmonary hypo plasia sequence. PPHN in preterm infants, along with maximum supportive treat ment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44721196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastric volvulus in neonates is an extremely uncommon disorder, which is challen ging to diagnose because of its nonspecific clinical manifestations. Early diagnosis of gastric volvulus is important to avoid lifethreatening complications, such as gastric ischemia, necrosis, and perforation. A definitive diagnosis could be made with radiological upper gastrointestinal series. In this report, we present two cases of neonate gastric volvulus, which were confirmed by radiological upper gastrointe stinal series, and the patients underwent surgical treatment.
{"title":"Two Cases of Gastric Volvulus in Neonates","authors":"Min Yeong Kim, M. Park, Jang Hoon Lee","doi":"10.5385/NM.2021.28.1.36","DOIUrl":"https://doi.org/10.5385/NM.2021.28.1.36","url":null,"abstract":"Gastric volvulus in neonates is an extremely uncommon disorder, which is challen ging to diagnose because of its nonspecific clinical manifestations. Early diagnosis of gastric volvulus is important to avoid lifethreatening complications, such as gastric ischemia, necrosis, and perforation. A definitive diagnosis could be made with radiological upper gastrointestinal series. In this report, we present two cases of neonate gastric volvulus, which were confirmed by radiological upper gastrointe stinal series, and the patients underwent surgical treatment.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"28 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46771445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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