Current Controversies In Perinatology An Issue Of Clinics In Perinatology

Current Controversies in Neonatology, An Issue of Clinics in Perinatology, E-Book

Neonatal-perinatal medicine has a strong history of evidence based practice but unfortunately there remain many areas of uncertainty and unproven hypotheses and treatments that may harm our highly vulnerable patients. When new ideas are introduced into the labor and delivery room or the NICU we have to evaluate these procedures and therapies before they become accepted as standards of care. We need to learn from the past lessons of grey baby syndrome and chloramphenicol and of kernicterus and sulfonamide antibiotics where therapeutic good intentions actually did more harm than good and increased the mortality rate of premature babies in the NICU.This proposed edition addresses a broad range of current topics in perinatal neonatal practice. The AAP has just issued new guidelines for the approach to a neonate exposed to maternal genital herpes virus infection. The recommendations were not evidence based and are highly controversial as well as confusing. These topics are addressed in a scholarly and objective manner to both address the controversy and help the practitioner make informed decisions.

Neonatal-perinatal medicine has a strong history of evidence based practice but unfortunately there remain many areas of uncertainty and unproven hypotheses and treatments that may harm our highly vulnerable patients. When new ideas are introduced into the labor and delivery room or the NICU we have to evaluate these procedures and therapies before they become accepted as standards of care. We need to learn from the past lessons of grey baby syndrome and chloramphenicol and of kernicterus and sulfonamide antibiotics where therapeutic good intentions actually did more harm than good and increased the mortality rate of premature babies in the NICU.This proposed edition addresses a broad range of current topics in perinatal neonatal practice. The AAP has just issued new guidelines for the approach to a neonate exposed to maternal genital herpes virus infection. The recommendations were not evidence based and are highly controversial as well as confusing. These topics are addressed in a scholarly and objective manner to both address the controversy and help the practitioner make informed decisions.

In this issue of Clinics in Perinatology, guest editor Robert M. Kliegman brings his considerable expertise to the topic of Current Controversies in Neonatology. Provides in-depth reviews on the latest Current Controversies in Neonatology. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Current Controversies in Perinatology is covered in this issue of Clinics in Perinatology, guest edited by Drs. Michael Uhing and Robert Kliegman. Authorities in the field have come together to pen articles on Strategies to prevent bacterial and fungal infection in the NICU, Drugs of choice for sedation and analgesia in the NICU, Iron therapy for preterm infants, Management of fetal arrhythmias, Inhaled nitric oxide for preterm infants, Racial disparity in low birth weight and infant mortality, Evaluation and treatment of hypotension in the preterm infant, Indications for home apnea monitoring, Short bowel syndrome: how short is too short?, Anemia in the preterm infant: the role of transfusions and erythropoietin, Evaluation and management of stroke in the neonate, Screening for postpartum depression in the NICU, Treatment of gastroesophageal reflux in the preterm and term infant, Optimizing growth in the preterm infant, The role of postnatal steroids in the treatment of bronchopulmonary dysplasia, and The role of genomics in the NICU.

The 16 articles in this issue draw on the expertise of internationally recognized experts who have collectively provided cross-cutting reviews with a broad perspective on the current state of the field. The authors have provided succinct, up-to-date clinical perspectives and highlight current controversies and future challenges. As a result, this issue is a cutting-edge compendium of this complex and fast-moving field. Throughout the issue, the reader is encouraged to acquire a more comprehensive perspective by drawing connections between earlier and later articles that are thematically grouped around issues dealing with pathogenesis, diagnosis, and therapy. This issue underscores the vital importance of continued support to encourage and nurture collaboration among clinicians and scientists.

The Guest Editors have collaborated on a state-of-the-art presentation of current clinical reviews on Quality in Neonatal Care. Top experts have prepared articles in the following areas: Standardizing Practices: How and why to standardize, using checklists, measuring variation; Health Informatics and Patient Safety; Using Statistical Process Control to Drive Improvement in Neonatal Care; Improving Value in Neonatal Intensive Care; Culture and Context in Quality of Care: Improving Teamwork and Resilience; Has Quality Improvement Improved Neonatal Outcomes; National Quality Measures in Perinatal Care; Perinatal and Obstetric Quality Initiatives; Family Involvement in Quality Improvement; Perinatal Quality Improvement: A Global Perspective; Delivery Room Care / Golden Hour; Respiratory Care and Bronchopulmonary Dysplasia; Reducing Incidence of Necrotizing Enterocolitis; Alarm Safety and Alarm Fatigue; and Patient Safety: Reducing Unplanned Extubations. Readers will come away with the clinical information they need improve quality in the NICU.

In consultation with Dr. Lucky Jain, Consulting Editor, Drs. Dempsey and EL-Khuffash have chosen a wide range of topics in cardiovascular issues that cover new diagnostic techniques and important areas of management, including the role of volume administration, inotropes, and corticosteroids in the setting of cardiovascular instability. These remain critical questions in neonatal care, and authors were selected based on their expertise and ability to provide the reader with the most recent up-to-date evidence upon which to direct intervention. The clinical review articles in this issue will address the relationship between intervention and outcome in preterm hypotension, the management of cardiovascular instability in the setting of pulmonary hypertension and therapeutic hypothermia, and finally ask if it’s time for a definitive trial in the management of PDA. The final article in the issue highlights the clinical trials to date, what trials are currently ongoing, and what the future holds in cardiovascular support for the preterm infant. The reader will come away with the most current information on this topic from international experts including Europe, Canada, USA, and Australia.