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Contributors
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iii-v
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Contents
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vii-xi
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CME Accreditation Page and Author Disclosure
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xii-xiii
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Forthcoming Issues
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xiv
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The Challenge of Managing Drugs Safely in the Newborn
13 January 2012
The challenge of safe and appropriate use of drugs in the neonatal period is a daunting one and is complicated by the glaring lack of evidence-based data that should guide decision-making. Clinicians ...
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Lucky Jain
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xv-xvi
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Preface
03 January 2012
It has become increasingly apparent in the practice of modern medicine that evidence-based practices and quantitation of patient outcomes have become critical foundations of clinical care. While clini...
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Alan R. Spitzer,
Dan L. Ellsbury
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xvii-xviii
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A Quality Improvement Approach to Optimizing Medication Use in the Neonatal Intensive Care Unit
13 January 2012
Despite many years of heavy use in premature and critically ill newborns, surprisingly few medications have been rigorously tested in neonatal multicenter randomized clinical trials. Little is known a...
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Dan L. Ellsbury,
Robert Ursprung
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1-10
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Drug Studies in Newborns: A Therapeutic Imperative
24 January 2012
Although some drugs have been developed for the neonate, drug development for the least mature and most vulnerable pediatric patients is lacking. Most of the drugs are off-label or off-patent and are ...
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George P. Giacoia,
Perdita Taylor-Zapata,
Anne Zajicek
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11-23
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Therapeutic Drug Monitoring–the Appropriate Use of Drug Level Measurement in the Care of the Neonate
13 January 2012
Neonates and young infants are in a unique and dynamic pharmacokinetic state, in which they undergo relatively rapid maturational changes in drug absorption, distribution, metabolism, and excretion. I...
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Thomas E. Young
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25-31
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Obstetric Interventions Beneficial to Prematurely Delivering Newborn Babies: Antenatal Corticostetroids, Progesterone, Magnesium Sulfate
12 January 2012
Although improvements in neonatal care have continued to result in reduced mortality and morbidity of prematurely delivering newborns for decades, the results of a myriad of obstetric efforts and inte...
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Thomas J. Garite,
C. Andrew Combs
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33-45
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Evidence-Based Neonatal Pharmacotherapy: Postnatal Corticosteroids
Corticosteroids are used in the neonatal intensive care unit primarily to treat two conditions: bronchopulmonary dysplasia (BPD) and hypotension (cardiovascular insufficiency). Historically, high-dose...
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Kristi Watterberg
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47-59
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Antibiotic Use and Misuse in the Neonatal Intensive Care Unit
03 January 2012
Neonatal sepsis causes significant morbidity and mortality, especially in preterm infants. Clinicians are compelled to treat with empiric antibiotics at the first signs of suspected sepsis. Broad-spec...
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Nidhi Tripathi,
C. Michael Cotten,
P. Brian Smith
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61-68
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The Use of Antiviral Drugs During the Neonatal Period
24 January 2012
Parenteral therapy of viral infections of the newborn and infant began with vidarabine (adenine arabinoside) for the treatment of neonatal herpes simplex virus (HSV) infections in the early 1980s. Acy...
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Richard J. Whitley
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69-81
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The Use of Antifungal Therapy in Neonatal Intensive Care
13 January 2012
Invasive fungal infections remain a significant cause of infection-related mortality and morbidity in preterm infants. Central nervous system involvement is the hallmark of neonatal candidiasis, diffe...
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Daniela Testoni,
P. Brian Smith,
Daniel K. Benjamin
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83-98
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Metoclopramide, H2 Blockers, and Proton Pump Inhibitors: Pharmacotherapy for Gastroesophageal Reflux in Neonates
13 January 2012
Pharmacotherapy for gastroesophageal reflux (GER) in neonates, aimed at interfering with this physiologic process and potentially reducing the negative sequelae that providers often attribute to GER, ...
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William F. Malcolm,
C. Michael Cotten
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99-109
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Evidence-Based Use of Indomethacin and Ibuprofen in the Neonatal Intensive Care Unit
16 January 2012
Indomethacin and ibuprofen are potent inhibitors of prostaglandin synthesis. Neonates have been exposed to these compounds for more than 3 decades. Indomethacin is commonly used to prevent intraventri...
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Palmer G. Johnston,
Maria Gillam-Krakauer,
M. Paige Fuller,
Jeff Reese
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111-136
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Evidence-Based Methylxanthine Use in the NICU
The introduction of methylxanthines, especially caffeine, for the treatment of apnea of prematurity has been one of the most important and effective therapies in the neonatal intensive care unit (NICU...
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Alan R. Spitzer
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137-148
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Pulmonary Vasodilator Therapy in the NICU: Inhaled Nitric Oxide, Sildenafil, and Other Pulmonary Vasodilating Agents
The perinatal transition from fetal to extrauterine life requires a dramatic change in the circulatory pattern as the organ of gas exchange switches from the placenta to the lungs. Pulmonary hypertens...
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Nicolas F.M. Porta,
Robin H. Steinhorn
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149-164
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The Use and Misuse of Oxygen During the Neonatal Period
09 January 2012
This article describes aerobic metabolism, oxygen free radicals, antioxidant defenses, oxidative stress, inflammatory response and redox signaling, the fetal to neonatal transition, arterial oxygen sa...
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Máximo Vento,
Javier Escobar,
María Cernada,
Raquel Escrig,
Marta Aguar
et al.
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165-176
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Hematological Interventions in NICU Care: the Use of rEpo, IVIG, and rG-CSF
This article focuses on the use of rEpo, IVIG, and rG-CSF in the NICU. It discusses the most recent studies and the most definitive and clinically relevant evidence, rather than summarizing all publis...
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Robert D. Christensen
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177-190
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Management of Neonatal Thrombosis
Neonates have one of the highest risks for thromboembolism among pediatric patients. This risk is attributable to a combination of multiple genetic and acquired risk factors. Despite a significant num...
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Matthew A. Saxonhouse
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191-208
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Neonatal Diuretic Therapy: Furosemide, Thiazides, and Spironolactone
03 January 2012
Diuretics are commonly used to treat infants with oxygen-dependent chronic lung disease. However, there are limited data suggesting a beneficial effect of long-term diuretic therapy on pulmonary funct...
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Jeffrey L. Segar
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209-220
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Neonatal Blood Pressure Support: The Use of Inotropes, Lusitropes, and Other Vasopressor Agents
24 January 2012
A solid understanding of the mechanisms of action of cardiovascular medications used in clinical practice along with efforts to develop comprehensive hemodynamic monitoring systems to improve the abil...
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Shahab Noori,
Istvan Seri
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221-238
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Anesthesia and Analgesia in the NICU
Painful procedures in the neonatal intensive care unit are common, undertreated, and lead to adverse consequences. A stepwise approach to treatment should include pain recognition, assessment, and tre...
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R. Whit Hall
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239-254
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Index
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255-267
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