Abstract:
:Most pharmacokinetic and biologic attributes of digitalis are age dependent. They are determined in great measure by the chemical structure of the specific cardiac glycoside being used. These effects differ in the intact normal circulation and in heart failure because of the altered autonomic nervous system and hormonal control that exist in the latter. Digitalis is effective only in the presence of myocardial dysfunction, but in a clinical setting, cardiac performance may be difficult to gauge; improved tools are needed for this purpose. The dosages of digoxin recommended for infants and children have been steadily reduced in the past decade, and there is no good evidence that more favorable risk-to-benefit ratios are achieved when higher doses are used or when higher plasma concentrations are sought. Massive digitalis toxicity is a serious, often fatal, complication in young infants, especially when the drug is given parenterally; it may be difficult to diagnose early. The only reliable deterrent for this complication is the adoption of careful safety standards whenever the drug is employed. Experience with digoxin antibodies is still scarce in children, especially in infancy, but their use generally has been associated with a favorable outcome. Endogenous substances that interfere with the digoxin radioimmunoassay (DLIS) occasionally yield clinically relevant, erroneously high, plasma digoxin concentration readings in neonates. An interesting hypothesis currently being investigated is the physiologic and pathologic role of these compounds in sodium hemostasis; they may be part of a putative endogenous NaK-ATP-ase inhibitor involved in the pathogenesis of hypertension and renal diseases.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Hastreiter AR,John EG,van der Horst RLsubject
Has Abstractpub_date
1988-09-01 00:00:00pages
491-522issue
3eissn
0095-5108issn
1557-9840journal_volume
15pub_type
杂志文章,评审abstract::Oxygen saturation targeting is widely used in neonatal intensive care, but the optimal target range in very preterm infants has been uncertain and is the subject of recent debate and research. This review briefly discusses the technology of oxygen monitoring and the role of oxygen toxicity in preterm infants. The back...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2015.08.008
更新日期:2015-12-01 00:00:00
abstract::Oxygen therapy is an essential part of neonatal care. Targeting oxygen saturations and preventing hypoxemia and hyperoxemia is difficult, particularly in preterm infants. The mode of oxygen delivery directly affects the stability of oxygen saturations, hypoxemia, and hyperoxemia. This stability has important clinical ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2019.05.012
更新日期:2019-09-01 00:00:00
abstract::Normal pregnancy produces profound metabolic alterations that occur, in large part, by the conclusion of the first trimester. Although necessary to support the metabolic needs of the conceptus, the metabolic and cardiovascular changes of pregnancy are well established weeks before the metabolic needs of the fetus and ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract::Neonatal stress responses have been investigated only in recent years. Term neonates mount substantial hormonal and metabolic responses, which are distinct from those of adult patients. These responses can be altered significantly by the effects of prematurity, the effects of graded surgical stress, and the anesthetic...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Neonatal Cushing syndrome (CS) is most commonly caused by exogenous administration of glucocorticoids and rarely by endogenous hypercortisolemia. CS owing to adrenal lesions is the most common cause of endogenous CS in neonates and infants, and adrenocortical tumors (ACTs) represent most cases. Many ACTs develop in th...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2017.10.002
更新日期:2018-03-01 00:00:00
abstract::When cystic hygroma is detected antenatally, the prognosis is usually poor, and intrauterine or neonatal death are common. This seems especially true for Turner syndrome (the largest etiologic group associated with cystic hygroma) and the lethal multiple pterygium syndromes. However, some fetuses with Turner syndrome,...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::The educational programs that have been developed in newborn special care facilities have two purposes: first, they teach personnel the manual skills that are necessary to manage the sick newborn infant; second, they provide personnel with a better understanding of neonatal pathophysiology so that they can begin to re...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Visual evoked potentials (VEPs) are easily recorded in the neonatal intensive care setting using light-emitting diode goggles as the flash stimulus. They are sensitive measures of CNS integrity and are altered or abolished by hypoxia. Prognosis in newborns with birth asphyxia or hypoxia is difficult to predict; howeve...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Exogenous surfactant therapy has been a significant advance in the management of preterm infants with RDS. It has become established as a standard part of the management of such infants. Both natural and synthetic surfactants lead to clinical improvement and decreased mortality, with natural surfactants having additio...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/s0095-5108(05)70112-3
更新日期:2001-09-01 00:00:00
abstract::The specific pathologic processes preceding the onset of irreversible cerebral injury seem to be a combination of several complex mechanisms due to the severity and duration of the insult to the biochemical modifications in the brain. An early diagnosis of the newborn at high risk for brain damage is relevant for prev...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2004.03.008
更新日期:2004-03-01 00:00:00
abstract::Although it has been customary to treat neonatal jaundice at lower serum bilirubin levels in low-birth weight infants than in term infants, the threshold bilirubin levels and long-term benefits for early treatment of preterm infants have not been validated. This article summarizes and evaluates existing evidence and s...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70012-9
更新日期:2000-03-01 00:00:00
abstract::The lifespan risk of seizures is highest in the neonatal period. Current therapies have limited efficacy. Although the treatment of neonatal seizures has not changed significantly in the last several decades, there has been substantial progress in understanding developmental mechanisms that influence seizure generatio...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2009.08.001
更新日期:2009-12-01 00:00:00
abstract::Pulse oximetry, a noninvasive technique of measuring oxygen saturation continuously, is being used increasingly in the intensive care setting. This article provides information regarding physiologic basis and practical aspects of clinical usage of pulse oximetry in the neonate, both in medical and surgical units. ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::Billions of dollars are spent yearly in perinatal medicine on studies designed to improve outcomes for mothers and their neonates. However, implementing research findings is challenging and imperfect. Strategies for implementation must be multifaceted and comprehensive. These implementation challenges extend to, and a...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.01.003
更新日期:2018-06-01 00:00:00
abstract::Numerous articles have chronicled the problems that stem from patients' lack of compliance with health care recommendations, yet there has not been a systematic approach to the development of a strategy for increasing the effectiveness of health education programs. In this article, making use of anticipatory guidance,...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::The percentage of United States cesarean births increased from 20.7% in 1996 to 31.1% in 2006. Cesarean rates increased for women of all ages, race/ethnic groups, and gestational ages and in all states. Both primary and repeat cesareans have increased. Increases in primary cesareans in cases of "no indicated risk" hav...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.03.007
更新日期:2008-06-01 00:00:00
abstract::To understand medical disorders such as obstructive apnea, or pulmonary aspiration, one must understand the many functions performed by the upper airway. These functions include respiration, airway protection at the face, feeding, and regulation of thoracoabdominal pressure. The neuromuscular mechanisms that perform t...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Many aspects of the forward propulsion of enteral nutrients are not fully mature in the preterm and term neonate. Because the regulation of motor activity in the gastrointestinal tract is complex and multifaceted, many levels of regulation of this activity are immature in the preterm infant; however, as neonatologists...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::A number of ethical considerations arise with regard to screening for, detecting, and managing fetal anomalies. Some of these considerations involve the need to give attention to emotional distress the pregnant woman might be experiencing. The ethical principle of beneficence gives rise to a duty of the obstetrician t...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:10.1016/s0095-5108(02)00083-0
更新日期:2003-03-01 00:00:00
abstract::Postpartum hemorrhage is an obstetric emergency that represents a major cause of maternal morbidity and mortality. With the recent rise in the cesarean delivery rate, prompt recognition and proper management at the time of cesarean delivery are becoming increasingly important for providers of obstetrics. Preparedness ...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2008.07.007
更新日期:2008-09-01 00:00:00
abstract::Congenital lobar emphysema is an uncommon but potentially life-threatening cause of respiratory distress in the newborn. The clinical picture and radiologic findings are diagnostic. Lobectomy in the distressed neonate is curative. In infants with onset of symptoms between one and four months of age surgery may not be ...
journal_title:Clinics in perinatology
pub_type: 杂志文章
doi:
更新日期:1978-03-01 00:00:00
abstract::The newborn infant's skin is not a complete barrier to the absorption of externally applied agents, particularly if it is damaged, diseased, or immature. Immaturity is the most important factor that determines percutaneous absorption. Very immature infants in the early neonatal period have a poorly developed epidermis...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::Advances in fetal echocardiography are providing highly accurate diagnoses of congenital heart disease prior to delivery, making it possible to plan the delivery-room management of these newborns. Knowledge of the expected transitional circulation occurring with birth and the pathophysiologic implications of congenita...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2005.09.014
更新日期:2005-12-01 00:00:00
abstract::The authors believe that the literature provides sufficient evidence that antenatal corticosteroid administration is beneficial and safe even in conditions of ruptured membranes. The evidence by now is remarkably robust and one can be reasonably confident regarding the benefits of antenatal corticosteroids in the sett...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(03)00078-2
更新日期:2001-12-01 00:00:00
abstract::Congenital cytomegalovirus is the most common viral congenital infection, and affects up to 2% of neonates. Significant sequelae may develop after congenital cytomegalovirus, including hearing loss, cognitive defects, seizures, and death. Zika virus is an emerging virus with perinatal implications; a congenital Zika v...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2018.01.005
更新日期:2018-06-01 00:00:00
abstract::The photoplethysmogram (PPG) is a noninvasive circulatory signal related to the pulsatile volume in tissue and is displayed by many pulse oximeters. The PPG is similar in appearance to the invasive arterial waveform, but is noninvasive and ubiquitous in hospitals. There is increasing interest in seeking circulatory in...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2012.06.012
更新日期:2012-09-01 00:00:00
abstract::Late preterm neonates have unique susceptibilities to infection. The closed setting of the neonatal ICU (NICU) and the immunologic immaturity of premature infants set the state for the development of nosocomial infections. This article discusses infections that might be seen in this population and gives options for di...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2006.09.005
更新日期:2006-12-01 00:00:00
abstract::In the past, all women with a family history of breast or ovarian cancer were considered to be at increased risk of cancer themselves. The discovery of BRCA1 and BRCA2 demonstrated that susceptibility to breast and ovarian cancer can be inherited by women as a single-gene autosomal dominant disorder. For such women, e...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70091-9
更新日期:2001-06-01 00:00:00
abstract::The LBW infant with congenital heart defects is likely to be at a higher risk for postoperative death and complications than their normal-sized counterparts because of the effects of prematurity and other organ system dysfunction. Current experience, however, does not suggest that waiting to obtain an arbitrary weight...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0095-5108(05)70078-6
更新日期:2001-03-01 00:00:00
abstract::Antepartum fetal surveillance with Doppler ultrasound of umbilical artery has shown significant diagnostic efficacy in identifying fetal compromise in pregnancies complicated with fetal growth restriction (FGR). Its effectiveness in decreasing perinatal mortality has been shown by randomized clinical trials (Level I e...
journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
doi:10.1016/j.clp.2010.12.004
更新日期:2011-03-01 00:00:00