RESUMO
It is well known that hyperkalemia may cause arrhythmia, right bundle branch block, and cardiac conduction block. These dysrhythmias have the potential to affect cardiac function. We present a premature newborn with hyperkalemia and right bundle branch block causing left ventricular dyssynchrony with mitral regurgitation, which led to decreased pump function.
Assuntos
Débito Cardíaco/fisiologia , Bloqueio Cardíaco/fisiopatologia , Doenças do Prematuro/fisiopatologia , Recém-Nascido Prematuro , Função Ventricular Esquerda/fisiologia , Doença do Sistema de Condução Cardíaco , Diagnóstico Diferencial , Ecocardiografia , Eletrocardiografia , Bloqueio Cardíaco/diagnóstico , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , MasculinoRESUMO
Caffeine citrate is one of the most prescribed drug in the present day NICU for apnea. Its efficacy, tolerability, wide therapeutic index and safety margin has made it the drug of choice among the methylxanthines. Its therapeutic uses in apnea of prematurity, mechanical ventilation, bronchopulmonary dysplasia has made it a "silver bullet" in neonatology. However, there are still controversies surrounding this drug. This review is aimed to update the reader about the basic pharmacology, current therapeutic uses, adverse effects, controversies as well as present and future research of caffeine.
Assuntos
Cafeína/farmacologia , Estimulantes do Sistema Nervoso Central/farmacologia , Citratos/farmacologia , Cafeína/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Citratos/uso terapêutico , Humanos , Recém-NascidoRESUMO
Group B Streptococcus is a known cause of neonatal sepsis, being more common in the early period by maternal genital tract transmission and less so in the late neonatal period, ascribed to intestinal colonization or horizontal transmission. Although breastmilk transmission of Group B Streptococcus has rarely been reported in the past, most cases are of patients nursed on the mother's breast and less commonly in expressed breastmilk-fed infants. This case describes a preterm infant (born at a gestational age of 24 weeks 6 days) in the neonatal intensive care unit who acquired recurrent late-onset sepsis with Group B Streptococcus with the mother's expressed breastmilk culture growing the same organism that was later matched to the infant's isolate. The mother had presented with features of mastitis only during the second episode of sepsis and was then treated with oral antibiotics. The infant was fed on formula feeds after the second incidence and remained healthy, being discharged on a regular follow-up plan at 39 weeks corrected gestational age.