Infectious diseases in the period of newborns
Infectious diseases in the period of newborns
Infectious diseases of the neonatal period ™ occur when a child is infected intrauterinely during transplacental infection, when a child passes through the birth canal during birth, and also from external sources after birth.
Fetal infection, which can occur in any period of prenatal development, is the result of a clear or subclinical infectious disease in the mother. Consequences depend on the pathogen and the time of infection and include spontaneous abortion, intrauterine growth retardation, premature birth, stillbirth, congenital malformations and obvious infection in the newborn.
patients in late adolescence and young age, responsible for their own choices. Therefore, they need to know what remains in reserve and what can be done.A sign of respect for a patient suffering from an MB is to make sure that he has all the information and the opportunity to make a life choice, including having a hand supporting him to determine how and when to accept death. Often, discussion of transplantation is required. Thinking about transplantation, patients need to weigh the benefits of longer graft life versus the uncertainty of receiving a transplant and the constant problem of life with a transplanted organ.
Patients with deterioration need to discuss the likelihood of death. Patients and their families should know that often death comes quietly, without severe symptoms. Palliative treatment, including sufficient sedative therapy, should be offered, if it is appropriate, to ensure a peaceful death. One of the possible ways for the patient is to consider the possibility of taking part in the short-term test of fully aggressive treatment, if necessary, but discuss in advance the parameters that will indicate the need to stop treatment and accept death.
Normal growth and stabilization of pulmonary function can be achieved with enteral nutrition via a nasogastric tube, gastrostomy or an inostasis. Has not been proventhat the use of drugs that increase appetite, and or androgens effectively, their use is not recommended.
Surgical treatment may be indicated for local bronchiectasis or atelectasis that are not amenable to conservative treatment, nasal polyps, chronic sinusitis, bleeding from esophageal varicose veins with portal hypertension, lesions of the gall bladder and intestinal obstruction due to the bowel movement or invagination that cannot be resolved by conservative . In patients with terminal liver failure, liver transplantation is successfully performed. Bilateral cadaveric lung transplantation and lung lobe transplantation from a living donor are successfully performed in patients with severe cardiopulmonary lesion.
MB therapy and patient care in the terminal period
The patient and his family deserve a confidential conversation about the prognosis and preferred care and treatment, especially if the patient has an increasingly pronounced limitation of reserves. Intranatal infection occurs when passing through infected birth canal or with ascending infection with a prolonged anhydrous interval.Among the most common viral pathogens are herpes simplex virus, HIV, cytomegalovirus and hepatitis B; less often, infection with these diseases occurs transplacentally. Bacterial pathogens include group B streptococci, intestinal gram-negative microorganisms, gonococci and chlamydia.
Postnatal infection occurs on contact with an infected mother, either directly or through breast milk, or on contact with a doctor and hospital flora.
The risk of intra- and postnatal infection is inversely proportional to gestational age. Newborns are immunologically immature, with a decreased function of polymorphonuclear neutrophils and monocytes; All this is especially true for premature babies. Maternal IgG antibodies are actively transmitted through the placenta, but their effective level is reached only approximately to the term of full term delivery. IgM antibodies do not pass through the placenta. Premature babies are also more often required invasive procedures, which predisposes to the development of infections.
The choice of the drug is almost the same as in adults, since infectious agents and their sensitivity to antibiotics are not specific to newborns. However, many factors influence the dose and dosage regimen.
The dose for newborns younger than 7 days weighing less than 2000 g is 5 mg / kg after 12 hours.
Serum concentration in preterm infants should be monitored.
noglikozidov) in comparison with adults. Lower serum albumin concentrations in premature babies can lead to reduced binding of antibiotics to blood proteins. Drugs that displace bilirubin from the compound with albumin, increase the risk of developing nuclear jaundice.
The absence or lack of certain enzymes in newborns can increase the half-life of some antibiotics and increase the risk of toxic effects. Changes in GFR and renal tubular secretion in the first month of life entail the need to change dosages for other drugs.
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