Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients

Medical and economic impact of extraintestinal infections due to Escherichia coli: focus on an increasingly important endemic problem

Iron Deficiency in Infancy and Childhood

Bacterial sepsis in the neonate is a clinical syndrome characterized by systemic signs of infection and accompanied by bacteremia in the first month of life. Meningitis in the neonate usually is a sequela of bacteremia and is discussed in this chapter because meningitis and sepsis typically share a common cause and pathogenesis. Infections of the bones, joints, and soft tissues and of the respiratory, genitourinary, and gastrointestinal tracts can be accompanied by bacteremia, but the cause, clinical features, diagnosis, and management of these infections are sufficiently different to warrant separate discussions. Sepsis and meningitis caused by group B Streptococcus, Staphylococcus aureus, Neisseria gonorrhoeae, Listeria monocytogenes, Salmonella species, and Mycobacterium tuberculosis are described in other chapters.

Bacterial Sepsis and Meningitis

https://espen.info/documents/ENPancreas.pdf

ESPEN guidelines on parenteral nutrition: pancreas.

•Objective. —To determine the long-term outcome of neonatal bacterial meningitis and the relationship between the outcome and specific features in the acute stage of the disease; and to compare the outcome between infants with neonatal meningitis and high-risk infants without meningitis. Design. —Prospective clinical evaluations of 21 survivors of meningitis and 21 matched controls who were retrospectively selected from a high-risk patient population. Setting. —Program of follow-up performed at the Children and Youth Project's High Risk Center of the Department of Pediatrics, University of Louisville, Louisville, Ky. Neonates were inborn at a university hospital with a high-risk obstetric unit and level III nursery. Patients. —Twenty-six consecutive neonates born between 1970 and 1980 with culture-proven bacterial meningitis, excluding neonates with congenital neurologic defects. Nineteen of 21 survivors and 21 controls matched by age, sex, race, birth weight, and gestational age were followed up from 1 to 14 years (mean, 7.8 years). Both survivors and controls fell below the federal poverty guidelines. Results. —Gram-positive meningitis was twice as common as gram-negative meningitis with co-occurrence of meningitis and sepsis in half of the cases. Neonates with gram-positive meningitis and higher birth weight had a higher survival rate, but this finding was not statistically significant. The mortality rate in neonates with gram-negative meningitis was almost three times higher than that of neonates with gram-positive meningitis, but no significant difference was observed between their morbidity rates. Eight (38%) of 21 survivors were normal, while another eight (38%) and five (24%) had mild and moderate to severe sequelae, respectively. Survivors of meningitis had lower IQ scores and more severe sequelae than matched controls. Conclusion. —Neonatal bacterial meningitis results in poorer long-term outcome than in controls, but improved outcome compared with previous studies of neonatal meningitis. ( AJDC . 1992;146:567-571)

Long-term outcome of neonatal meningitis.

Premature rupture of membranes and its effect on the newborn.

• With the use of ethanol in hyperalimentation regimens and for the inhibition of premature labor, there is increased opportunity for exposure of the fetus to this potentially toxic substance. We reviewed the literature regarding the effects of ethanol on the fetus and neonate, and illustrate its potential toxicity by the report of a case of neonatal depression secondary to acute maternal ethanol ingestion. (Am J Dis Child129:1075-1076, 1975)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=peds&articleId=506166&pdfFileName=archpedi_129_9_014.pdf

Acute transplacental ethanol intoxication.

Fat Emulsions and Hypertriglyceridemia

Retrolental fibroplasia (RLF) has most often been observed in preterm infants exposed to high ambient oxygen concentrations. This case report describes an infant near term who was never exposed to supplemental oxygen but in whom stage 4 RLF developed. The etiologic role of exchange transfusion is discussed.

Billy F. Andrews

Papers

Long-term outcome of neonatal meningitis.

Premature rupture of membranes and its effect on the newborn.

Acute transplacental ethanol intoxication.

Fat Emulsions and Hypertriglyceridemia

Nonhyperoxic retrolental fibroplasia.