Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Part I Epidemiology, Pathophysiology, and Pathogenesis of Fetal and Neonatal Brain Injury
- Part II Pregnancy, Labor, and Delivery Complications Causing Brain Injury
- Part III Diagnosis of the Infant with Asphyxia
- Part IV Specific Conditions Associated with Fetal and Neonatal Brain Injury
- Part V Management of the Depressed or Neurologically Dysfunctional Neonate
- 34 Neonatal resuscitation: immediate management
- 35 Extended management
- 36 Neuroprotective mechanisms after hypoxic–ischemic injury
- 37 Neonatal seizures: an expression of fetal or neonatal brain disorders
- 38 Improving performance, reducing error, and minimizing risk in the delivery room
- 39 Nutritional support of the asphyxiated infant
- Part VI Assessing the Outcome of the Asphyxiated Infant
- Index
- Plate section
35 - Extended management
from Part V - Management of the Depressed or Neurologically Dysfunctional Neonate
Published online by Cambridge University Press: 10 November 2010
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Part I Epidemiology, Pathophysiology, and Pathogenesis of Fetal and Neonatal Brain Injury
- Part II Pregnancy, Labor, and Delivery Complications Causing Brain Injury
- Part III Diagnosis of the Infant with Asphyxia
- Part IV Specific Conditions Associated with Fetal and Neonatal Brain Injury
- Part V Management of the Depressed or Neurologically Dysfunctional Neonate
- 34 Neonatal resuscitation: immediate management
- 35 Extended management
- 36 Neuroprotective mechanisms after hypoxic–ischemic injury
- 37 Neonatal seizures: an expression of fetal or neonatal brain disorders
- 38 Improving performance, reducing error, and minimizing risk in the delivery room
- 39 Nutritional support of the asphyxiated infant
- Part VI Assessing the Outcome of the Asphyxiated Infant
- Index
- Plate section
Summary
The events that comprise the period of extended intensive care of the depressed neonate are subject to medicolegal challenge less frequently than are those of the immediate resuscitation and prenatal periods. In part, this may be the case because infants requiring extended intensive care are among the most critically ill and usually are transferred to level III intensive care nurseries where their management can be supervised by board-certified neonatologists. The range of therapies that can be undertaken in these well-equipped facilities, with subspecialist consultants and specifically trained nurses and other personnel, is quite broad and encompasses a variety of treatments that address specifically identified disabilities or dysfunctions. Within this spectrum of medical practice are many different management schemes that may be acceptable. It is not the intent in this chapter to review all the management protocols used for the numerous conditions encountered in neonatal intensive care. Rather we focus on the early transitional period following birth and resuscitation, during which the condition of a depressed infant can be substantially improved by expert care.
Failure to provide competent care, optimizing the opportunity for cerebral recovery, while the infant is prepared for referral to a level III intensive care nursery, is frequently the basis for litigation in the USA.
- Type
- Chapter
- Information
- Fetal and Neonatal Brain InjuryMechanisms, Management and the Risks of Practice, pp. 692 - 714Publisher: Cambridge University PressPrint publication year: 2003