Browsing by Author "Sivanandan, Sindhu"

Now showing 1 - 4 of 4
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    Advances in the Management of Meconium Aspiration Syndrome
    (2011-11-22) Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu
    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS.
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    Advances in the Management of Meconium Aspiration Syndrome
    (Hindawi Publishing Corporation, 2011-10-09) Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu
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    Choice and Duration of Antimicrobial Therapy for Neonatal Sepsis and Meningitis
    (2011-11-20) Sivanandan, Sindhu; Soraisham, Amuchou S.; Swarnam, Kamala
    Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Signs and symptoms of sepsis are nonspecific, and empiric antimicrobial therapy is promptly initiated after obtaining appropriate cultures. However, many preterm and low birth weight infants who do not have infection receive antimicrobial agents during hospital stay. Prolonged and unnecessary use of antimicrobial agents is associated with deleterious effects on the host and the environment. Traditionally, the choice of antimicrobial agents is based on the local policy, and the duration of therapy is decided by the treating physician based on clinical symptoms and blood culture results. In this paper, we discuss briefly the causative organism of neonatal sepsis in both the developed and developing countries. We review the evidence for appropriate choice of empiric antimicrobial agents and optimal duration of therapy in neonates with suspected sepsis, culture-proven sepsis, and meningitis. Moreover, there is significant similarity between the causative organisms for early- and late-onset sepsis in developing countries. The choice of antibiotic described in this paper may be more applicable in developed countries.
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    Choice and Duration of Antimicrobial Therapy for Neonatal Sepsis and Meningitis Journal: International Journal of Pediatrics
    (Hindawi Publishing Corporation, 2011-10-04) Sivanandan, Sindhu; Soraisham, Amuchou S.; Swarnam, Kamala