Neo Reviews

NeoReviews current issue

  • International Perspectives: Birth-Associated Neonatal Encephalopathy: Postresuscitation Care in West African Newborns
    The West African subregion has the highest burden of neonatal mortality globally and the neonatal mortality rate is decreasing very slowly. A high proportion of newborn deaths are preventable and improved quality of care can reduce long-term morbidity in survivors. Perinatal asphyxia is the major cause of death and disability in term infants in the subregion. Neonatal resuscitation training programs have reduced stillbirths and early neonatal mortality but the overall effect on survival to discharge, population-based perinatal mortality, and long-term impairment is uncertain. Gaps in the health system and quality of postresuscitation care for affected newborns may defeat gains from global efforts to improve care around the time of birth. The aim of this review is to discuss the current situation of postresuscitation care of term infants with presumed birth-associated neonatal encephalopathy in West Africa. Limitations in diagnosing and treating affected infants and feasible interventions to improve acute and postdischarge care are discussed.

  • Neonatal Antibiotic Use: What Are We Doing and Where Shall We Go?
    Antibiotic stewardship aims to ensure that clinicians administer the right antibiotics, to the right patients, for the right reasons. These principles are being widely applied in medical care, but have been particularly challenging in the NICU. Infectious risk factors and clinical instability are common among neonatal patients, and lead to significant cumulative antibiotic exposures in the NICU setting. Both the frequency with which antibiotics are administered and the potential unintended consequences of antibiotic administration differ between preterm and term infants. Multiple metrics are available to measure antibiotic use, yet no single measure is universally applied to neonatal stewardship.

  • NICU Communication: The Many Disguises of Opportunity
    In the NICU, communication with parents, family, and other members of the care team is extremely important. Multiple issues can impede effective communication around goals of care, particularly in the context of end-of-life discussions. This review looks at a select few of those difficult topics and identifies them as opportunities for deeper and more productive discussions with parents of critically ill neonates as well as medical staff.

  • Magnetic Anastomosis as a Minimally Invasive Treatment for Esophageal Atresia
    Esophageal atresia without fistula is a rare congenital abnormality for which treatment historically required a surgical repair. A new minimally invasive procedure with US Food and Drug Administration–approved Humanitarian Device Exemption has now emerged as a possible treatment option in place of, or in conjunction with, surgical repair for infants with esophageal atresia. This procedure uses magnets placed under fluoroscopic guidance to create an anastomosis between the stomach and the esophagus. In this article, we will review a new magnetic anastomosis catheter-based system, describing how the procedure is performed as well as the reported outcomes and potential complications of this approach. We will highlight a recent case of a patient who underwent the procedure.