Neoreviews
HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-Letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kurepa, D.
Right arrow Articles by Ibrahim, H.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Kurepa, D.
Right arrow Articles by Ibrahim, H.

NeoReviews Vol.7 No.11 2006 e586
© 2006 American Academy of Pediatrics

Index of suspicion in the nursery

The first 20% of the full text of this article appears below.


   Case Presentation
 
A set of nonidentical twins is born at 24 weeks gestational age by normal spontaneous vaginal delivery to a 25-year-old gravida 3 para 2 female. The infants are appropriate for gestational age, weighing 525 and 520 g. Both twins are intubated in the delivery room, given surfactant via endotracheal tubes, and placed on high-frequency oscillators in the neonatal intensive care unit (NICU). Results of clinical examination on admission to the NICU are normal for both twins. On the fourth day after birth, each infant is started on continuous fentanyl infusions at 3 mcg/kg per hour. Urinary output begins to decline 24 hours after initiation of the fentanyl infusions, with a simultaneous decline in renal function (Table). On postnatal day 7, marked abdominal distention is noted in both twins.


Table. Renal Function Parameters During and After Fentanyl Infusions

Parameter Twin A
 Twin B
Fentanyl Infusion Fentanyl Infusion Discontinued (after 24 h) Fentanyl Infusion Fentanyl Infusion Discontinued (after 24 h)
Urine output (mL/kg per hour) 0.2 6 0.4 6
Serum creatinine (mg/dL/[mcmol/L]) 1.9 (168) 1.2 (106.1) 1.9 (168) 1.2 (106.1)


   Case Discussion
 
Renal ultrasonography on both infants reveals bilateral hydronephrosis and very distended, urine-filled bladders extending under the hepatic border (Figs. . . . [Full Text of this Article]

Dalibor Kurepa, MD
Hilary Tice, PharmD
Guillermo Sangster, MD
Ahmad Abo Kayass,
Hassan Ibrahim, MD

Department of Pediatrics and Department of Radiology, Louisiana State University Health Science Center-Shreveport, Shreveport, La.






HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Academy of Pediatrics.