Neonatal hypertension

Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.     

Neonatal tracheobronchomegaly

Tracheobronchomegaly is rarely reported in neonates. We present five cases of tracheobronchomegaly occurring in neonates receiving intensive ventilatory and oxygen support. Barotrauma is speculated to be the primary pathophysiologic factor in these cases.     

Neonatal oxygen-cardiorespirograms

To those used to intermittent blood sampling, intermittent viewing of ECG, or intermittent counting of heart and respiratory rates, the rapid changes in these variables, as revealed when monitored continuously, must come as a surprise. These rapid changes are found even in quiet, healthy infants. Because of this variability and the diagnostic significance of each single variable, the potential of these variables can be utilized only if they are continuously recorded. It is like studying movement from a videorecording instead of from a couple of photographs taken at different intervals. Knowing normal levels and the trend of changes in all the variables, it becomes easier and more accurate to predict significant clinical changes than before. Or, in M. E. Avery's words, "Those of us who have used continuous monitors would not like to return to the era of sporadic sampling of information."     

Neonatal Circumcision

The American Academy of Pediatrics has stated that there is no valid medical reason for performing routine neonatal circumcision. Although the issue is hotly debated in medical circles, little attention has been given to the issue in the nursing literature. It is important that nurses understand the medical, social, religious, and child care issues involved in order to help parents make informed decisions regarding circumcision of their neonate