NICU Protocols of Jipmer- 2nd Edition

Preface to the Second Edition

We are happy to present the second edition of NICU Protocols of JIPMER. The response to the first edition from the neonatal caregivers was really heartening, and the printed copies sold out very quickly. We had a choice of reprinting or bringing out a new edition of the book and chose the second option so that we could update the earlier chapters, and add new protocols that the readers including our own residents requested. We, the authors, editors, and publishers, are sure that you will extend us the same support that you did for the previous edition.

Scientific knowledge keeps changing in any field and neonatology cannot be an exception. We have tried to include protocols for most of the common issues related to the care of newborns. Our experience over the years has been amalgamated with evidence from the scientific literature to provide the latest and most relevant answers to the issues we face when delivering care to neonates. We sincerely hope that the book will help in improving neonatal care in your institution and in the country as a whole.

The challenges faced by individual neonatal units may differ across the country. Please feel free to modify the information given in this book to suit the local context. A protocol book offers a framework for managing common issues but cannot be complete in all respects. Please complement the information in this book with information from other scientific sources when managing an individual infant.

We have added twenty new protocols in this edition. Although the book is a bit thicker than the previous one, it is still a handy size to carry to your workplace. We have made every effort to check the accuracy of the contents, but a few errors must have inevitably crept in. With your feedback, the contents can be even better the next time.

We are thankful to all our contributors.  They are our present and past faculty and residents and have put in long hours updating the earlier protocols and drafting the fresh ones. Dr. Adhisivam Bethou, Additional Professor and present Head of the Department of Neonatology, needs to be specially thanked for all the help. We are also thankful to our readers who provided us with valued feedback.

We thank Prof I. C. Verma, Prof S. K. Kabra, and the managing trustees of the Indian Journal of Pediatrics for publishing our work. We are also thankful to Ms. Nidhi Mehta, Mr. Rajiv Dhir and others in the IJP team for providing us with much-needed technical assistance. We are indebted to them for their active contribution throughout the process.

We are also thankful to all our readers, who encouraged us to write this second edition by buying up all copies of the first! It is our hope that this edition will be received even more enthusiastically than the first

1. Vishnu Bhat

Director–Medical Research,

Professor of Pediatrics and Neonatology,

Aarupadaiveedu Medical College and Hospital, 

Vinayaka Mission’s Research Foundation, Puducherry

2. Nishad Plakkal

Associate Professor of Neonatology,

JIPMER, Puducherry

CONTENTS Of NICU PROTOCOLS OF JIPMER (2nd Edition)

(For any queries, please call us at 9810290145 or email at ijpsub@gmail.com)

		III PAGE
Foreword		V
Preface	..	VI
Contributors	..	VII–VIII
Normal Newborn, Essential Newborn Care and General Issues
1. Care of the Normal Newborn	..	3-6
2. Care of the Newborn in the Labor Room	..	7-11
3. Breastmilk and Breastfeeding	.	12-17
4. Thermoregulation	..	18-21
5. Neonatal Resuscitation	..	22-33
6. Kangaroo Mother Care	..	34-37
7. Developmentally Supportive Care	..	38-41
8. Human Milk Banking	..	42-46
9. Infant with Congenital Malformations	..	47-54
NICU: Admission & Discharge
10. NICU Admission and Discharge	..	57-59
11. Discharge Planning of the High Risk Neonate	..	60-62
12. Palliative Care	..	63-65
Nutrition and Gastrointestinal System
13. Feeding of Preterm Infants	..	69-72
14. Fluid and Electrolyte Balance in Newborns	..	73-82
15. Parenteral Nutrition	..	83-89
16. Neonatal Jaundice	..	90-100
17. Neonatal Necrotizing Enterocolitis	..	101-105
18. Neonatal Acute Liver Failure	..	106-109
Respiratory System
19. Approach to the Neonate with Respiratory Distress	..	113-123
20. RDS and Surfactant Therapy	..	124–129
21. Meconium Aspiration Syndrome	..	130-134
22. Neonatal Pneumonia		135-139
23. Apnea of Prematurity		140-143
24. Congenital Diaphragmatic Hernia
Respiratory Support and Critical Care		144-151
25. Quick Guide to NICU Equipment	..	155-162
26. Neonatal Pulmonary Graphics	..	163-167
27. Noninvasive Respiratory Support	..	168-174
28. Mechanical Ventilation of the Neonate	..	175-184
29. Neonatal Transport	..	185-188
Cardiovascular System		144-151
30. Shock in Neonates	..	191-204
31. Patent Ductus Arteriosus in Preterm Infants	..	205-212
32. Critical Congenital Heart Disease	..	213-219
33. Acute Kidney Injury	..	223-228
34. Disorders of Sex Development	..	229-235
Central Nervous System
35. Neonatal Seizures	..	239-248
36. Hypoxic Ischemic Encephalopathy	..	249-256
Metabolic and Hematologic Problems
37. Hypoglycemia and Hyperglycemia	..	259-264
38. Hypocalcemia	..	265-267
39. Polycythemia	..	268-270
40. Neonatal Anemia	.	271-275
41. Thrombocytopenia	..	276-281
42. Inborn Errors of Metabolism	..	282–290
43. Blood Component Therapy	..	291–297
44. Metabolic Bone Disease	..	298–302
Endocrine Problems
45. Congenital Hypothyroidism	..	305-310
Infection and Antimicrobial Therapy
Housekeeping in the NICU Prevention of Infection Neonatal Sepsis and Antibiotic Policy	.. .. ..	313-316 317–326 327–336
49. SARS-CoV-2 Infection (COVID-19) in Neonates	..	337–343
50. Management of Common Perinatal Infections	..	344–350
Annexures
Annexure A: Common Drugs Used in the NICU	..	353–360
Annexure B: Fenton 2013 Growth Charts	..	361-362
Annexure C: Immunization Card JIPMER Immunization, Growth and Development Record	..	363-367
Annexure D: Blood Pressure Centile Charts	..	368
Annexure E: Ventricular Index	..	369-370
Annexure F: Reference Values for Lab Parameters	..	371-374
Subject Index	..	375-378