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Manual of Newborn Critical Care Medicine
© 2006, Dipak K Guha
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2006
Typeset at JPBMP typesetting unit
Printed at Paras Press
Mothers of IndiaForeword
The neonatal care has achieved its due recognition and now the focus would shift to the care of critically sick babies so as to have the maximum intact survival. Time is crucial factor for saving the babies and there is very little scope of error or misjudgment. Hence, there is urgency for providing optimal care, not missing out anything which is important and doing no harm to these young premature sick babies. Currently all of us have to refer to the textbooks with exhaustive information, or refer to Western handbooks, which often may not be alive to Indian scenario.
Dr Guha has been one of the pioneers in providing the textbook of neonatology which serves the purpose of all from students to the practitioners of neonatal care, however, there has been a need for providing a manual which is easy to read, quick to refer and gives step-wise approach to tackle the unwell babies. The short and precise book covers wide ranging subjects from normal care to common diseases, how to approach them, investigate and manage them in a check-list fashion. This kind of approach of presentation helps the busy but not so experienced physician available on the spot without an experienced help.
The manual is very strong in providing the useful information in bullets and tables so that the common conditions are given due importance but even the rare conditions are not completely ignored.
Practical procedures are often very difficult to perform on small babies and many a times, physicians have not had any training to handle these procedures especially in sick babies who may get further compromised while performing the procedures and also not yield the correct information. The book has devoted considerable attention to this aspect and the young neonatal physicians would find this chapter very useful to develop correct skills.
The chapter of drugs therapy is another important chapter which provides useful hints regarding drug dosage, modification under various conditions and how to calculate and administer safely.
I am sure this would be a very handy book for all the doctors and nurses who deal with acutely sick newborn babies for quick reference so as to avoid any faults in the management.
Professor of Pediatrics
Head of Pediatrics
Advanced Pediatric Centre
Postgraduate Institute of Medical Education and Research
Neonatology is firmly rooted as a superspeciality of Pediatrics and a very exciting field indeed. The part of the excitement of neonatology is that it involves a combination of acute emergencies, requiring rapid decision making, intervention and long-term follow-up. It is also a superspeciality in which you can continue to be involved in the management of every system because there are none or very few neonatal cardiologist or gastroenterologist, or other superspecialists as yet! There are exciting overlaps with antenatal diagnostic techniques and obstetric management. Radiologist, obstetrician, surgeon, etc. can be very meaningful sources of advice and information.
The methods and approach to newborn intensive care is not only changing rapidly but complexity of newborn care is also increasing by leaps and bounds. The care givers to newborns, residents and medical students may be overwhelmed by the quantity of medical knowledge potentially applicable to newborn care.
Because of its comprehensiveness, even as a distillate of the broad field of neonatology, Guha's Neonatology—Principles and Practice cannot be carried wherever one is caring for newborn. Therefore, the editors and contributors summarised this enormous amount of information and relevant science into this pocket size companion manual. This is not a mini-textbook or outline of neonatology. It is a manual to assist neonatal residents, fellows and junior level consultants in initiating critical care management of sick newborn with conditions that require immediate attention, to provide them with reminders to help them in their daily work, and to give the detailed instructions for performing procedures.
In this manual, we describe current and practical approaches for evaluation and management of conditions encountered in newborn with greater emphasis on the problems in developing countries, e.g. respiratory infections, nutrition Jaundice, metabolic, neurological and neonatal nursing. Efforts have been made to provide more practical guidelines in the areas of care of newborn where many of our level III units are focussing their attention, e.g. respiratory support, ventilation, and TPN. Certain important and common problems have not been covered deliberately particularly congenital malformation and chronic problem. This manual has been written to fill the void in the field of practical critical care newborn medicine in developing countries so that all informations you need to manage common neonatal problems are available in this manual. We hope that this Manual of Newborn Critical Care Medicine will fill both the gap in the market and the gap in your pocket as nothing like this is available which has been written in Indian context or for that matter for developing countries.
Dipak K Guha