• a. LED phototherapy
• b. LED intensity: 30–50 W/cm²/nm; LED life: 20,000–30,000 hours
• c. Wavelength: 450–460 nm
• d. Advantages:
  • Less hyperthermia/dehydration
  • Longer life
  • Less UV damage
  • Less power usage
  • Reduced treatment period

• a. Erythema toxicum
• b. Yellowish papules on an erythematous base
• c. Appears on day 2–3 and resolves by 1 week
• d. Trunk and back
• e. Scrapings—on wright stain will show predominance of eosinophils

• a. Hour-specific bilirubin chart—AAP normogram for phototherapy; For neonates of 35 or more weeks of gestational age
• b.
  • Dotted line: Lower risk—38 weeks or more with no risk factors
  • Dashed line: Medium risk—38 weeks or more with risk factors or 35–37 weeks with no risk factors
  • Dark line: Higher risk—35–37 weeks with risk factors
• c. Risk factors:
  • Isoimmune hemolytic anemia
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Asphyxia
  • Sepsis
  • Temperature instability
  • Acidosis
  • Significant lethargy
  • Hypoalbuminemia

• a. Physiological benefits:
  • i. Increases the functional residual capacity (FRC) by preventing alveolar collapse which leads to improved oxygenation
  • ii. Splints the upper airways and also stimulates the stretch receptors in the lung and pleura which prevents apnea
• b. Indications:
  • Preterm respiratory distress syndrome (RDS) as primary mode
  • Postextubation respiratory support
  • Apnea
  • Transient tachypnea of the newborn (TTN)
  • MAS
  • Bronchopulmonary dysplasia (BPD)
• c.
  • Continuous flow devices: Ventilator CPAP/bubble CPAP
  • Variable flow devices: Infant flow driver
• d. If the surface tension (T) increases or the radius of a sphere decreases, the pressure (P) required to prevent collapse of the sphere—the collapsing pressure—increases: P = 2T/r.
• e. Disadvantages:
  • Can be used only in neonates with spontaneous respiratory drive
  • Gastric distension/“CPAP belly”
  • Air leaks
  • Hypotension due to decreased venous return

• a. Coronal view of USG cranium
• b. Bilateral grade 3 IVH
• c. Lethargy, apnea, tone abnormalities, altered sensorium, and hypotension
• d. Complications:
  • Posthemorrhagic hydrocephalus (PPH)
  • Seizure
  • Neurological disability

• a. Respiratory alkalosis with metabolic acidosis
• b. Compensation calculation:

Disorder	Acute	Chronic
Respiratory acidosis	• 10 mm Hg increase in pCO2 above 40 • HCO3 increase by 1 mmol/L	• 10 mm Hg increase in pCO2 above 40 • HCO3 increase by 4–5 mmol/L
Respiratory alkalosis	• 10 mm Hg decrease in pCO2 below 40 • HCO3 decrease by 2 mmol/L	• 10 mm Hg decrease in pCO2 below 40 • HCO3 decrease by 4–5 mmol/L

Each arterial pCO2 shift of 10 mm Hg is accompanied by a pH shift of 0.08, while for chronic respiratory disturbances (where renal compensation has time to occur) each pCO2 shift of 10 mm Hg is accompanied by a pH shift of 0.03.

• c. Ventilator changes: Reduce PIP/TV (tidal volume) for low pCO2 and reduce FiO2 for hyperoxia
• d.
  • i. Low pCO2: Periventricular leukomalacia (PVL)/cerebral ischemia
  • ii. High pO2: ROP

• a. Tracheoesophageal fistula
• b. Type C
• c. VACTERL: Vertebral, Anorectal, Cardiac, Tracheoesophageal, Renal dysplasia, Limb anomalies.
• d. Management:
  • Minimize the risk of aspiration and avoid gastric overdistension
  • Replogle suction—continuous suction of blind proximal pouch
  • Head-end elevated to 30°—to reduce aspiration
  • Mechanical ventilation: If required with optimal pressures
  • Surgical correction of the defect—primary or secondary closure based on the distance between the defects

• a. Hypertrophic pyloric stenosis
• b. Olive mass in right hypochondrium, visible gastric peristalsis—left to right
• c. Hypochloremic, hypokalemic metabolic alkalosis
• d. String sign/double-track sign
• e. Correct hydration/dyselectrolytemia/pyloromyotomy

• a. Indications: Apnea, postextubation, prevention of BPD
• b. Loading dose 20 mg/kg IV/oral over 30 minutes (10 mg base) followed by 5–10 mg/kg IV/oral once daily, 24 hours after first dose
• c. Adenosine antagonist
• d. Caffeine for apnea of prematurity (CAP) trial—reduced BPD rates, better survival without ND disability at 18–21 months corrected age
• e. Side effects: Jitteriness, vomiting, and tachycardia

• a. Birth weight <1,500 g (also for 1,800–2,000 g)
• b. Unfortified human milk provides insufficient nutrients (especially proteins, calcium, and phosphorus) to the preterm infants when fed at usual feeding volumes
• c. On reaching 80–100 mL/kg feeds, human milk fortifier (HMF) is added. Dose is 1 g for 25 mL of human milk.
• d.
  • Standard
  • Individualized—adjustable and targeted

• a. Pneumoperitoneum
• b. Causes:
  • Necrotizing enterocolitis (NEC)
  • Spontaneous intestinal perforation
• c. Management:
  • Nil per oral (NPO), intravenous fluids
  • Surgical: Drain the air from the peritoneal cavity using glove drain if needed open laparotomy with resection and anastomosis

• a.
  • AaDO2 = Partial pressure of oxygen in alveoli (PAO2) – Partial pressure of oxygen in arterial blood (PaO2)
  • PAO2 = [(Patm – PH2O) × FiO2] – (PaCO2/RQ)
    • Patm: Atmospheric pressure at sea level (760 mm Hg)
    • PH2O: Partial pressure of water vapor (47 mm Hg)
    • PaCO2: Partial pressure of carbon dioxide
    • RQ: Respiratory quotient (0.8)
  • AaDO2 = [(760 – 47) × FiO2] – (PaCO2/RQ) – PaO2
    • = [(713 × 1) – (55/0.8)] – 30
    • = 644 – 30
    • = 614 (Very high)
  • Oxygenation index (OI) = Mean airway pressure (MAP) × FiO2 × 100 / PaO2
    • MAP = (PIP – PEEP) × [Ti / (Ti + Te)] + PEEP
    • MAP = (34 – 6) × [0.3 / (0.3 + 0.7)] + 6 = 28 × 0.3 + 6 = 8.4 + 6 = 14.4
    • OI = (Very high)
• b. Start high-frequency oscillatory ventilation (HFOV) and start inhaled nitric oxide

• a. T-piece resuscitator
• b.
  • (1) Can be used to administer free flow O2
  • (2) Also used to administer PEEP and PIP
• c.
  • (1) Needs air–O2 source
  • (2) Blender needed to set required FiO2

• a. Reference growth chart
• b. Six developed countries—Germany, USA, Australia, Canada, Scotland, and Italy.
• c. Gender-based growth charts from previous version; Equivalent to the World Health Organization (WHO) growth charts at 50 weeks.

• a. Cephalohematoma
• b. Caput succedaneum, subgaleal hematoma
• c. 1–3 days after birth and persists for weeks.
• d. Anemia, hyperbilirubinemia, and secondary infection

Feature	Caput succedaneum	Cephalohematoma	Subgaleal hemorrhage
Day of occurrence	Day 1	>1	Day 1
Site	Edema of scalp	Subperiosteal	Subaponeurotic
Resolves	1–2 days	Weeks	Weeks
Margins	Not well defined	Confined to bone	Crosses over suture lines
Anemia/jaundice	None	May be present	Mostly

• a. Score ranges from -10 to 50
• b. To assess gestational maturation of the neonate
• c. Negative scoring is included here. It can be used to assess maturity between 20 and 44 weeks (old Ballard: 26–44 weeks)
• d. Performed between 30 minutes to 96 hours.

• a. Left side congenital diaphragmatic hernia (CDH)
• b. Bag and mask to be avoided; intubation is recommended if there is respiratory distress; place oro-/nasogastric (NG) tube for gastric decompression
• c. Types of CDH:
  • Anterior (Morgagni): 25–30%
  • Posterolateral (Bochdalek): 70% most common
  • Central: 2–5%
• d. Antenatal predictors of CDH:
  • i. Observed/expected lung-to-head ratio (o/e LHR)
  • ii. Total fetal lung volume (TFLV)
  • iii. Intrathoracic liver herniation

• a. Duodenal atresia
• b. Double bubble sign
• c. Down’s syndrome, heterotaxy syndrome, microdeletions
• d. Timeline of abdominal gas shadow appearance:
  • Soon after birth—swallowing of air which reaches stomach
  • 1 hour after birth—duodenum
  • 3 hours after birth—proximal small bowel
  • 12 hours after birth—entire small bowel
  • 24 hours after birth—rectum

• a. Endotracheal (ET) tube, NG tube in situ, Lungs—ground glass appearance with reticulogranular pattern
• b. Optimal PEEP, surfactant, mechanical ventilation if required
• c. Minced porcine lung extract surfactant (dose 200 mg/kg of phospholipid intratracheally, can be repeated after 12 hours with a dose of 100 mg/kg of phospholipid)
• d. Less invasive surfactant therapy / minimally invasive surfactant therapy

• a. Air leaks
• b. Flow-volume loop
• c.
  • i. Ventilator circuits to be checked
  • ii. Optimal size ET tube
  • iii. Rule out pneumothorax

• a. Increased expiratory resistance in pressure-volume loop and flow-volume loop
• b. In pressure-volume loop with change in pressure there is not much change in expiratory volume whereas in flow-volume loop scooped out appearance of expiratory limb is shown.
• c. Bronchodilators

• a. Give surfactant therapy and consider invasive ventilation
• b. CPAP failure: SpO2 <90% or Silverman Anderson Score (SAS) >6 on FiO2 60% and PEEP of 6 cm of H2O or recurrent apneas (>2 episodes) needing stimulation or PPV (Bag and Mask ventilation) in 24 hours

• a. Patent ductus arteriosus
• b. Increase in PEEP, optimal fluids, chest X-ray and echocardiography to look for hemodynamically significant patent ductus arteriosus
• c. Paracetamol 15 mg/kg 6 hourly for 3–7 days oral or IV, or ibuprofen 10 mg/kg first dose followed by 5 mg/kg/dose next 24 and 48 hours orally.

• a. Ventricular dilatation/hydrocephalus
• b. Posthemorrhagic ventricular dilation, complication of meningitis, and ventriculitis
• c. Ventricular index (VI) >97th percentile + 4 mm and anterior horn width (AHW) >10 mm and/or Thalamo-occipital distance (TOD) >25 mm or any of the clinical criteria—head circumference growth >2 cm per week:
  • Separated sutures
  • Bulging anterior fontanel or when no stabilization occurs on repeated lumbar punctures
• d. Resistive index (RI): (Systolic flow – diastolic flow) / systolic flow; Normal RI is 0.6–0.85 and >0.85 is hydrocephalus

• a. Anechoic collection (fluid) in pleural space
• b. Chylous fluid and chylothorax
• c. Nil per oral, followed by medium-chain triglycerides (MCTs)-based diet. In severe cases, pleural tapping using intercostal chest tube drainage and octreotide infusions.

• a. Neonatal stroke (right-sided infarct in the middle cerebral artery)
• b. Causes for neonatal stroke:
  • Maternal factors: Thrombotic state of pregnancy, thrombophilias, drug abuse (cocaine), infection, preeclampsia, and labor complications
  • Fetal/neonatal factors: Inherited thrombophilias, twin-twin transfusion, infection, perinatal asphyxias, congenital heart diseases, hypoglycemia, polycythemias, and catheter-related complications
  • Environmental factors: Gender, race, dehydration, and antiphospholipid antibodies

• c. Chloride 104 mmol/L (Normal chloride levels are <90 mmol/L)

Normal fetal urine values:

• Sodium: <100 mmol/L
• Chloride: <90 mmol/L
• Calcium: <2 mmol/L
• Beta-2 microglobulin: <6 mg/L
• Osmolarity: <200 mOsm/L

• a. White forelock (Waardenburg syndrome)
• b. Autosomal dominant
• c. Hirschsprung’s disease

• a. Voiding cystourethrogram
• b. Posterior urethral valve
• c. Posterior urethral valve ablation or diversion therapy

• a. Subcutaneous fat necrosis
• b. Risk factors: Perinatal asphyxia, therapeutic hypothermia, cord prolapse, meconium aspiration, infant of diabetic mother, and Rh incompatibility
• c. Hypercalcemia, thrombocytopenia, hypoglycemia, and hypertriglyceridemia

• a. Subpleural consolidation
• b. Pneumonia

• a. Pressure overshoot
• b. Reduce the inspiratory flow rate

• a. Subgaleal bleed
• b. Instrumental delivery
• c. Hypovolemic shock

• a. Plastic bags, cling wraps, caps, thermal mattress, blended oxygen, delivery room CPAP
• b. 60–65%
• c. 30%
• d.
  • M: Mask readjustment
  • R: Reposition head and neck
  • S: Suction mouth then nose
  • O: Open airway
  • P: Pressure increase
  • A: Alternative airway

• a. Good tone, breathing, or crying
• b. False
• c. Positive-pressure ventilation should be started if baby is apneic, gasping, or heart rate <100 beats/min
• d. Check for chest rise. If not, perform MRSOPA
• e. Endotracheal intubation or laryngeal mask airway; Start chest compression, increase FiO2 to 100%, and secure umbilical vein catheter

• a. Pneumomediastinum
• b. The spinnaker-sail sign is noticed in the X-ray showing the cardiac border separated from the thymus by air in the mediastinum

• a. Congenital lobar emphysema
• b. Severe cases—surgical intervention (lobectomy); mild to moderate—conservative management

• a. Septic arthritis of left shoulder
• b. Antibiotics and arthrotomy
• c. Long-term complications include limb-length discrepancy, joint subluxation, and dislocation, avascular necrosis, pathological fractures, and premature osteoarthritis

• a. Give 10% dextrose 2 mL/kg IV bolus and check blood sugars after 20 minutes; if baby is alert can continue with oral feeds, if not, start IV glucose infusion rate of 6 mg/kg/min.
• b. In late preterm and term babies, operational threshold of blood sugar for intervention:
  • Symptomatic: Blood sugar <40 mg/dL
  • Asymptomatic:
    • <4 hours of age: 25 mg/dL
    • 4–24 hours of age: 35 mg/dL
    • 24–48 hours of age: 50 mg/dL
    • More than 48 hours: 60 mg/dL
• c. Diagnostic criteria for hyperinsulinemic hypoglycemia (when blood glucose <50 mg/dL):
  • Low B-hydroxybutyrate: <1.8 mmol/L
  • Low free fatty acids: <1.7 mmol/L
  • Detectable insulin: >2 µU/mL
  • Detectable C-peptide: >0.5 ng/mL
  • Glycemic response to glucagon: ≥30 mg/dL increase in plasma glucose after glucagon administration

• a. Check magnesium levels, if low, magnesium correction by IV 50% magnesium sulfate (50 mg/kg slow IV over 1–2 hours); hypomagnesemia leads to low parathormone production leading to hypocalcemia
• b. Acute therapy: Injection calcium gluconate 10% 200 mg/kg by slow IV infusion over 15–30 minutes
• c. Injection calcium gluconate 10% 800 mg/kg/day IV for 48 hours followed by 400 mg/kg/day IV for 24 hours either by continuous infusion or 6 hourly divided doses.
• d. Hypocalcemia is defined as:
  • Term infants and preterm (BW ≥1,500 g): Ionized Ca <4.4 mg/dL (<1.1 mmol/L) or total serum Ca <8 mg/dL (<2 mmol/L)
  • Preterm infants (BW <1,500 g): Ionized Ca <4 mg/dL (<1 mmol/L) or total serum Ca <7 mg/dL (<1.75 mmol/L)

• a. Right-sided pneumothorax
• b. Intercostal chest tube drainage

• a. Necrotizing enterocolitis stage 2A
• b. Pneumatosis intestinalis on staging of NEC
• c. NPO, gastric decompression, antibiotics (ampicillin, gentamycin, and metronidazole) for 10–14 days

Stage	Systemic signs	Abdominal signs	Radiological signs	Treatment
1A	Temperature instability, apnea, bradycardia, lethargy	Abdominal distension, emesis, heme-positive stool	Normal or intestinal dilation, mild ileus	NPO and antibiotics
1B	Same as above	Gross bloody stool	Same as above	Same as 1A
2A	Same as above	Same as above plus absent bowel sounds with or without abdominal tenderness	Intestinal dilation, ileus, pneumatosis intestinalis	NPO and antibiotics for 7–10 days
2B	Same as above plus metabolic acidosis and thrombocytopenia	Same as above, absent bowel sounds, definite tenderness, with or without abdominal cellulitis and right lower quadrant mass	Same as above plus ascites	NPO and antibiotics for 14 days
3A	Same as above plus hypotension, bradycardia, combined metabolic and respiratory acidosis, disseminated intravascular coagulation (DIC), neutropenia	Same as above plus peritonitis	Same as above	NPO and antibiotics for 14 days
3B	Same as above	Same as above	Pneumoperitoneum	Same as above plus surgery

• a. Amniotic band syndrome/constriction ring syndrome
• b. Constrictive rings around both the lower limbs, amputated right toes and right fingers, and swelling of right ankle and foot

• a. Left facial nerve palsy (lower motor neuron palsy)
• b. Causes of congenital facial nerve palsy:
  • Birth injuries: Forceps
  • Syndromes: Mobius syndrome, Goldenhar syndrome, and branchio-oto-renal syndrome
  • Genetic: Myotonic dystrophy

• a. Sacral dimple
• b. The sacral dimple located >2.5 cm from anal verge or larger than 5 mm or presence of hemangioma/lipoma/subcutaneous mass/dermal sinus/tuft of hair may be associated with spinal disorders.

• a. Clinical Assessment of Nutritional (CAN) status score chart
• b. Clinical index used for identifying fetal malnutrition
• c. CAN score ranges between 36 (highest) and 9 (lowest)
• d. Fetal malnutrition is considered when CAN score is below 25

• a. Vein of Galen malformation
• b. Dilated cardiac chambers and pulmonary hypertension
• c. High-output congestive heart failure, seizures, hydrocephalus, and developmental delay

• a. A lines; Horizontal lines (artifacts) parallel to the pleural line (reverberation of pleura)
• b.
  • i. Air bronchograms (left); Subpleural consolidation (right)
  • ii. Respiratory distress syndrome

• a. Type 1 congenital pulmonary airway malformation
• b. CVR: CPAM volume ratio, sonographic indicator to evaluate fetuses at risk for hydrops
  • CVR = Volume of CPAM (length × height × width × 0.52) / head circumference
  • <1.6 = <3% risk of hydrops

  • 1.6 = >75% risk of hydrops

• a.
  • (A) Levene index: distance between the falx and the lateral wall of the anterior horn of the lateral ventricle in the coronal plane
  • (B) Anterior horn width: diagonal width of the anterior horn at its widest point in the coronal plane
• b. Volpe’s grading:
  • Grade 1: Germinal matrix hemorrhage with no IVH or IVH occupying <10% of the ventricular area in parasagittal view.
  • Grade 2: IVH occupying 10–50% of the ventricular area on parasagittal view.
  • Grade 3: IVH occupying >50% of the ventricular area on parasagittal view, distending lateral ventricle.
  • Grade 4: Parenchymal echodensity representing periventricular hemorrhagic infarction

• Source: Bovine lipid extract surfactant
• Dosage: 135 mg phospholipid/kg
• Route: Intratracheally

• a. SMOF lipid components:
  • S: Soyabean oil (30%)
  • M: MCT oil (30%)
  • O: Olive oil (25%)
  • F: Fish oil (15%)
• b. 3–4 g/kg/day
• c. 20% lipid is preferred over 10%; 20% intralipid emulsion has lower phospholipid–triglyceride ratio, so triglycerides are cleared efficiently
• d. Omegaven (fish oil)
• e. 1:2.5 (ω-3 to ω-6 ratio)

• a. Volume-pressure loop showing beaking (pressure continues to rise without change in volume)
• b. Intervention—reduce the inspiratory pressure
• c. C20/C < 1 indicates overdistension; Compliance in the last 20% of inspiration / total compliance

• a. 2–3 weeks of postnatal age (PNA)
  • First screening for ROP should be performed at 4 weeks PNA.
  • In neonates <28 weeks of gestation or with birth weight <1,200 g (if gestation at birth is not confirmed conclusively), the first examination for ROP should be preponed to 2–3 weeks PNA.
• b. All babies <34 weeks, babies <2 kg (if gestational age is unknown), and babies between 34 and 36 weeks of gestation with the following risk factors:
  • Cardiorespiratory support
  • Prolonged oxygen therapy
  • Respiratory distress syndrome
  • Chronic lung disease
  • Fetal hemorrhage
  • Blood transfusion
  • Neonatal sepsis
  • Exchange transfusion
  • Intraventricular hemorrhage
  • Apneas
  • Poor postnatal weight gain
• c. Long-term morbidities of ROP are myopia, anisometropia, astigmatism, strabismus, glaucoma, late retinal detachment, and amblyopia

• a. Follow the following steps for preparing baby prior to ROP screening:
  • Maintain euthermia and asepsis
  • Feeding 1 hour prior at least
  • Dilate the pupils with tropicamide (0.5%) and phenylephrine (2.5%) 1 drop three times at 10 minutes interval. Pupil usually dilates in 30 minutes time and it persists for 30–45 minutes.
  • Developmental supportive care
  • Analgesia can be given 30 seconds prior to insertion of speculum
  • Milk swab or pacifier or nonnutritive sucking
  • Documentation of date, time, finding in both eyes across quadrants by ophthalmologist, and inform parents
• b. Yes. Criteria for ROP treatment (Type 1 ROP):
  • Zone I ROP: Any stage with plus disease
  • Zone I ROP: Stage 3, no plus disease; and
  • Zone II: Stage 2 or 3 with plus disease
• c. LASER and anti-vascular endothelial growth factor (anti-VEGF) (bevacizumab, ranibizumab, and aflibercept)

• a. AABR (automated acoustic brainstem response)
• b. 34 weeks
• c. Measures signals from 8th cranial nerve onward till inferior colliculus of midbrain. Detects both sensorineural hearing loss and auditory neuropathy. AABR tests the presence or absence of wave V of ABR at stimulus of 35 dB.

• a. Otoacoustic emission (OAE) screening test: OAE receives signal from outer hair cells recorded by microphone.
• b. Transient evoked OAE (TEOAE) and distortion product OAE (DPOAE)
• c. Screening—AABR, OAE; Diagnosis—BERA (brainstem evoked response audiometry)
• d. 1-2-3 rule:
  • 1 month—screening
  • 2 month—identification
  • 3 month—intervention

• a. Wave V is the most reliable and easily identifiable wave in tracing.
• b. Inferior colliculus
• c. Prolonged latency and interwave conduction time (I-III and I-V), decreased amplitude (I, III, and V)
  • Wave I—outer hair cells
  • Wave II—inner hair cells
  • Wave III—superior olivary complex
  • Wave IV—lateral lemniscus
  • Wave V—inferior colliculus
  • Wave VI—medial geniculate body
  • Wave VII—auditory radiations

• a. (1) Skin-to-skin contact, (2) exclusive or nearly exclusive breastfeeding / expressed human milk, and (3) early discharge and KMC at home and follow-up
• b. 1 hour
• c. Immediate KMC—continuous KMC given as early as possible after birth in babies between 1 and <1.8 kg. It reduces mortality.

• a. Beer–Lambert law
• b. Signal extraction technology (SET): It is a patented technology of MASIMO. It reduces motion artifact.
• c. Rainbow SET pulse oximetry uses seven algorithms and measures SpO2 along with total hemoglobin, respiratory rate, Pleth variability index, oxygen content, levels of carboxyhemoglobin, and methemoglobin.

• a. Transcutaneous bilirubinometer
• b. Measures the spectral reflectance of bilirubin by difference in optical density of light reflected by skin.
• c. Forehead and sternum
• d.
  • Advantage: Noninvasive, good correlation with total serum bilirubin (TSB)
  • Limitation: Unreliable in neonates <35 weeks of gestation, underestimates TSB at higher ranges >15 mg/dL, not accurate once phototherapy started, and costly.

• a. Oxygen analyzer or FiO2 monitor—used to monitor FiO2 in certain devices which do not have inbuilt FiO2 analyzer like hood and incubators.
• b. Oxygenation index (OI) = (MAP × FiO2) / PaO2
  • Where MAP is mean airway pressure, FiO2 is fraction of inspired oxygen in percentage, and PaO2 is partial pressure of oxygen in arterial blood
• c. AaDO2 is alveolar arterial gradient:
  • AaDO2 = Partial pressure of oxygen in alveoli (PAO2) – Partial pressure of oxygen in arterial blood (PaO2)
  • PAO2 = [(Patm – PH2O) × FiO2] – (PaCO2/RQ)
  • Patm—atmospheric pressure at sea level (760 mm Hg)
  • PH2O—partial pressure of water vapor (47 mm Hg)
  • PaCO2—partial pressure of carbon dioxide
  • RQ—respiratory quotient (0.8)
  • AaDO2 = [(760 – 47) × FiO2] – (PaCO2/RQ) – PaO2

• a. Replogle tube
• b. It is used in esophageal atresia and tracheoesophageal fistula in preoperative period.
• c. It helps in continuous drainage of secretions through low suction device
• d. It prevents aspiration by continuously removing the secretions from esophageal pouch.

• a. It is used to measure the irradiance output of phototherapy units.
• b. 30 μW/cm2/nm

• a. Inhaled nitric oxide delivery system
• b. Newborns ≥34 weeks of gestation with PaO2 <100 on 100% FiO2 or oxygenation index >15–20
• c. Pulmonary vasodilatation, decreases extrapulmonary right-to-left shunting, microselective effect, decreases inflammation, and decreases oxidant injury
• d. Starting dose is 20 ppm.
• e. Following response is expected in 30 minutes:
  • PaO2 increase ≥20 mm Hg or 20% improvement from baseline
  • An increase in oxygen saturation ≥10%
  • 20-20-20 rule: Consider starting at OI of 20 with iNO at 20 ppm and an increase in PaO2/FiO2 ratio of 20 mm Hg or more.
• f. Consider weaning the iNO when the FiO2 is ≤0.60 and PaO2 is maintained at 60 mm Hg for at least 60 minutes (60-60-60 rule of iNO)

• a. Cerebral function monitoring / aEEG (amplitude-integrated EEG)
• b. CFM records a single channel of EEG by using biparietal or frontal lead (three electrodes). The acquired signal is filtered, rectified, and semilogarithmically compressed.
• c. Neonatal seizures, prognostication of hypoxic-ischemic encephalopathy (HIE), monitoring anticonvulsant drug response, and degree of encephalopathy

• a. Omphalocele
• b. True—isolated omphalocele with the sac containing only intestine is associated with more genetic defects than extracorporeal liver
• c. Trisomy 18, 13, and 21 and Beckwith–Wiedemann syndrome
• d. The pentalogy of Cantrell—abdominal wall defect, lower sternal defect, cardiac defects, defects in pericardium, and diaphragmatic defects.