INIS-Workshop课件.ppt

 Is this baby eligible for INIS? 23 weeks gestation, birth weight 475g Day 3 - reduced activity on ventilator, looks seriously ill Screening bloods - CRP 45mg/l,platelets 88 Antibiotics commenced Confirmation of infection day 2 with GBS on blood culture ? 23 weeks gestation, birth weight 475g Day 3 - reduced activity on ventilator, looks seriously ill Screening bloods - CRP 45mg/l,platelets 88 Antibiotics commenced Confirmation of infection day 2 with GBS on blood culture 26 weeks gestation, birth weight 950g Day 4, deterioration on ventilator Increasing oxygen requirement to 80% Appears unwell ETS recently grown coagulase negative staphylococci and CXR consistent with pneumonia Antibiotics commenced ? 26 weeks gestation, birth weight 950g Day 4, deterioration on ventilator Increasing oxygen requirement to 80% Appears unwell ETS recently grown coagulase negative staphylococci and CXR consistent with pneumonia Antibiotics commenced 27 weeks gestation, 1.3kg PROM 27 hrs GBS on maternal HVS Intrapartum antibiotics not given Asymptomatic infant Antibiotics commenced as hospital policy ? 27 weeks gestation, 1.3kg PROM 27 hrs GBS on maternal HVS Intrapartum antibiotics not given Asymptomatic infant Antibiotics commenced as hospital policy ? 27 weeks gestation, birth weight 1360g Day 38 intermittent bradycardias, then apnoeas resulting in ventilation Distended, tender abdomen noted with bilious aspirates Serial AXRs confirm fixed, oedematous bowel loops NEC diagnosed and antibiotics commenced Term infant Cyanotic episodes at 2hrs age Increasing oxygen requirement CXR patchy consolidation both lung fields Commenced on antibiotics CRP 19 ? Term infant Cyanotic episodes at 2hrs age Increasing oxygen requirement CXR patchy consolidation both lung fields Commenced on antibiotics CRP 19 But If there was offensive liquor, raised inflammatory markers or this baby was to become unwell This baby would be eligible for INIS Deterioration day 34 Recurrent apnoei