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DR. GEETANJALI SAHARIAH KHOUND, DCH

DR. GEETANJALI SAHARIAH KHOUND, DCH. DR. PRAKRITISH BORA, MD. DR. R.K.BORKOTOKY, MD. DR. A.L.SAHA, MD, DCH. DR. TONMOY DAS , MD DM (NEPHROLOGY). INTERNATIONAL HOSPITAL “ LOTUS TOWER ” G.S.ROAD GUWAHATI - 5. CASE STUDY.

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DR. GEETANJALI SAHARIAH KHOUND, DCH

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  1. DR. GEETANJALI SAHARIAH KHOUND, DCH DR. PRAKRITISH BORA, MD DR. R.K.BORKOTOKY, MD DR. A.L.SAHA, MD, DCH DR. TONMOY DAS , MD DM (NEPHROLOGY) INTERNATIONAL HOSPITAL “ LOTUS TOWER ” G.S.ROAD GUWAHATI - 5

  2. CASE STUDY OF A NEW BORN WITH ARF SECONDARY TO SEVERE BIRTH ASPHYXIA

  3. A TERM AGA , BABY WAS BORN TO A PRIMIGRAVIDA MOTHER BY EMERGENCY LSCS (INDICATION – MSL) PRESENTED ON 2ND DAY OF LIFE WITH A HISTORY OF BIRTH ASPHYXIA - SEVERE RESPIRATORY DISTRESS - MAS - GENERALIZED SEIZURE - REFUSAL OF FEEDING - ANURIA -

  4. CLINICAL FINDINGS TACHYCARDIA - TACHYPNOEA - SEVERE RETRACTIONS - LETHARGY - POOR REFLEXES - PERIPHERAL CYANOSIS - LARGE CEPHALHAEMATOMA LEFT SIDE - POOR AIR ENTRY BILATERALLY ON THE CHEST - SPO2 WAS MAINTAINED IN 60 – 70 % WITH O2 @ 10 LTS / MIN -

  5. INVESTIGATION POSITIVE SEPSIS SCREEN - CHEST X-RAY – OVER INFLATED CHEST - INFILTRATES - ELECTROLYTE IMBALANCE - HIGH SERUM CREATININE – 6.8 mg / dl ( Normal – 0.5 – 1.4 mg / dl ) -

  6. DIAGNOSIS HIE STAGE II - SEPTICEMIA - MAS - ARF -

  7. MANAGEMENT STABILIZATION AND FLUID RESUSCITATION - MECHANICAL VENTILATION STARTED IN VIEW OF DESATURATION AND INCREASED WORK OF BREATHING - I.V. ANTIBIOTICS & SUPPORTIVES - PERITONEAL DIALYSIS -

  8. PERITONEAL DIALYSIS 1ST PERITONEAL DIALYSIS ON 3RD DAY OF LIFE - EACH EXCHANGE 50 ml DIALYSATE - TOTAL 58 EXCHANGES - 2ND PERITONEAL DIALYSIS ON 7TH DAY OF LIFE - IN VIEW OF INCREASING SERUM CREATININE LEVEL (8.6 ml / dl ) - EACH EXCHANGE50 ml DIALYSATE - TOTAL 30 EXCHANGES -

  9. PROGRESS EXTUBATION DONE ON 11TH DAY OF LIFE - URINE OUTPUT – .7 - .8 ml / kg / hour - CREATININE LEVEL HAS GONE DOWN TO 1.6 mg / dl - TOLERATING NASO GASTRIC FEEDING - STARTED BREAST FEEDING - SHIFTED TO MOTHER -

  10. FOLLOW UP WEIGHT GAIN - NORMAL - RENAL FUNCTION TEST - NORMAL - BORDERLINE DELAYED MILE STONES -

  11. DISCUSSION ARF IN NEONATE IS DEFINED AS SERUM CREATININE LEVEL > 1.5 mg / dl DESPITE NORMAL MATERNAL RENAL FUNCTION - • CAUSES OF ARF IN NEONATE ARE • SEPSIS • METABOLIC DISEASE • PERINATAL ASPHYXIA • PREMATURITY - Cont.

  12. DISCUSSION INCIDENCE OF ARF IN NICU IS 3 – 10 % - MORTALITY RATE IN ARF IS 20 – 24 % - ARF NEEDS FOR DIALYSIS ALONG WITH MECHANICAL VENTILATION ARE ASSOCIATED WITH HIGH MORTALITY . -

  13. T H A N K Y O U

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