Neonatal medicine Introduction Xiaoping Luo, MD Professorand chairman Department of Pediatrics, Tongji Hospital Director, Center for the Diag nosis of Genetic Metabolic Diseases Tongji medical college Huazhong University of science and Technology Adjunct Professor Department of paediatrics Faculty of medicine University of Toronto Toronto, Canada
Neonatal Medicine --Introduction Xiaoping Luo, MD Professor and Chairman Department of Pediatrics, Tongji Hospital Director, Center for the Diagnosis of Genetic Metabolic Diseases Tongji Medical College Huazhong University of Science and Technology Adjunct Professor Department of Paediatrics Faculty of Medicine University of Toronto Toronto, Canada
Historical perspectives Early History of Care of Infants (1900 small infants were not expected to live temperature: hot-water bottles, heated cribs feeding: tube feeding, diluted cow milk separated facilities, isolation, washing hands hyaline membrane diseases---respiratory distress syndrome 1940s, modernized incubator, more oxygen 1940s, retrolental fibroplasia 1945,The Physiology of the Newborn Infant))--C Smith
Historical Perspectives ➢ Early History of Care of Infants (1900~ - small infants were not expected to live - temperature: hot-water bottles, heated cribs - feeding: tube feeding, diluted cow milk - separated facilities, isolation, washing hands - hyaline membrane diseases---respiratory distress syndrome - 1940s, modernized incubator, more oxygen - 1940s, retrolental fibroplasia - 1945, 《The Physiology of the Newborn Infant》--C. Smith
Historical perspectives Rapid advances in Neonatal care (1955~1970 1959, surfactant deficiency, Avery ME, Mead am Dis Child 1960,Disease of the Newborn )-Neonatology -A. Schaffer culture, blood counts, urinalyses, radiographs, biopsies milk formulas breast milk bank iv glucose bicarbonate blood gas analysis improved incubators early attempts of mechanical ventilation
Historical Perspectives ➢ Rapid Advances in Neonatal Care (1955~1970) - 1959, surfactant deficiency, Avery ME, Mead J. Am J Dis Child - 1960, 《Disease of the Newborn》-Neonatology -A. Schaffer - culture, blood counts, urinalyses, radiographs, biopsies - milk formulas, breast milk bank - iv glucose & bicarbonate - blood gas analysis - improved incubators - early attempts of mechanical ventilation
Historical perspectives > Emergence of neonatal Intensive Care (1971-1989) 1971, continuous positive airway pressure(CPAP)--gregory neonatal intensive care unit(NICU) designated by level according to the intensity of service : normal birthing and nB care, I: common obstetric complications intermediate nB care II: high risk maternal care and NICU transferring of high risk infants or mothers high risk and long term outcome 1980S, extracorporeal membrane oxygenation(ECMO)
Historical Perspectives ➢ Emergence of neonatal Intensive Care (1971~1989) - 1971, continuous positive airway pressure (CPAP) --Gregory - neonatal intensive care unit (NICU) - designated by level according to the intensity of service I: normal birthing and NB care, II: common obstetric complications & intermediate NB care III: high risk maternal care and NICU - transferring of high risk infants or mothers - high risk and long term outcome - 1980s, extracorporeal membrane oxygenation (ECMO)
Historical perspectives Expansion of Clinical Trials to Assess Therapy the Surfactant Era (1980-1996 1970s-1990s, glucocorticoids to accelerate lung maturation 1980, first surfactant replacement therapy in humans total parenteral nutrition (TPN high frequency oscillators inhaled nitric oxide prenatal diagnosis and genetic counseling prospective, controlled clinical trials for intervention quiet premature nursery'"a bustling space station
Historical Perspectives ➢ Expansion of Clinical Trials to Assess Therapy: the Surfactant Era (1980~1996) - 1970s~1990s, glucocorticoids to accelerate lung maturation - 1980, first surfactant replacement therapy in humans - total parenteral nutrition (TPN) - high frequency oscillators - inhaled nitric oxide - prenatal diagnosis and genetic counseling - prospective, controlled clinical trials for intervention - “quiet premature nursery” to “a bustling space station
Le Tour d'abandon (Decertion Tower)
Le Tour d’abandon (Decertion Tower)
CENTURY QE DR。sR Century of Progress International Exposition Chicago Worlds Fair, Chicago, Illinois 1833 1933 LVING BABIES ARIS XIRATOR WORLD FAIR
Century of Progress International Exposition Chicago World's Fair, Chicago, Illinois
画哪 ,,.dozens of faces peered at her curiously
1s·H· Julius hess quiet premature nursery The Dionne quintuplets May28,1934, 13 pounds 6 ounces, All together! me
The Dionne quintuplets May 28, 1934, 13 pounds 6 ounces, All together! Emelie, Cecile, Marie, Annette, Yvonne Julius Hess “quiet premature nursery
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