Biomedical subjects
Publications and source records attributed to Debbie Fraser Askin.
The liver is the largest organ in the body and is critical to a number of metabolic, regulatory, and detoxification processes. These include the production of bile, metabolic processing of nutrients, synthesis and regulation of plasma proteins and glucose, and biotransformation of drugs and toxins.
Explore the source record for details and available documents.
The transition from fetus to neonate is a time of significant physiologic adaptation. In addition to the normal physiologic tasks of transition, some neonates must also cope with underlying congenital abnormalities, birth injury, or disease. Careful assessment and astute nursing care are needed during the period of transition to ensure that the neonate who is experiencing problems with transition is recognized and appropriate interventions are initiated. This article examines the physiology of transition and discusses factors placing the neonate at risk of illness. A plan of care for neonates experiencing symptoms of underlying disease during transition is presented.
The liver, the largest organ in the body, performs many essential functions, including the storage and filtration of blood, production of bile, regulation of plasma proteins and glucose, and biotransformation of drugs and toxins. Many neonates display signs of hepatic dysfunction such as hyperbilirubinemia, hepatomegaly, or elevated liver enzymes. Primary liver disease in neonates is rare; much of the liver dysfunction seen in the neonatal period is secondary to systemic illness such as sepsis or hypoxic injury. It is important for the clinician to have the skills and knowledge necessary to distinguish intrinsic liver disease from liver dysfunction resulting from extrahepatic causes. Early intervention to address the cause of dysfunction is critical to successful management of liver disease. This article reviews the assessment of liver function in neonates and examines the techniques used to diagnose liver dysfunction.
The liver, the largest organ in the body, is critical to a number of key metabolic functions. Its also plays an important role in removing the waste products of metabolism (particularly ammonia) and in detoxifying drugs and other substances such as endogenous hormones and steroid compounds. In addition, the liver plays a major role in the production of clotting factors, plasma proteins, bile salts, and bilirubin. Many neonates display signs of hepatic dysfunction such as hyperbilirubinemia, hepatomegaly, or elevated liver enzymes. These often occur secondary to systemic illness, such as sepsis or hypoxic injury, or following the use of drugs or parenteral nutrition to treat other problems. Although rare, primary liver disease does occur in neonates and must be recognized promptly, with treatment initiated in a timely manner to prevent unnecessary sequelae. This article, the third in a series on the liver, examines causes of liver dysfunction in neonates, beginning with an overview of jaundice and hepatomegaly and moving to a discussion of specific diseases.
Gastroschisis, one of the more common congenital abdominal wall defects, results in herniation of fetal abdominal viscera into the amniotic cavity. This article discusses theories about gastroschisis etiology, in utero diagnostic tools, delivery options, and postdelivery care. Included are detailed considerations regarding immediate interventions after delivery to support the infant's thermal and fluid management needs and to protect the exposed bowel. Surgical options and postoperative care issues and complications are reviewed, as are respiratory distress and vena cava compression from increased abdominal pressure, nutritional support, and interventions related to the prevention of infection. Giving birth to an infant with gastroschisis is an upsetting experience for parents. Evidence suggests, however, that with today's advances in neonatal care and nutrition and with meticulous attention, the survival rate for infants born with gastroschisis can be excellent.