Today was a varied day. Because the nurses on the night shift had noticed that a baby on the ward was not feeling well, the doctors took a look this morning. In fact, it responded only very sparsely to touch and kept its eyes closed. Its skin colour was relatively pale and it had tachypnoeic episodes. Blood gas analysis showed mild acidosis and lactate was minimally elevated. In neonates, sepsis does not present with fever, as is often the case in adults. To be sure and to counteract a possible late onset sepsis, the baby's blood was drawn for a blood culture and then an antibiosis of flucloxacillin and gentamicin was started. Presumably, the newborn had become infected with skin germs via his umbilical catheter.
Afterwards, I attended the ward rounds again. The newborn with the asphyxia got a cranial ultrasound. Apart from a few slight subcortical lightenings, which need to be observed further, there do not seem to be any abnormalities so far. More details can only be given after the MRI on the 5th postpartum day. The EEG also shows no convulsions so far, but it is still too low voltage (the lower peaks of the blue EEG bands should be at least 5). The doctors cannot yet say whether it is due to the asphyxia or the medication, including midazolam and morphine. We were also a little worried about the baby's sparse micturition. Fortunately, an ultrasound of the bladder showed that only the catheter was not in an optimal position.
Furthermore, today I was allowed to watch a blood draw from an artery with a special blue light lamp.
The EEG of the baby with asphyxia.
A good reference book on the subject of EEGs in newborns. Linda S de Vries still actually gives student lessons at LUMC since her retirement.
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