Browsing by Author "Maccioni Romero, Andrea"

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    Hypomagnesemia in newborns with hypoxic ischemic encephalopathy and whole-body hypothermia
    (SOC CHILENA PEDIATRIA, 2020) Maccioni Romero, Andrea; Mena Nannig, Patricia
    In newborns with the diagnosis of hypoxic- ischemic encephalopathy (HIE) treated with hypothermia, metabolic alterations are observed, which are associated with neurological prognosis. Hypo-magnesemia has been reported frequently in the literature in these patients, but it is not measured or corrected in all neonatal healthcare centers. Objective: To evaluate the frequency of hypomagnesemia and hypocalcemia in newborns with HIE treated with whole-body hypothermia and to evaluate the response to the magnesium sulfate administration. Patients and Method: Prospective, observational and descriptive study in hospitalized newborns with the diagnosis of HIE and treated with whole-body hypothermia between the years 2016 and 2017. Serial blood measurement of magnesemia (Mg) and calcemia (Ca) was performed. When presenting an Mg level <= 1.8 mg/dl, supplementation with magnesium sulfate was administered to maintain levels between 1.9 and 2.8 mg/dl. The frecuency of hypomagnesemia, hypocalcemia and clinical evolution was registered. A descriptive statistical analysis was performed, with central tendency measures. Results: Sixteen cases were included, 13 of them presented hypomagnesemia (81.3%), with early-onset (6-36 hours of life), which was normalized with magnesium sulfate treatment, receiving a second dose 4 patients. Six of 16 patients presented hypocalcemia (37.5 %). Conclusions: Hypomagnesemia is frequent (80%), similar to that described in the literature, and should be controlled and corrected early, given its physiological role, in the same way that calcium is controlled.
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    Prenatal diagnosis and early neonatal management of patients with hypoplastic left heart syndrome: experience of a perinatal center
    (2021) Cubillos Celis, Maria Paz; Maccioni Romero, Andrea; Galleguillos Galindo, Constanza; Garrido Sepulveda, Claudia; Martinovic, Carolina; Vargas Innocenti, Paula
    Hypoplastic Left Heart Syndrome (HLHS) is the most common form of functional single-ventricle heart disease. Despite improvements in medical and surgical care, morbidity and mortality remain high, especially around the first surgical stage. Objective: To describe the clinical characteristics of newborns with HLHS, seen at a perinatal referral center. Patients and Method: Retrospective descriptive study of all newborns with pre and/or postnatal diagnosis of HLHS between 2014 and 2019 in the Complejo Asistencial Dr. Sotero del Rio. Medical records were reviewed collecting demographic and perinatal variables, clinical evolution, mortality associated with the first surgery, and survival at one year. Results: Nineteen patients were included. Most were term newborns and 13/19 were female. All had a prenatal diagnosis. Five patients had associated extracardiac anomalies. 16/19 required vasoactive drugs and 17/19 used invasive mechanical ventilation. Seven patients received enteral feeding, without episodes of enterocolitis. The median age at transfer for surgery was 8 days. Thirteen patients underwent the Norwood procedure, with 31% of mortality, and 47% of survival at one year. Conclusions: Neonatal management of patients with HLHS is complex and the multidisciplinary approach is fundamental. Mortality around the first surgical stage of our cohort is greater than the international reports which could be influenced by the absence of fetal therapy and the higher incidence of extracardiac malformations.