The first signs of this kind of hemolysis often include jaundice and high bilirubin levels in the baby’s blood (hyperbilirubinemia) [1517]. Dr. Brodman found that the study of history often illuminates G-418 disulfate the meaning of the present and indicates logical possibilities for the future [5]. The history of the development of neonatal crucial care, like that of medical librarianship, has doubtless been influenced and developed by pioneering thinkers. One such thinker and contemporary of Dr. Brodman, Mildred T. Stahlman, MD, was also a leader in education, practice, and research in her chosen field, neonatal crucial care medicine. In 1961, Dr. Stahlman, known as the pioneer of modern neonatal rigorous care, led a National Institutes of Health research project to explore the physiological aspects of the developing fetus and changes that occur at birth [6,7]. At a critical point in her research, Dr. Stahlman made the groundbreaking decision to adapt a scaled-down respirator, a breathing machine originally developed for polio patients, to assist breathing in an infant born with severe hyaline membrane disease, a lung disease seen in premature infants whose lungs have not yet fully developed. The infant, who previously confronted certain death, was able to survive with this first-ever respiratory therapy that gave a viable treatment option for preterm babies with underdeveloped lungs [6,8]. This groundbreaking research led Dr. Stahlman to develop the first modern neonatal rigorous care unit (NICU) at Vanderbilt University or college Medical Center [6]. Today, NICUs have become an essential a part of health care in the United States for critically ill infants and their families, providing constant observation and care for these babies. Premature babies, infants born earlier than thirty-seven weeks gestation (the typical threshold for defining normal gestation) [9], symbolize a high percentage of those cared for by a NICU. These babies often have a variety of developmental issues requiring rigorous treatment. Given the constantly evolving state of clinical research, NICU teams frequently encounter information needs requiring discussion of the medical literature. == The Case == You are a librarian collaborating with the clinical team in your hospital’s NICU, who round at the bedside of a thirty-six-week gestation infant girl. Although the baby was premature, the diagnosis that prompted her admission to the NICU was ABO incompatibility, a condition that can appear in both premature and full-term babies and a part of a broader family of conditions that includes Rh incompatibility [10]. The human ABO system includes four blood groups: A, B, AB, and O [10]. Blood cells of individuals with type A or B blood have small molecules on their surfaces called antigens. The human body generates antibodies against whichever blood group antigens it does not have [11]. Humans with group A G-418 disulfate generate G-418 disulfate anti-B antibodies; those with G-418 disulfate group B generate anti-A antibodies; AB individuals have both antigens so they do not produce anti-A or anti-B antibodies; and individuals with type O blood do not have these surface antigens, so they create antibodies against both A and B [11,12]. If the mother’s blood type does not match the fetal blood type (in the current case, this baby is usually type B and her mother is usually type O), then the mother’s immune system may create antibodies against the fetus’s blood type, which then can travel back across the placenta to the fetus [13,14]. After the baby is born, some of the baby’s reddish blood cells (RBCs) may be coated with Rabbit polyclonal to EpCAM the maternal antibodies, leading to destruction of some of the RBCs (hemolysis, also referred to as hemolytic disease of the newborn) by the baby’s immune system. The first indicators of this kind of hemolysis often include jaundice and high bilirubin levels in the baby’s blood (hyperbilirubinemia) [1517]. Clinicians aggressively treat these symptoms in infants affected by ABO incompatibility, because hyperbilirubinemia can cause serious adverse effects for the baby if left untreated. Such adverse events include kernicterus (brain damage due to high bilirubin), cerebral palsy, or deafness [15]. ABO incompatibility occurs in approximately 15% of all pregnancies, but hemolytic disease of the newborn evolves in only 4%. This condition is usually also more common.