{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T19:31:43Z","timestamp":1774985503082,"version":"3.50.1"},"reference-count":20,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,10,25]],"date-time":"2020-10-25T00:00:00Z","timestamp":1603584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>The urea cycle is a series of metabolic reactions that convert ammonia into urea in order to eliminate it from the body. Urea cycle disorders are characterized by hyperammonemia, which can cause irreversible damages in central nervous system. We report a series of three newborns presenting irritability, poor feeding and tachypnea. Their first gas analysis revealed respiratory alkalosis. Hyperammonemia was confirmed, and three different enzymatic blocks in the urea cycle were diagnosed. Immediate treatment consisted in the removal of ammonia by reduction of the catabolic state, dietary adjustments, use of nitrogen scavenging agents and ultimately hemodiafiltration. Hyperammonemia is a medical emergency whose treatment should not be delayed. This report aims to highlight the importance of suspecting urea cycle disorders in newborns with aspecific signs of hyperammonemia and respiratory alkalosis, and to sum up the broad lines of hyperammonemia management.<\/jats:p>","DOI":"10.3390\/pediatric12030019","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:21:06Z","timestamp":1604017266000},"page":"77-85","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Irritability, Poor Feeding and Respiratory Alkalosis in Newborns: Think about Metabolic Emergencies. A Brief Summary of Hyperammonemia Management"],"prefix":"10.3390","volume":"12","author":[{"given":"Stefano","family":"Del Re","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aur\u00e9lie","family":"Empain","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Metabolism, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-3519","authenticated-orcid":false,"given":"Alfredo","family":"Vicinanza","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu","family":"Balasel","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Britt","family":"Johansson","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Philippe","family":"Stalens","sequence":"additional","affiliation":[{"name":"Neonatal Non-Intensive Care Unit, Centre Hospitalier de Wallonie Picarde (Site Union), 7500 Tournai, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"De Laet","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Metabolism, H\u00f4pital Universitaire des Enfants Reine Fabiola, Universit\u00e9 Libre de Bruxelles, 1020 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1002\/jimd.12100","article-title":"Suggested guidelines for the diagnosis and management of urea cycle disorders: First revision","volume":"42","author":"Burlina","year":"2019","journal-title":"J. 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