i think it is not only sarnat. We should consider infants had evidence of perinatal depression with at least one of the following: 10-minute Apgar score <5, need for resuscitation at 10 min, pH < 7.00 in an arterial or venous cord or infant gas performed by 60 min of age, or base deficit ≥15 mmol/L in a cord or infant gas performed by 60 min of age. if the baby does not have any of the above criteria in addition to sarnat, can be defined as mild

I think they are not related to each other. if no reaccumulation of pneumothorax after clamping, remove the tube. if fit for extubation, extubate whichever comes first

remove tube first

today, on November 17, is World Prematurity Day. We, being neonatal health care professionals, are much aware of the many unmet needs for preterm newborns. But, for the larger context, there is still much to do, creating awareness of the large public health challenge to reduce the burden of preterm birth. If you have some time today, join the WHO webinar about the launch of a new global clinical practice guide for Kangaroo Mother Care (KMC). Register here!

Background The MPROvE academy is running the Lung and Airway US Course, starting on March 15th and running through to the 15th of May. We will mentor a small group of candidates through the course, combining online teaching, workshops, and interactive discussions. The course covers LUS in 4 modules over three months 1. The Normal Lung 2. Lung Pathology 3. Clinical correlation, diagnosis, and Clinical Approach 4. Diagnostic and Therapeutic Interventions Structure Sessions will be organised weekly to cover a fixed curriculum shared below. Our faculty is quite diverse, including colleagues from the UK, France, UAE, Saudi Arabia, Canada and India. The material can be accessed online on the site, watched live, or at your own time. An overview of the course is on this link: https://lnkd.in/dqYXXCJq POCUS -Course Fee Please email us at mproveonline@gmail.com. Please note that if you practice in an LMIC country, the course fee is discounted. There are 5 scholarship placements only provided through a formal application with your CV, and after due consideration MCQ and Accreditation For those of you who would like accreditation via the course, it is mandatory that you have access to a US machine and can share cases and images in an anonymised way. We will teach you how to do that. At the end of the course, you must give an online exam with a passing mark, which will review the three core parts of the curriculum as outlined above. Testing can be done at any time within the first six months after the module starts.

Background The MPROvE Academy is running a Neonatal and Paediatric Cranial Ultrasound Course from May 22nd through to the 22nd of July. We will mentor a small group of candidates through the course, combining online teaching, workshops, and interactive discussions. A detailed curriculum for the sessions is provided in the attachment. The course covers CRUS in 4 modules over three months 1. The Normal Brain 2. Brain Pathology 3. Clinical correlation diagnosis and Clinical Approach 4. Diagnostic and Therapeutic Interventions The commitment is 60-90 minutes a week for the course period, on a scheduled 2 days of the week. If you cannot attend the live sessions, then the topic will be shared with you online for your review. Peer Review Each session will include time for you to share your cases for online critique, and this is held after the teaching is complete. We will supply you with a logbook to keep your images. More details on the video - https://lnkd.in/die4aW37 POCUS -Course Fee: Please email us at mproveonline@gmail.com to arrange payment. Just so you know, if you practice in an LMIC country, the course fee is discounted. There are only five scholarship placements available through a formal application with your CV, and they are selected after careful consideration. MCQ and Accreditation: For those of you who would like accreditation via the course, it is mandatory that you have access to a US machine and can share cases and images in an anonymised way. We will teach you how to do that. At the end of the course, you must give an online exam with a passing mark, which will review the three core parts of the curriculum as outlined above. Testing can be done at any time within the first six months after the module starts.

I remember consoling myself that day and saying that at least I was fortunate to continue my life cycle .

Would extubate first. Reason being that preterm baby after extubation usually requires CPAP/ NIPPV/HHFNC which do carry some risk of pneumothorax.

After clamping there is no reaccumulation of air, removal of chest tube should be first followed by extubation. It’s my opinion

Welcome to the MPROvE Academy YouTube channel. Over 300 videos covering Neonatal procedures, Point of Care US, Neonatal and Perinatal Ethics, Human factors Training, Quality MPROvEment and much more We have added 50 new videos on point of care US in neonatology Free to watch and lots of new topics covered https://m.youtube.com/%40mprove-multiprofessionalne4091?fbclid=IwVERDUAN6Z7RleHRuA2FlbQIxMABzcnRjBmFwcF9pZAwzNTA2ODU1MzE3MjgAAR6I8xSCw_v-LjD1N9sryNQGTJu055JcfIgzScqZAVSrhMaKbUmGfiBd9MsqtQ_aem_jy3ORcH9qqT2W9XdtU0FeQ

Chest drain is very painful. Opioids are no problem on a ventilated baby. And before Cpap we want to be sure that there no second pneumothorax occurrs. So I would remove chest drain first

Preterm, severe RDS, ventilated, tension pneumothorax resolved with chest drain, no reaccumulation for >24 hours, low MAP, FiO2 25%, off iNO. Which you would do first - extubate or remove chest drain?

@Mohan I looked into the original publication and it seems to be the Sarnat classification. PubMedMild hypoxic-ischemic encephalopathy (HIE): timing and pa...Almost two-thirds of infants with mild HIE have evidence of brain injury on MRI obtained in the early neonatal period. Subacute brain injury was seen in 37% of infants with mild HIE. Neuroprotective t

My question for diagnosing Mild HIE has not been answered as yet.

I really enjoyed reading your thoughtful reflection on the decline of meaningful neonatal engagement on social media. I share your view that the online landscape has evolved, making it increasingly difficult to sustain genuine, thoughtful discussion. Platform fragmentation has scattered users across multiple channels, causing conversations to fade quickly due to reduced visibility and participation. When professionals feel unheard, many gradually stop posting. Algorithms on major platforms also tend to amplify “sensational” or “easily digestible” content over professional dialogue, burying valuable insights under unrelated material. Unlike the early adopters of “Med Twitter,” who once thrived on open and spontaneous exchanges, newer professionals often prefer private spaces such as WhatsApp groups. While these communities foster closer interactions, they also make public dialogue less visible and knowledge sharing more siloed. What Can Be Done? We can begin by reconnecting through emerging communities. Platforms like NICUVERSE could serve as hubs that curate and share content (with permission and credit) from other spaces. Meaningful discussions often arise in the least expected places. In one large WhatsApp group I participate in, we’ve informally developed a “digital” network of advisors, where members can seek advice from senior neonatologists and share insights on recent articles. Even so, most participants remain silent observers. Nonetheless, our aim is to normalize live sharing again and strengthen a culture of participation. A ward of caution: Competition across platforms can stifle progress. Adopting a “curate, don’t compete” approach may be more effective. Offering weekly or monthly digest summarizing key discussions can help reduce platform fatigue and keep professionals connected. P.S. On a related note, I’m sharing a link to a WhatsApp channel I launched almost two years ago for your kind review. If you find the topics engaging or relevant, please feel free to share them on your platform. https://whatsapp.com/channel/0029VaDcch19RZAdAmmwlN2c

Es muy dispar el diagnóstico de encefalopatía leve. En muchos lugares, se monitoriza , pero no se hace Resonancia.

I admit we don't do this in any systematic way. But I found this systematic review, in case it has not come on your radar https://pubmed.ncbi.nlm.nih.gov/38213009/

Can someone give latest update about visual stimulation in premature babies. When to start , what are the contraindications, duration of visual stimulation in a day. Thank you

Register for the webinar here: https://us06web.zoom.us/meeting/register/fAHaXREDSP2h3RqKMbnq4Q Scientific Webinar by Neobiomics We are excited to invite you to our exclusive autumn webinar session, where leading neonatologists will discuss their clinical experiences with probiotics. DATE: 18 November 2025 TIME: 16.30-17.30 CET What to expect: · Prof. Dr. Christoph Härtel, Head of the Pediatric Department at University Hospital Würzburg, will share his team’s experience with probiotics in neonatal care — from early implementation to clinical outcomes. He will highlight key learnings, clinical results, and practical insights from their NICU experience. · Dr. Adam Reynolds and his team recently presented a poster on their NICU’s experience with probiotics at the BAPM British Association of Perinatal Medicine Conference in September 2025. In this webinar, Dr. Reynolds will share insights from the first year of implementation, highlighting both the clinical outcomes and the cost aspects of introducing probiotics in neonatal care. · Connect with fellow neonatology professionals around Europe, learn from each other and share best practices! AGENDA: 16:30: Welcome and Introduction – Dr. Stefan Johansson 16:35: Experience of Probiotics in the NICU at University Hospital Würzburg, Germany - Prof. Dr. Christoph Härtel, Head of the Pediatric Department 16:45: Clinical and Cost Insights 1 Year After Implementation at Royal Jubilee Maternity Hospital, Belfast Health and Social Care Trust - Dr. Adam Reynolds, MRCPCH PhD, Consultant Neonatologist 17:00: Q&A 17:25: Closing Remarks - Dr. Stefan Johansson Seats are limited, so don’t miss out on this opportunity! Register for the webinar here: https://us06web.zoom.us/meeting/register/fAHaXREDSP2h3RqKMbnq4Q We look forward to your participation! Best regards, Neobiomics Team

Register for the webinar here: https://us06web.zoom.us/meeting/register/fAHaXREDSP2h3RqKMbnq4Q Scientific Webinar by Neobiomics We are excited to invite you to our exclusive autumn webinar session, where leading neonatologists will discuss their clinical experiences with probiotics. DATE: 18 November 2025 TIME: 16.30-17.30 CET What to expect: · Prof. Dr. Christoph Härtel, Head of the Pediatric Department at University Hospital Würzburg, will share his team’s experience with probiotics in neonatal care — from early implementation to clinical outcomes. He will highlight key learnings, clinical results, and practical insights from their NICU experience. · Dr. Adam Reynolds and his team recently presented a poster on their NICU’s experience with probiotics at the BAPM British Association of Perinatal Medicine Conference in September 2025. In this webinar, Dr. Reynolds will share insights from the first year of implementation, highlighting both the clinical outcomes and the cost aspects of introducing probiotics in neonatal care. · Connect with fellow neonatology professionals around Europe, learn from each other and share best practices! AGENDA: 16:30: Welcome and Introduction – Dr. Stefan Johansson 16:35: Experience of Probiotics in the NICU at University Hospital Würzburg, Germany - Prof. Dr. Christoph Härtel, Head of the Pediatric Department 16:45: Clinical and Cost Insights 1 Year After Implementation at Royal Jubilee Maternity Hospital, Belfast Health and Social Care Trust - Dr. Adam Reynolds, MRCPCH PhD, Consultant Neonatologist 17:00: Q&A 17:25: Closing Remarks - Dr. Stefan Johansson Seats are limited, so don’t miss out on this opportunity! Register for the webinar here: https://us06web.zoom.us/meeting/register/fAHaXREDSP2h3RqKMbnq4Q We look forward to your participation! Best regards, Neobiomics Team

There’s much to say about Mastodon, and how it is part of a large group of online plattforms / technologies that are connected together, i.e. federated. Here are two short videos about the principals, and see you in the NICUVERSE. Click here to join!

I spent a few wonderful days at jENS 2025. While I had great days at this large neonatology conference, I also checked in into the various social media channels, to find out about missed out things. And realised… the neonatal social media is pretty dead ☹️ In the beginning, we had a pretty basic Internet. It offered the opportunity to search for information unilaterally and connecting people over electronic mail. Later came the embryo of the social web, taking the communication beyond emails. The first multi-lateral gatherings happened on so-called Bulletin Boards, often geeky/niched online spaces where like-minded people found freedom and space to “share and care”, as the saying went back then. The 99nicu Discussion Forum was started in 2006 with such an intention, to build a dedicated online community for NICU staff. The social web, as we know it today, was/is built on scale. I believe the initiatives that developed into the large global platforms had sound intentions, but the magnitude of fast growth required business models and venture capital to sustain. As we all know, there is no such thing as a free lunch. Through massive user bases and algorithms, the typical social media feed selectively promotes content aligning with your own posts. In the early days of Twitter, this worked wonderfully well. I was an early Twitter user and truly enjoyed an engaging and active feed. Back then, Twitter was my primary space for finding and discussing new research publications. However, when the open athmosphere got lost, I decided to log out for good. Large social media platforms will, sooner or later, need to capitalise on you, using your data/content for promotion of advertising content. Furthermore, the social web offers anonymity and automation, enabling less nice accounts to ruin your good feeling about your freedom of speech. “Enshittification”… Coming back to jENS and social media... There are a larger set of social webs now. In addition to “the old” X, Facebook, and LinkedIn, we now have Threads, BlueSky, and Instagram. I checked in myself on all mentioned platforms, browsing the conference hash tags #jENScongress and #jENS2025. The results were indeed disappointing. With the exception of companies advertising their presence, very few posts popped up with professional reflections, questions, and comments about sessions and workshops. Back in the days, it was possible to follow news and views shared as conference "live-feeds" on Twitter, as if almost being there in person. The social media coverage of jENS was nothing but a disappointment. Why this? This variety of social webs has led to fragmentation. Today, there is no natural single space for online instant sharing/discussion. People are spread out, there is no critical mass of niched content / people. What now? As a believer of independent initiatives driven by Greater Good Goals beyond business models, I think there is indeed room for our older and slower 99nicu Discussion Forums. But I would love to have an instant feed like Twitter with focused neonatology content, like my old Twitter feed. A large number of NICU staff has joined BlueSky, but despite my attempt to curate a focused feed, it gets cluttered by pets, politics, and all problems in today’s complicated world. I have nothing against pets, politics, or world problems (the other way around!), but I prefer to get such content through other channels (like regular news media). Some time ago, 99nicu opened “the NICUVERSE”, i.e an own Mastodon server. Mastodon is a self-hosted social media platform that gives full control to you as a user (and to us hosting it). There is a slightly higher threshold to get into how it all works. And, the technical platform is also a work in progress (being open source). But we are all smart people and learn by doing! There are several principal advantages with Mastodon: there are no adverts, no one sells your data, you control your integrity and privacy. I do believe Mastodon to be the platform for a community feed with uncluttered neonatal care content. If you are curious to try this out, register for the NICUVERSE here! I will do my best to contribute with content 😀