Respiratory Disorders

I would like to hear about your choices when it comes to diuretics as BPD treatment. Which drugs and doses do you use?

PPHN could be idiopathic or secondary and leads to increased pulmonary vascular resistance.There is no clear consensus on the management of PPHN. The goals of treatment are to improve oxygenation, reduce pulmonary vasoconstriction, maintain systemic Blood pressure and perfusion and pulmonary vasodilator therapy. How do you manage a term newborn baby with PPHN in your institution? Please note that multiple options/replies can be ticked.

We currently use sterile water in our Fisher & Paykel Bubble CPAP system. We have noticed a lot a rain out lately in our circuits, with some of our infants getting "lavaged" at times, and are somewhat worried about infection. What liquids are other NICUs using in their BCPAP systems - 0.25% acetic acid, vinegar mixed in the water, etc, and has any one noticed increased infection rates because of this rain out in the circuits?

Is a male newborn at 34 weeks gestation with respiratory distress without infecting circumstances. Caesarean section on labor started. He comes from the twins pregnancy, he is the second born and sister is without symptoms. What suggest the radiologic image?

I would love to hear your local practice in regards to repeated doses of surfactant in neonates with respiratory distress? The study publish by Soll in cochrane showed benefits of multiple vs single dose, but the RCT were done in the 90's when gentle ventilation and antenatal steroids were not standard in the NICU! What do Neos across the world do in this regard? If you do repeat the treatment, what is your criteria? GA, time after birth, degree of respiratory distress or respiratory modality? Thanks for you feedback on this interesting topic. I am a neo neo trained in the post surfactant era, support trial and nCPAP to treat very small preemies with RDS, so is not ha…

I would be grateful for thoughts from members regarding what appears to be a creep of use of nitric oxide for the extreme pretermers based on little more than earlier anecdotal successes. Regards Alistair

Again from spain¡¡ helow¡¡ Has anybody experience in nasal VAFO?. Thank you.

Age of the baby--- 57days Salient features-- 1. Operated case of Tracheo-esophageal fistula 2.Right vocal cord palsy with restricted movements of left vocal cord with tracheomalacia 3.Acute life threatening episodes (desaturations) 4. Excessive respiratory secrestions and Recurrent, migratory pneumonia This female baby was born at 34 wks GA by LSCS in view of PROM and BW was 1.9kg. She was nursed in prone position and prepared for surgery of TOF.( Color Doppler of heart showed ASD 4 mm and mild PAH) She was operated for TOF on day 3 of life. There was a blind upper end of esophagus and there was a fistula with lower end of esophagus. Fistula was closed…

Dear colleagues, do you have experience with surfactant treatment in innate and nosocomial pneumonia? Many thanks for attention.

Hi colleagues, I had the pleasure recently to manage a premature infant (30wks EGA), who was born by precipitously vaginal delivery after mother arriving at the hospital with abdominal pain and vaginal bleeding, (later confirmed to be placental abruption). Good prenatal care, GBS positive in mother's urine 3wks PTD. The female infant was born lifeless, required PPV and chest compression by the bedside nurse and was intubated quickly when the neonatology arrived at the bedside at 2 MOL. Apgars 1,3 and 7. Infant was brought to the NICU placed on CMV initially at 20/5, then increased to 25/5, RR of 40, FiO2 40-60%; suvanta given and PIP pressures reduced slowly to 18/5. BP…