Respiratory Disorders

Term AGA baby was noted to have mild stridor on D2 of life . On D3 baby developed acute worsening of stridor with desaturation. No h/o birth asphyxia, trauma, intubation CXR,CT Thorax and neck wnl. please discuss management . we dont have facility for laryngoscopy.

Hi dear friends... I'm looking for advice. Our Hospital is facing a hard financial time. We use Survanta as our brand surfactant. Administrators wants to buy a cheaper surfactant ( Richet... from Argentina ) . We want to make sure we are using in our babies products that are safe and effective. Really concern .... Wellcome your opinions. Kind Regards... Leonora.

Good Morning 99Nicu, I would be grateful for an educational leg up! Very often a term PPHN is normocarbic yet we struggle with PaO2. What are the underlying factors that allow CO2 clearance but fail to enhance PaO2? Best wishes Alistair

New born baby born by elective CS at 38+5 weeks of gestation with B.wt of 3.02 kg. antenatal period was uneventful. Immediate neonatal period was also normal . But the baby has intermittent n frequent fast breathing (RR - 58-64/min) with b/l subcostal retractions. No stridor/ noisy breathing. Feeding well at breast. Chest is clear n cardiovascular system is normal . Your views? Mother is worried !! Wat CAn it be ??

can i take your opnions in this case 26 w GA infant refered to me after 3h after birth so i give him surfanta within 1/2 -3/4 h after thin i start to lower pip and fio2 till reach to fio2 30% pip 12 peep 4 but in 2nd day IVH occur manifest by drop in HB and irritability after bl trx and plasma ,start dopamin on 3rd day baby still on mv stable ,but with no active movement on 4th day start to develop resp acidosis then bring pul hage.............then die i doute about PDA but clinically there is no any murmur,active pericordium , bounding pulsation could i start ibuprofen as regard as he is ELBW, RDS and take surfanta or i must do ECHO first if it is not PDA wha…

Namaste Netters Do you have different or modified INSURE protocols different from what is published by Bohlin et al 2007 or by Dani et al 2004 The questions I would like to ask are What are the indications? Do you use any pre-medication? Fraction of volume of surfactant delivered? Post medications for reversal? How long do you bag after administration of each fraction? How long do you bag after administering the complete dose before reinstituting nCPAP How do you control pressures during administration

We have a 32 week gestation 1.6kg baby referred from another hospital at 60 hours of age. No antenatal steroids given. CXR on day 1 and 2 show established RDS. On arrival, baby on SIMV 24/5 rate 50/minute Ti 0.35 FiO2 60%. Would you suggest surfactant administration at this age? Cost of surfactant is a big issue and I would give only if it is likely to be beneficial. Please opine.

2 days ago we had a case of full term female suffering from sever perinatal hypoxia and 8 hours after birth she had pulmonary haemorrhage , and she died . I want to know what is the appropriate management of pulmonary haemorrhage , and what amount of blood components and fluids shoud i give to a neonate loosing large amount of blood in a short time , thank you . ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ Mohamad Ismail Neonatology Resident Mansoura , Egypt .

We have tried most of treatment modalities in a resistant case of PPHN-including iNO,sildenafil,inotropic support,PG,and eventually iloprost-aerosolized form-....it worked well on conventional dragger 8000 but unfortunately DID NOT on sensormedics.....a technical diffculty-I guess-because of different flow rate.. could you tell me your experience of using iloprost with sensormedics!!! thanks. atef

Dear Friends Please see this link to a recent review article just published. I hope it will be interesting. http://www.dovepress.com/respiratory-management-of-the-preterm-newborn-in-the-delivery-room-peer-reviewed-article-RRN