Respiratory Disorders

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

Hi there, T/SGA with perinatal asphyxia/DIC/pneumothorax/mas/ sepsis-clinically improving-activity better, no bleeds, pneumo resolved, on SIMV(1:1 vent)-13/4/23(rate) /25%-latest abg-7.6/21/102/22.Respiratory efforts are poor/ ocassional. No sedation, phenobarbitone also stopped . Responds to physical stimuli with respiration going >60. what ventilatory changes do you suggest.

How do you differentiate PIE vs. early cystic BPD? A former 25week preemie developed cystic lung lesions as evidence of chest x-rays at 2weeks of age. The infant was born through maternal chorio, no NAS given, developed RDS, required two doses of survanta and antibiotics started for suspected sepsis, completed 7 days. Initial Hct was 19, infant received multiple PRBS transfusions, but developed pressor-resistant hypotension requiring Dopa/Dobutamine/Epinephrine/Hydrocortisone. A left grade 4 IVH and right grade IVH was noted on DOL2, stable on follow ups. Pt remained on CMV, moderate settings until DOL7 that was switched to HFOC due to requiring significant peak pressure…

Dear colleagues I'd like to know if anyone uses Respironics NM3 monitor, and how reliable it is in premies < 1000g. Your feedback will be highly appreciated.

Kind regards to all. In the NICU of our hospital in the city of Quito, we hospitalized 72 days for a girl who have diagnosed a Congenital Central Hypoventilation Syndrome (‘Ondine’s curse). Almost every day of his life has been connected to a mechanical ventilator. We want to know if anyone has any suggestions as to its management. Sincerely, Fernando Agama C. Unidad de Neonatología Hospital "Dr. Enrique Garcés" Quito-Ecuador