Respiratory Disorders

Hi All, I am looking for information about orally feeding infants while on nasal CPAP. What are your NICU's doing? Does anybody know of any research supporting it or not supporting it? We have twins (ex-25 weekers, now 44 weeks GA) who have not been able to tolerate transitioning to nasal cannula. They remain on nasal CPAP and our medical team is asking about oral feeding. I would welcome any information that anyone has. Thanks!

Dear colleagues..... We havd been confronted with three neonates with Tracheal atresia , all have died in few hours time...if any experience with such cases..would be much appreciated... Thanks

dear colleagues.... any body have an experience using MgSo4 in treating newborns with pulmonary hypertension ? thanks

Dear Colleagues, An request from Ecuador: I would like him to help us to design a strategy of alveolar recruitment early for RDS and if it is possible to use of entrance HFOV for this same illness. Sincerely, Fernando Agama C. Neonatology Hospital Dr. "Enrique Garcés" Quito-Ecuador

Have a premie who underwent surgical ligation of PDA, and several weeks later, shows significant elevation of the left hemidiaphragm. Has been stable on CPAP, but have not been able to wean the pressure. Had some difficulty extubating in the post-op period, but aside from the issue of the diaphragm, had a relatively uncomplicated post-op course.

Dear 99ers, i was wondering, what your practice is regarding patients with obstructive lung pathology, for example atypic varicella pneumonia, who need inahalative therapy with nebulized Albuterol (Ventolin) and are ventilated with high peak pressures >30cmH2O and high peep around 8cmH2O? My thesis is that every time one disconnects the patient from the ventilator to connect the nebulizer, one predisposes the patient for derecruitment of lung volume (atelectasis). My question is if this practice brings more harm then benefit for the patient? I am wondering what others do regarding that matter. Does anyone use inline nebulizing systems, which allows the system (n…

Would anyone be willing to share their evidence based protocol or guideline for the Infant Flow SiPAP? Owen's 2008 survey of UK NICU's use showed that 36% of those that responded used SiPAP. I have looked at the available evidence, but I also need to review existing protocols/guidelines. Given the relatively small amount of evidence, it may be fair and reasonable to include information on the "who, when and how" from other NICU's who have had more experience with SiPAP. If you are interested and can help, please email me andrew.shearman@mater.org.au Thank you.

Does anyone use Pulmozyme in their NICU in patients with atelectasis? Thanks, Beau

Please read this article and then answer my questrions: Should we administer antenatal steroids to mothers preganat 34-37 weeks planned for elective CS? Bastek JA, Sammel MD, Paré E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008 Oct;199(4):367.e1-8.

Dear 99nicu friends Please give your comments on this pioneer study. J Pediatr. 2008 Jun 3. [Epub ahead of print] A Randomized Controlled Trial of Theophylline Versus CO(2) Inhalation for Treating Apnea of Prematurity. Al-Saif S, Alvaro R, Manfreda J, Kwiatkowski K, Cates D, Qurashi M, Rigatto H. Departments of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada. OBJECTIVE: To determine whether inhalation of 0.8% CO(2) in preterm infants decreases the duration and rate of apnea as effectively as or better than theophylline with fewer adverse side effects. STUDY DESIGN: A prospective, randomized, control study of 42 preterm infants of gestati…