Respiratory Disorders
168 topics in this forum
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I just wanted to share this wonderful lecture that surfaced on my Twitter-radar, I share the Tw-post below from the handle @NICUofThings By Prof Colin Morley, a fun lecture and full of facts, published on Youtube six years ago but much great content still up-to-date!
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Hi everyone, recently I have noticed a practice that is creeping in when it come to the prevention and the management of BPD. It is the use of Azithromycin and Hydroxychloroquine in BPD. While there are three RCTs for the use of Azithromycin, two with positive outcome and one with negative outcome when it come to BPD, it is still an experimental drug. I can not find any articles or studies on the use Hydroxychloroquine in BPD. My concerns are these drugs are experimental at best and by trying them without proper parents counselling which can lead misleading hope for parents and increase risk of side effect and complication without tangible benefits. If an…
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Pototo replied -
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Hi guys, what is your approach to Ventilation Associated Pneumonia VAP? What is your definition? Do you routinely send ETT aspirations for culture? And do you use blinded end catheter? Do you treat colonisation? I am asking because it is a source of continuous excuse to keep babies on antibiotic with no clear benefit very interested in hearing your thoughts
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Mo7 replied -
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I need help to clear a doubt on mechanics of HFOV with VG. We use Fabian ventilator with HFOV. It is known that increasing frequency on HFOV decreases CO2 washout ( although that's not a change we prefer as most of us alter the amplitude for a desired change in CO2). However occasionally we use the VG mode on HFOV ( HFOV + VG). It was recently pointed out by a colleague that if VG is on with HFOV, increasing the frequency has the opposite effect on CO2 wash out as compared to HFOV without VG. Since I was not aware of this I searched for guidelines on this but could not find any literature which clarifies this concept for me. On working out theoretically…
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sujatad replied -
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If preterm baby already given caffeine loading and on maintenance, after 4-5 days want to extubate him , is it enough for him that he already on caffeine maintenance or shall we give him extra dose of caffeine 1-2 hours before extubation to prevent failure of extubation
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bimalc replied -
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We are a group of international neonatologists from various parts of the world with a common interest and goal of improving the knowledge and current evidence regarding pulmonary hemorrhage (PHEM). Pulmonary hemorrhage (PHEM) is a life-threatening event in extremely premature infants. Currently, treatment of PHEM is mainly supportive. There is a lack of conclusive evidence regarding specific management strategy for PHEM because of the rarity of its occurrence and significant mortality associated with it. This leads to a wide variation in care practice across the institutions. Through our survey, we aim to identify the various therapeutic interventions used in managem…
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Hello 99ers, I have recently encountered a difference of opinion as to the factors that dictate the approach to removal of chest drains. One train of thought is that when there is no bubbling or swinging then clamp leave for a period of time, CXR and blood gas and then remove. Another is to simply clamp, leave for a set period of time and if the infant remains clinically stable then remove. Also do you have a set approach of using pig tail or straight as first line use for air leak? Appreciate thoughts on approach and any evidence to support. TIA. Many thanks Alistair
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Dr. Saad Ahmed Seth replied -
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Hello everybody, Does anyone use lung recruitment maneuvers during CMV or CPAP to achieve optimal FRC and oxygenation? If so, do you have a procotol and/or any practical tips? I've read some articles and the Cochrane Review, but I'd to hear your opnion.. Thanks!
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Tamimi replied -
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Does somebody use, the new diagnosis of BPD published in 2019 by Jensen, Dysat, Gantz,Bamat and keszler?? What do you think about? Thanks
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bimalc replied -
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Dear colleagues, do you see post-extubation stridor regularly at your NICU? We recently had 2 quite severe cases of late preterm babies who at that time already were around 40+0 and that only had been on the ventilator for a few hours (1 for minor surgery and 1 for an MRI). They were treated with nebulized adrenaline and corticosteroids and luckily got better pretty fast. How do you treat it? Do you have any protocol on that and do you have a protocol or guideline on how to prevent it like some of our PICU colleagues (i.e. https://secure.library.leicestershospitals.nhs.uk/PAGL/Shared Documents/Post Extubation Stridor UHL Childrens Intensive Care Guideline.pdf )? …
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Bernhard Bungert replied -