Respiratory Disorders

Hi guys! What's your first choice of ventilation suport for extreme preterm babys after delivery Room? nCPAP, NIPPV or HFNC? Most places I know uses nCPAP. But, the last Cochrane Review (2017) about this issue states that NIPPV reduces respiratory failure and need for intubation, without worsening of adverse effects. Any thoughts? The same goes for post extubation treatment..

Greetings all. Sometimes we have to change caffein to aminophylin and vise versa (due to availability issues). Do you use a loading dose when you change it? Or continue just with maintenance dose? thank you so much

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!

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…

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

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…

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