Respiratory Disorders

What are the present recommendations on use of surfactant in MAS? What is the upper age limit till when it can be used?

Hi Guys, I would like an opinion on HFOV, HFOV+VG as a mode of ventilation for extremely preterm infants. Case: 24 weeks, 600g baby (day2-3) past honeymoon period, on 2x inotropes just maintaining borderline BP. Ventilation: HFOV+VG, Hertz 6, VG:3.3mls/kg. Blood gas was reasonable. The baby was put on this mode as there were apparently issues with CO2 clearance. My experience with this mode is (...use it when nothing works!) limited. I have used it comfortably in term or near-term infants but in an extremely preterm infant, I was a bit shaky. Anyhow, I thought gases are stable and the baby seems to be coping well... let's not rock the boat! Unfortunately, the V…

What approaches are in use around the world for the ventilation of CDH (especially pre-operative on or off ECMO)? Many guidelines continue to list PIP limits based on earlier studies of 'gentle ventilation' improving survival, but these studies were done before significant advances in microprocessors enabled accurate volume targeted ventilation. Given what we know about the importance of volume-trauma as opposed to baro-trauma, is anyone volume ventilating pre-operative CDH and permitting higher peak pressures?

Can anyone share his experience in using iNO in PT with Pulmonary hypertension in BPD Sent from my MHA-L29 using Tapatalk

Given recent results from placebo-controlled trials on inhaled budenoside and systemic hydrocortisone, how do you practically approach the questions on steroid use in your NICU? As you are probably well aware, the NEUROSIS trial (inhaled budenoside) showed some reduction in BPD among survivors, but the 2y followup showed a increased nb of deaths in the budenoside group and no benefit with regards to neurodevelopment (NEJM 2015 and NEJM 2018). The PREMILOC trial found that systemic low-dose hydrocortisone reduced the BPD risk, without a clear benefit on neurodevelopmental outcomes (Lancet 2016 and JAMA 2017). Further, a meta-analysis came out just the other week …

Hello 99ers, how is your experiance with iNO via nCPAP in premies? Do you use it at your ward? We got some good and bad experiances at our Department and i would like some unbiased experiances/opinions from your side before i tell our stories 😀 Best, Lukas

This is a practical question that surfaces in my hoods from time to time - whether to routinely recommend an apnea monitor when discharging extremely preterm infants, and use it during the first months of life (or not!)? Would be great to see how you would do it? Do you have guidelines, or do you decide from family to family?

Can you please share an educational PPT for pulmonary hemorrhage in Neonates ? Thanks

Hello dear where i work, i have seen a lot of babies admitted and treated for pneumonia and a significant number of them have had no maternal risk factors for infection. this point is making a lot of of argument and discussion between us and the obs-gyn team. usually we look for PROM, UTI, Meconium, GBS, prematurity, Chorio. Also we take into consideration other risks like the need for resuscitation and apgar score. Recently , i red an article about the role of multiple vaginal examination as a risk for infection and in another article they were discussing the possibility of vernix as a main factor leading to pneumonia . Now i will formulate m…

Dear All, I would like to ask about your experience with volumen guaranteed mechanical ventillation in case of early onset CLD. We have 24 weeker, who is now 2 weeks old, and having bronchospasms, typical XR signs of CLD, and spontaneous hypoxemic episodes. We try to wean her from MV, but her weight and irregular respiratory activity makes the thing trickier. I was thinking about lowering the PIP, and TV to prevent the further damage, she recieves supportive care for the CLD. I would like to read your experience. Thank you for your answers.