Respiratory Disorders

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.

I have a a 30 day of neonate with CDH. never been extubated. Got him down to 50% and in 0.5-1ppm of Nitric Oxide. Have tried weaning him slowly of the NO on multiple occasions. Always go into 90% TO 100% Fio2. Already on maximum doses of Sildenafil. Not oedematous on PCAC 20/5 with good CO2 clearance. I cannot get the final bit of NO off. Any strategies from the forum would be greatly appreciated. PS Operated not paralysed synchronising well good drive

I got this on my radar, through the Twitter feed from @EBNEO - whether surfactant could be administered as easy as an oropharyngeal squirt? Have look in the latest issue of @Acta Paediatrica here: http://onlinelibrary.wiley.com/doi/10.1111/apa.14060/full´ And, here's a video demo posted by the article authors:

We would like to share one of our most recent EBNEO commentaries, on the recently published HIPSTER trial on whether HFNC is noninferior to nCPAP. Please find full commentary on ebneo.org

There is some relatively strong data supporting a saturation target at 90-95%, at least during intensive care (level-3 settings) and for extremely preterm infants. This commentary from EBNEO is quite interesting: https://ebneo.org/2017/02/oxygen-saturation-targets-in-extremely-preterm-infants/ However, the studies on saturation targeting has some methodological aspects that is also good to consider. Have a look on a lecture by Barbara Schmidt below, a lecture that problematize the evidence. Further, what shall we target in the majority of preterm infants not born extremely preterm, and cared for in level-2 settings? Like a 31- or a 34-week infant who may need CP…