Respiratory Disorders

I would welcome comments/suggestions from my neonatology colleagues on a specific issue of weaning of postnatal steroids in chronic lung disease. We use low dose dexamethasone, 120mcg/kg/day to help babies come off the ventilator if they seem to be stuck. In rare situations if babies respond only partially, we increase the dose to dexamethasone and try to extubate the baby e.g we will go to 250mcg/kg/day. Following the extubation, on to cpap or biphasic, if after few days baby seems to be going backwards, we sometime increase the dose of dexamethasone to prevent baby going back on the ventilator. So e.g if baby who is on 50mcg/kg/day on CPAP and FiO2 goes up signific…

I know that all of us use some sort of Nasal CPAP support in NICU. And as we get to learn about it, the more we prefer it to conventional tracheal intubation and ventilation. I have often noticed that sometimes preterm babies keep their mouth open (intermittently) while on Nasal CPAP support. I am sure that will cause loss of pressure transmitted to the airways distal to the nasopharynx. I wanted to know how our colleagues around the world deal with this issue. Do you have any protocol to ensure that babies dont keep their mouths open? I am very eager to find out. And if possible you could post some photos in this forum of how you enforce your protocols.…

hello every one .. i found this words ( lung recruitment) difficult to understand and to apply in the real practice any one has experience to aplly the manuever? thanks

I just had a LGA term baby born through shoulder dystocia; noted with respiratory distress shortly after birth. Placed on HFNC, need ~35% FiO2 on 2 LPM. Xray with right hemidiapragm elevation. Question: How long is prudent to wait for surgical intervention in these babies? Thanks

I wonder about hands-on experience with sildenafil for ex-preterm infants with severe bronchopulmonary dysplasia. The literature is not very convincing, seems that right ventricular strain improves (echo) but that clinical benefits (the babies!) is less clear. http://www.ncbi.nlm.nih.gov/pubmed/25824807 http://www.ncbi.nlm.nih.gov/pubmed/25796626 http://www.ncbi.nlm.nih.gov/pubmed/21941230 Please share your comments and experience!

Why on HFO we can manage a larger leak better than conventional ?

is it necessary to restrict ivf in case of RD in neonate "FT or PT" in 1st 48 h on NCPAP inspite of humidifier presence.

We have a new Babylog 8000 plus ventilator in our NICU for the first time and I have 2 questions about it: 1- What is the commonly used values regarding volume triggering ? 2- what is the acceptable percentage of leak ? ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ Mohamad Ismail, Neonatology resident, Mansoura, Egypt .

We are trying to implement VAP (Ventilator associated pneumonia) protocols in our NICU including elevating head of bed. Questions: Do you apply your VAP protocol to only intubated babies, all babies on oxygen, or babies on any heated oxygen source? Also, what do you use for oral care? If you have evidence to support your practice, I would greatly appreciate it. Thanks, Elizabeth Curry

FT baby delivered elective CS and develop respiratory distress for 3 days , after that we noticed poor activity and suckling reflex CBC , CRP -ve perinatal Hx -ve do MRI brain revealed basal ganglia calcification only what is possible diagnosis????