Cardiovascular Problems

whats and when indication echo in neonate under 1000gr ?

hi every one i want to ask questions regarding shock therapy in cardiogenic shock .. i know its beyond the scope of this forum , but iam looking for an expert answer (practical not theoritical) during my cardiology rotation. ive seen a lot of cases in late neonatal peroid or , more commonly early infancy, knowing or suscpected to have cardiological problem coming in compensated shock phase (tachycardic' poor perfusion , normal bl.p weak pulses , sweating and cold extr) , when i examined the liver, frequently i found it enlarged. some has adviced me to give lasix then fluid 10cc /kg .and here i want to ask whats the best approach in this situatio…

hi every one i want to ask about some practical point in managing hypotention . and here is the situations iam facing in every day practice : - delayed perfusion: ( septic chils or R.D ...etc) we dont wait to document hypotention in order to start therapy .. we give N/s then if no improvment we start iontrops so is it ok to manage and to start dopamine while the baby is still normotensive ??? - M.v babies on sedation Iv , we start dopamine to counter its effect even before documented delayed perfusion or hypotention so is it evidence based practice ? we dont have a protocol to follow , instead we adopt a managment plane in different sett…

The AAP committee on fetus and newborn has released its clinical report on PDA in the preterm infant, and it is available on http://pediatrics.aappublications.org/content/early/2015/12/13/peds.2015-3730 It is a short and well-written report. I especially like the headline "Clinical Trial Opportunities" and the following paragraph stressing that "systematic evaluation in clinical trials...are urgently needed to guide management of these infants". In addition to establishing causal effects of ductal shunting, we need to learn much more about benefits and harms related to our current interventions. Highly recommended reading!

hello every one ,, iam now working in the cardiology department and i see a lot of cases with congenital heart disease what we dont have here in my country is a program to enhance nutrition in these ill kids .. so almost for every case we diagnose for ex with big VSD ,, we know for sure that he will be a malnourished child in the next few months my question may be beyond the scoop of this forum but i hope i could find some resources to help me address this problem my goal is to help establishing a program in our unit to maximize the nutrition quality which is definitely will affect the outcome . how can i start ?? do i have to make a study over a certain population…

Professor Nick Evans at the Royal Prince Alfred Hospital in Sydney, Australia, emailed some good news about the education programs "Practical Ultrasound for the Neonatologist". The programs, one on echocardiography and one on brain ultrasound, is no longer distributed on CD-roms, but as digital downloads. Prices have also dropped to only 25 AUD (about 17 euro) + local taxes. The current downloadable programs are the same as anyone who bought the CDs since 2006 would have. Past CD customers are offered a digital license for free and anyone who downloads the programs in the near future before any upgrades are available will also get future upgrades for free. As before, the …

Just learned from the EvidenceUpdates- service that the Cochrane review on Ibuprofen for the treatment of patent ductus arteriosus has been updated. No sensational news really... Here the URL to EvidenceUpdates: http://plus.mcmaster.ca/EvidenceUpdates/NewArticles.aspx?Page=1&ArticleID=62564 And here the URL to Cochrane: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003481.pub6/abstract

I have a neonate with critical cyanotic heart disease on prostaglandin infusion after that perfusion improved Now the kid is hemodynamically stable Cardiac CT confirms Pulmonary Atresia and double PDA supplying lungs Shall we stop infusion? What are all options available for the baby survival?

Just wanted to share a recent and good experience with inhalation of epoprostenol in PPHN. I currently work in a large level2-unit (≈8000 inborn/y) with no access to NO-inhalation. Infants born in our delivery ward with PPHN and needing level-3-care (i.e. NO/mechanical ventilation) needs to be transferred. We recently had a baby with echo-verified PPHN, on CPAP and with saturations around 88-90% on 100% oxygen. While preparing for premed/relaxation and intubation we connected our CPAP inhalation device and inhaled epoprostenol with surprisingly good response! We avoided intubation and transfer. We gave two inhalations about 30 min apart initially, and shortly our…

Has anybody a current guidelines about Ductus. After the report of E. Bancalari et al, and Benitz et al, and after read recomendations in up to date 2013-2014 I am worried about it . Specially in < 1000 gr. < 28 Weeks