Cardiovascular Problems

We are in process of revising our policies on intropes infusion Can I ask my colleagues to share their practice policies regarding the following: 1 - What dose range do you use for Dopamine, Dobutamine and Adrenaline infusion ? 2 - Do you use combination of Dopamine and Dobutamine routinely ? Do you have a fixed ratio for these two inotropes ? 3 - What dilution do you use for Dopamine, Dobutamine and Adrenaline infusion ? 4 - DO you have fixed concentration for these drugs or do you use different concentration based on weight ?

I've been managing a term severe IUGR infant of 760g for the past two days and noticed recently that the lleg where a PICC line was placed the night before is slightly swollen. Unfortunately a 24gauge PICC was inserted. The leg is swollen mainly from the knee down to the foot unilateral, with only slight compacticity in the isolateral thigh, with no redness or increased temp. The opinion of the PICC team is that this is cause by obstruction of the venous flow and close monitoring should be suficient for now. I am concerned about the development of DVT! 1- Have you seen this associated edema in an extemity with a PICC line due to vein flow stasis? 1- Will you monitor the…

There is a very good lecture available as a web cast: professor Nick Evans and "Diagnosis and treatment of PDA - important clinical implications" The company Orphan-europe provides the web cast: you may need to register at http://www.pda-solutions.eu/ (but... I could also connect directly using the link: http://www.orphan-webcast.com/viewer/?presentation=64 )

Dear all, I'd like to forward this link to a web based atlas on congenital heart disease, from Yale Universtiy, US. http://info.med.yale.edu/intmed/cardio/chd/contents/index.html

DEAR COLLEAGUE I WOULD LIKE TO KNOW ABOUT THE EXPERIENCE OF USING ORAL IBUBRUFEN, VS IV IBUBRUFEN FOR CLOSURE OF PDA,, IN EXTREME PRETERM,

Dear all, We are sometime faced with this situation when the mean blood pressure is borderline for the gestational age. However, there is wide pulse pressure thereby decreasing diastolic pressure and contributing to lower mean blood pressure. For example, in a 26 week baby a blood pressure of 35 / 22 gives a higher mean blood pressure reading (26 mm of Hg) compared to 35 / 15 (21 mm of Hg). Would you accept lower mean blood pressure, if the systolic blood pressure is high enough (example 35 mm of Hg in the above mentioned example )

Dear Colleagues, I would be grateful of any existing protocols or clinical guidelines on the Protocol for the management and early identification of subgaleal haemorrhage following instrumental (vacuum) assisted birth.

Hi I need to know about your unit policy in babies diagnosed with simple cardiac murmur at >24hrs of age. What is your approach to such a babies, Do you consult cardiologist to see the baby, or you discharge the baby with cardiology follow up or etc etc. Please share with me any evidence based guideline or policy of your hospital with regards

I guess you may already have read about the paper in Nature Medicine showing that trombocytes contribute to duct closure. A "Research News" note is posted here! Nice paper, not often neonatal research finds its way into a Nature journal! Biologically plausible. Would be interesting to think about how this could be studied in clinical settings? Interventions?

i am working in nicu as a resident. i received a preterm newborn 33 wks born after difficult and prolonged labour. patient had mean BP around 25 after birth. then my teacher asked to administer 2 bolus of normal saline of 10ml/kg. and after that she advised to add adrenaline infusion @0.1 mcg/kg/min. Is it better idea to start with adrenaline rather than dopamoine?