Practical Procedures

Anyone have experience with atraumatic lumbar puncture? Does anyone know if there is a needle available for puncture in neonates? After reading this I am very curious: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32451-0/fulltext

There was an interesting discussion in the 99nicu Slack channel, we'd like to share here, posted by @rehman_naveed The following comments reported a similar episode with a UVC, but alternative explanations were the human factor (was the PICC really backed as intended) and the possibility of material stretching (could the PICC line plastic be stretched while backing?) Also, the possibility of PICC line displacement with arm position was also raised (see https://www.ncbi.nlm.nih.gov/pubmed/16758187) If you have further comments to this episode, please share here!

Hi All i was just curious as to whether anyone had any experience with the Vygon micro site & it's successful use in siting double lumen 2Fr catheters in ELBW? Any experience in general would be greatly appreciated! Many thanks RichMaus

Hi All I just had a question regarding the insertion of pigtail intercostal catheters using the seldinger technique. Our unit currently doesn't use pigtail catheters for ICC and we use the traditional method of blunt dissection down to the parietal pleura then entering the pleural space using curved forceps. Some of the Neonatologists in our unit do use the trochar that comes with the intercostal catheters to enter the pleural space. Our PICU colleagues have recently commented about the this technique and the problems they have found with air leaking around the entry site despite adequate securing of the catheter and dressings. They have suggested we switch to using …

Dear Colleagues We have produced videos for percutaneous long line, scalp long lines and umbilical venous and arterial line insertion. They are available on the MPROvE website http://www.wonepedu.com/MPROvE.html There are also videos on human factors. Alok

I am curious. Do you lock your central venous catheters which are not in use? How often do you change the lock?

Hi all There seems to be a wide variation in survival and morbidity in babies < 26 weeks. The data from Sweden and Japan are much better than the ones from rest of the world. I would like to know if any one from Sweden or Japan will be willing to share their protocol in the management of Babies < 26 weeks. Thanks Mike Mike Sukumar MD Rockville USA

Dear all Lung echography is having more and more importance thanks to its pecularities (simple, repeatable, no X ray exposition to the newborn, small time to achieve data), and thaks to its information about newborn disease (TTN vs RDS, PNX). What is your experience?

Hi all We all know NRP recommends using right hand for pulse oximeter probe placement during resuscitation to avoid hyperoxia. How many of you continue this practice in the NICU after admission and for how long? I was surprised to see many large studies did not mandate a specific location for the oximeter probe. Would you be kind enough to share your unit protocol if you have any specific guidelines on this issue? Appreciate your thoughts! Mike Mike Sukumar MD Rockville USA