Respiratory Support & Monitoring

Hi Team We are keen to start using end tidal CO2 monitoring in our unit. We currently use transcutaneous CO2 monitoring as standard of care for all of extremely preterm infants who are on HFOV or HFJV but thought that end tidal CO2 monitoring may be more useful for our bigger surgical babies, chronic BPD babies or babies with hydrops fetalis. I was wondering if anyone had a unit policy on the use of end-tidal CO2 that we could possibly review just so that we don't have to reinvent the wheel. Many thanks from Down Under. Richard

The so-called predischarge Car Seat Tolerance Screening is practised in some units, I think it is less common in European NICUs, at least, I have never come across in the Stockholm units where I have worked (during ~30y 🙂) A recent systematic review an meta-analysis came suggested that the NICU stay was extended without clear benefits (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2844812) Curious to know - what is your practise now and will your practise change?

We recently welcomed many extreme preterms (23 24 GA) with particularly complicated respiratory insufficiency. The initial management was ok but secondary degradation often led to intubation and finaly aggressive ventilation with HFO due to high oxygen dependancy. we're used to use NAVA or volume ventilation but these different modes didn't work for our last patients. In the end steroids were attempted but not always successful. Do you have a specific respiratory management in these gestational ages in case of secondary intubation in terms of ventilation mode, general prescriptions...? Thank you for your help,

We just learned, that the Neo Pod T Transporter Humidifier, will not be produced anymore. Which is a big issue for transporting our preemies. To my knowledge there is no other humidifier for transport available. Any thoughts or ideas? Yours Katja

Dear Colleagues The smallest macgills forceps that I can see online is the 6" 15cm (Infant). Is anyone using anything smaller for LISA and or nasal intubations please. Alok Sharma draloksharma74@gmail.com

Anyone here is aware or have a standard operating procedure to share, regarding the use of Microstream capnography in neonates, please?

Hi, As a fellow I would like to learn more about ventilating the preterm infant in a safe setting. Does anyone know about any good neonatal ventilation simulation software, for training and learning different ventilation strategies? Best regards, Gustaf

I was wondering if anyone has come across a good/realistic design for a DIY incubator to be used in a rural low-resource setting to transport premature newborns to a 2nd or 3rd-level neonatal ward. Similarly, could anyone share a link for a low-cost DIY incubator to be used in a neonatal ward (not for transport). Specifically for preterms 33-34 weeks in their first 72 hours of life or for more premature babies (26-32) who are several weeks old and already weaned off respiratory support, and receiving hospital kangaroo care. Basically a design for a safe, heated low-cost DIY incubator design where a stable premature baby can avoid hypothermia while their mother is g…

hi all Can anybody please explain to me the role of I:E ratio if high oscillatory ventilation. and also what is PEEP in HFOV? thanks

We got this email from colleagues in Cambridge UK, looking into novel ways to monitor vital signs and would like to ask all 99nicu members to join a short survey. Please consider to take this survey here: https://cambridge.eu.qualtrics.com/jfe/form/SV_23RCMdtgVhYaFAG