Pontus Johansson Posted October 7, 2020 Share Posted October 7, 2020 Dear collegaues! I´m very curious if things have changed and wanted to ask you all around the globe three questions on ventilation in the DR and also in the NICU? 1. What device do you mostly (only) use? a) Self inflating bag b) Flow inflating bag c) T-piece like Neopuff or other d) Ventilator 2. Do you also use some kind of respiratory function monitor and in that case, what parameter(s) do you primaly take in consideration for adjusting your actions (PIP, PEEP, Ti, Vte, Rate, leak%, other)? Yes/No 3. What adjunct to your ventilatory device do you prefer to start with? a) mask b) nasal prongs c) LMA d) ETT Any other comments? Thank you!🙏 2 Link to comment Share on other sites More sharing options...
Francesco Cardona Posted October 7, 2020 Share Posted October 7, 2020 1c 2 no 3a - might though be different in special situations 1 1 Link to comment Share on other sites More sharing options...
Stefan Johansson Posted October 8, 2020 Share Posted October 8, 2020 1c 2 No 3 depends on the context (pre-birth history, antepartal course, gest age etc-etc) but non-invasive startpreferable. In preterms, we apply nasal prongs and CPAP directly after birth (and soon, there may well be a nasal prongs/device for nasal ventilation, and connected to the NeoPuff/similar ) 1 Link to comment Share on other sites More sharing options...
Aedi Budi Dharma Posted October 8, 2020 Share Posted October 8, 2020 1. C 2. No 3. ETT 1 Link to comment Share on other sites More sharing options...
99nicu.org Posted October 8, 2020 Share Posted October 8, 2020 2 Link to comment Share on other sites More sharing options...
Urban Rosenqvist Posted October 8, 2020 Share Posted October 8, 2020 1c 2 No 3 for an asphyxiated baby: a For a premature baby: b (prophylactic nCPAP) 1 1 Link to comment Share on other sites More sharing options...
Bjorn Valentijn Posted October 12, 2020 Share Posted October 12, 2020 1/ in DR C, in NICU A or Ventilator In NICU Depending on situation and fastest availability. (when baby was on ventilator the ventilator is fastest with mask and I can see all items as suggested in question 2) 2/ In DR not, In NICU when mask is connected to ventilator 3/ A or C, depending on situation. (And I'm a nurse who is not qualified to intubate) 1 Link to comment Share on other sites More sharing options...
TMohns Posted October 12, 2020 Share Posted October 12, 2020 1. DR c, NICU c or d. We don't have heater integrated in our T-Piece setting so on the ward NICU we prefer warm and humidified gas (ventilator) if possible. 2. Not now in DR - we asked for budget to implement RFM next year but it's formal only for research ;-). Main issue is that there is no one with full approval/certification for clinical use in our population. Is well CE (technical) but a grey zone for our purpose (high risk intervention while stabilisation/resuscitation). If we use ventilator we can use measurements from this devices (Fabian). 3. We regularly start with a (facemask) and place the baby as soon as possible on binasal nCPAP with mask (Bi-nasal with flowdriver). In some cases we start with bij-nasal mask and in case of expected difficult airway we use c (LAM) or d (ETT). I would be very intersted in more information about a "legal" RFM for use in our population. Did anyone find a device? And also if someone is using EIT combined with RFM in the stabilisation of premature babies :-) 1 1 Link to comment Share on other sites More sharing options...
Nathan Sundgren Posted October 13, 2020 Share Posted October 13, 2020 1. C 2. No 3. A. mask. I am starting to use an (C) LMA in special circumstances as first line for ventilation. 1 Link to comment Share on other sites More sharing options...
Hamza Posted November 12, 2020 Share Posted November 12, 2020 !. c 2. No 3. a 1 Link to comment Share on other sites More sharing options...
Mfbasir Posted November 14, 2020 Share Posted November 14, 2020 1- a or c 2- except pulse O2 3- musk 1 Link to comment Share on other sites More sharing options...
Emilio Escobar Posted November 23, 2020 Share Posted November 23, 2020 Good evening everyone, God bless you all. 1.- A 2.- No 3.- Mask 1 Link to comment Share on other sites More sharing options...
newborn Posted November 26, 2020 Share Posted November 26, 2020 1. A will be C soon 2. Vte if possible, but usually PIP through non-invasive approaches. 3. RAM cannula if preterm and ETT if indicated for all. 1 Link to comment Share on other sites More sharing options...
Emilio Escobar Posted January 10, 2021 Share Posted January 10, 2021 i see a new devide called NEO TEE, is this sure for terms and preterms babies?. What do you say about Laerdal air bag (with PEEP)? 2 Link to comment Share on other sites More sharing options...
Francesco Cardona Posted January 11, 2021 Share Posted January 11, 2021 17 hours ago, Emilio Escobar said: i see a new devide called NEO TEE, is this sure for terms and preterms babies?. What do you say about Laerdal air bag (with PEEP)? We use the Neo TEE here in Vienna as an alternative for bag-mask-ventilation on our unit. It works, but is a bit more frail and I am not sure about reliability. In studies it does ok. 1 Link to comment Share on other sites More sharing options...
Pontus Johansson Posted January 11, 2021 Author Share Posted January 11, 2021 I´ve never used the Neo tee, but other T-piece resuscitators which work fine, especially in preterm babies but I was a bit concerned reading this article showing that some devices do not deliver set PIP at all times https://fn.bmj.com/content/104/2/F122.abstract A so called PEEP valve on a bag in my opinion does not create a sufficient (or any...) PEEP. You need some kind of device with a flow. Maybe in a term baby using a 500 ml bag and slowly squeezing the bag keeping FRC, but still you don´t know the amount of PEEP. A good adjunct in this situation could be to to use a Respiratory Function Monitor as whatever device you use you don´t know the leakage or more important the tidal volume. Even if the PIP is set the compliance changes and suddenly you might ventilate with to large VTe harming the baby. 2 1 Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now