Jump to content

JOIN THE DISCUSSION!

Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org

Leaderboard

  1. Stefan Johansson

    Stefan Johansson

    Administrators


    • Points

      418

    • Content Count

      2,585


  2. bimalc

    bimalc

    Members


    • Points

      109

    • Content Count

      150


  3. Francesco Cardona

    Francesco Cardona

    Administrators


    • Points

      93

    • Content Count

      425


  4. tarek

    tarek

    Editor


    • Points

      72

    • Content Count

      132


Popular Content

Showing content with the highest reputation since 10/21/2013 in Posts

  1. One of our fellows showed me these two videos on Youtube, on how to learn brain ultrasound. Both videos are very good! Enjoy Part 1 - anatomy and protocol Part 2 - IVH and PVL
    12 points
  2. I found this consensus on neonatal management of infants born to mothers infected or suspected COVID19. It's free online access. http://atm.amegroups.com/article/view/35751/html
    11 points
  3. Great question, Juan Carlos. I am partial to the VN500, but I'm sure both devices can deliver VG quite well. The problem is that babies don't like to be acidotic. Consequently, there is a problem with permissive hypercapnea in the first days of life in small preemies, because their kidneys are not able to compensate for respiratory acidosis. Therefore, the baby will try to generate a tidal volume sufficient to bring the PCO2 down and normalize the pH. As you know when the tidal volume exceeds the target value, PIP will come down and pretty soon, your baby may be on endotracheal CPAP with
    9 points
  4. I wanted to let the 99nicu community have the first look at my latest video. It is based on a ground rounds talk I gave on delayed cord clamping several months ago. I updated it and added lots of animation. You can find the video by following this link: https://youtu.be/6qA3CVGp5Sw The video is not public, meaning you can not search for it, but you can follow the link to view it. I'd appreciate any thoughts on the video, especially mistakes you see or if you felt anything I said was misleading about the evidence. Post your comments to this forum and I will respond. I'm hoping to make the
    8 points
  5. Check out the , now for the first time as a Virtual Meeting. More info on the attached PDF. Visit the web site for more info and to register: https://www.epiclatino.co/in-english
    7 points
  6. So I've seen LISA done once, I've now done it once, next is to roll it out unit wide in our NICU. See one, do one, teach one, right? I'd like to hear from those of you that have been doing LISA/ MIST for a while now. What is the best tip you have? What do you know now that you wish you had known when you first did LISA? What barriers to implementation did you have when you started? Any feedback is welcome. Also, I made a video for our nurses and respiratory therapists to just introduce the idea. Not too in depth, but something to get our education rolling. See what you think.
    6 points
  7. In Wuhan and outside Wuhan cities, the local neonatologists/Pediatricians reported only a few cases. No severe cases, All of the infants have no symptoms or only mild symptoms,and also,no death cases.
    6 points
  8. We recommend stopping breast-feeding until the mothers' COVID-19 test negative for two times . And also we stop vaccinated the suspected infants until the mothers' COVID-19 test negative for two times in the next 2 days.
    6 points
  9. I visited Hot Topics last year and one of the best lectures (according to me!) was held by Judy Aschner, about the use of sodium bicarbonate being principally useless (and could even have adverse effects). Please click here to read an excellent review article on the topic by Aschner and Poland. Unfortunately only the abstact is available for free, but the article is worth to order! As many other units, we have a strong tradition to consider the use buffer, if pH is less than 7.25 and BE less than -5 (at least in in ELBW infants) The article by Aschner and Poland has been subjected t
    6 points
  10. Hi all, we have published the fifth edition of our e-book “NEOQUESTIONS 1to1” . Please feel free to distribute among your other colleagues to help them gain the knowledge of neonatology. https://docs.wixstatic.com/ugd/92a170_54197b618fb34a39a7702b7679a085ec.pdf With Best Regards NAVEED
    6 points
  11. No electrolytes (except possible Ca) in the first day or so, introduce modest amounts of Na and K in IVF/PN on day 2 or 3 based on diuresis and serum Na level. Closer monitoring is required in ELBW/EPT infants. In my experience in the early going the biggest problem people get into is giving too much free water as opposed to being off on the amount or timing of Na administration. After a couple of days the biggest problem, especially in ELBWs, is that massive amounts of acetate given in TPN to compensate for the normal RTA are not adjusted quickly enough and people overshoot and end up with
    5 points
  12. Dear Mohan, from all studies by the team of Professor Stuart Hooper and Professor Arjan te Pas, we know that aeration of the lungs is the master switch to transistion a baby from placental circulation to autonomous circulation. As long as the placenta is not delivered, there is gas exchange and the newborn receives oxygen-rich blood via the placenta. It is therefore important that the baby aerates its lungs before cutting off placental circulation - to ensure that baby's heart receives sufficient oxygen rich blood from the placenta during transition. When the placenta has been delivered, there
    5 points
  13. I just wanted to share a link about inotropes, a blog post on a British FOAMed* web site: https://www.paediatricfoam.com/2017/01/inotropes-made-simple/ Managing circulatory failure with potent cardio- and vasoactive drugs can be a challenge, and it is necessary to understand the pathophysiology of the problem to choose the right set of interventions and drugs. *FOAMed = Free Open Access Medical Education
    5 points
  14. The NOTE programme (collaboration between ESPR and University of Southampton) are opening a Pharmacology module in June, led by Karl Allegaert and Sinno Simons, using virtual/remote teaching. More information in attachment and via link below 🙂 https://www.espr.eu/news/news-detail/e-learning-neonatology-paediatrics/186 Proposal NOTE module DINA4 v3 (1).pdf
    5 points
  15. The recommendation from the Austrian/German Society for neonatology is as follows: mother COVID-19 positive: isolation of mother and child and no breastfeeding until mother is COVID-19 negative.
    5 points
  16. A collective of the world’s leading newborn brain care providers have come together and launched the https://newbornbrainsociety.org/ (NBS). This new organization is focused on advancing newborn brain care through international multidisciplinary collaboration, education, and innovation. With founding leadership representation from prestigious programs such as Yale, Duke, Harvard, and UCSF, international representation from Canada, Brazil, and Ireland, and parent collaboration through the Hope for HIE Foundation, the goal is to bring together the resources of many programs to move the fiel
    5 points
  17. This is not an uncommon dilemma. We have developed a one paged trigger/ assessment tool for babies who meet criteria for monitoring for moderate or severe encephalopathy. It seems to work most times and one of our fellows is conducting an audit to see if we miss any babies with this tool. Based on this case, it sounds like the baby would have met criteria for clinical monitoring for moderate or severe HIE i.e. prolonged resuscitation and possibly Apgar scores? but not pH or BE related values and we would have then assessed this baby hourly for the first 6 hours of life for clinical signs
    5 points
  18. For those of you having follow-up clinics with children born preterm and affected by BPD, check out these European guidelines. A very thorough document. In short, most recommendations (screen shot below) are graded as low or even very low evidence. So there are lots of room for good research! Find the full document here (and yes, it is available as open-access): http://doi.org/10.1183/13993003.00788-2019
    5 points
  19. Hello, I am paediatric trainee currently working in Level 2 NICU in UK. I am doing the journal club presentation about the use of LMA for administration of surfactant in preterm babies. During my previous placements in Level 3 NiCUs, I never seen anyone using LMAs and I was wondering what experience do the rest of you have with using LMAs in neonates. What training did you undergo? Thank you. Lenka
    5 points
  20. This is great! Thanks so much. I was in Toronto for the NeoHemodynamics 2018 Conference and Workshop and one of the main take-home messages was that both transitional hemodynamics and knowledge of its physiology are key to tailoring therapeutic interventions both in preemies and term babies. The slides from the talks are available at neohemodynamics.com
    5 points
  21. Dear colleagues! Monday Jul 20th 2020 the first successful LISA procedure was made in NICU of Multiprofile Hospital for Active Treatment Pazardjik Bulgaria. Baby girl 28 weeks, 950 grams from mother with chorioamnionitis. Still on CPAP (no ventilation), no Dopamine, looks well, few apneas. I know that nothing is certain but it is a step towards the right direction. Congrats to our team!
    4 points
  22. Friends, I am glad to share that an article of mine about racial disparities, titled 'I Can't Breathe' was just published. Here is the link to the full text of the article (the full text is not available if you go through the journal website). Please share widely - I hope it stimulates action by readers to reduce racial disparities in care and outcomes in the field of perinatal and neonatal care. https://rdcu.be/b6cgM
    4 points
  23. https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.15495 With kind permission from Luigi Gagliardi. And as mentioned: the "official" accepted Ms. It is marked as "free download", so it is perfectly legal. (As soon as the final version is available, I will post the link )
    4 points
  24. Join experts in the field of neonatal neurology as they speak on clinical and research guidelines, educate on new techniques, and answer your questions! April Speakers: April 2nd: Betsy Pilon - Supporting HIE Families April 9th: Seetha Shankaran, MD - Hypothermia for HIE, Updates and Controversies April 16th: Gerda Meijler, MD - Neonatal Head Ultrasonography: How to Scan a Baby, Normal Anatomy of the Neonatal Brain April 23rd: Linda de Vries, MD - Neuroimaging in the Full Term Infant April 30th: Trainee Session RSVP below to confirm your attendance
    4 points
  25. hi.i live in iran,i have two neonate that mothers are suspected covid -19,what s advice for breastfeeding and vaccination?!
    4 points
  26. I'd like to clarify that comment a bit: Chile is entering its 6th week since the first COVID19 case was detected. There are areas with a high number of cases, so partial lockdowns are being put in place for 2 to 3 weeks. Those are being lifted (or not) depending on the number of new cases on a daily basis. There is an issue with availability of testing as is the case with most LA countries, but Chile is steadily increasing PCR testing availability country-wide. Recently, universal use of face masks when outside of home was recommended and made mandatory when using public transportation o
    4 points
  27. Final video version now public on YouTube. Please share with interested colleagues.
    4 points
  28. I just got this email from Dr's Meg Kirkley, Clyde Wright and @GauthamSuresh in the US - they are aggregating Neonatal Covid-19 literature to a spreadsheet. A fantastic initiative! Find the continuously updated spreadsheet here: https://docs.google.com/spreadsheets/d/1L9tsrLn9a7LMql_nnUfMA3uS1SSurrj4XUh2yT2bEUc/edit#gid=1867332198 Please find the full email below. Big thanks to Meg, Clyde and @GauthamSuresh for this iniative! _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ We have a resource to share!!! Meg Kirkley (Assistant Professor here in Colorado) and I
    4 points
  29. Dear sir Normally one starts off with I:E ratio of 1:2 or in some ventilators represented as a percentage like 33%.what it means is if you have selected a frequency of 10Hz( resp rate of 600) then total Ti for a single breath would be 0.03 seconds. Remember that this IE is for each oscillation and not for recruiting breaths (that has a separate entry parameter) This conventional 1:2 comes from the expiratory time constant which is twice as long as inspiratory. For a given MAP if i am able to manage oxygenation i would not touch on the IE ratio.if you feel that you are not able
    4 points
  30. This new paper just came onto my radar - on "State-of-the-art neonatal cerebral ultrasound: technique and reporting" in Pediatric Research. Great read! (and if those of us who cannot read, we can look at the pictures like the one below 😛 ) Open access here: https://www.nature.com/articles/s41390-020-0776-y
    4 points
  31. I find these posters very helpful as well. We will all have to look after eachother in the upcoming crisis. https://www.ics.ac.uk/ICS/Education/Wellbeing/ICS/Wellbeing.aspx?hkey=92348f51-a875-4d87-8ae4-245707878a5c #staffwellbeing
    4 points
  32. British Association of perinatal medicine has issued guidance today https://www.rcpch.ac.uk/resources/covid-19-guidance-paediatric-services Sent from my iPhone using Tapatalk
    4 points
  33. UK is not that drastic in isolating neonate from mom https://www.rcog.org.uk/en/news/national-guidance-on-managing-coronavirus-infection-in-pregnancy-published/
    4 points
  34. @Jose Ramon Fernandez thanks for sharing this link - very helpful.
    4 points
  35. We use this system on an ongoing basis. Very comfortable and does not damage the nasal septum.
    4 points
  36. Oh well, so many thoughts after reading this article! Thanks for sharing! Although I agree with every word she says, I think that we should keep in mind that she describes the American reality, which in many ways may be different from European experiences. In many (most?) countries in Europe, we are privileged to have a generous parental leave and (rather) well-coordinated healthcare system. It doesn't change the fact that becoming a parent in the context of the Neonatal Intensive Care Unit must be extremely challenging- and we need to recognize the need to support NICU parents not only d
    4 points
  37. In Linköping we have developed a structure on how to do this in deliveryroom on ELBW less than GW28. It works pretty well if you manage to deal well with the logistic. Receive on the foot-end of deliverybed between the legs of the mother, put the baby in a nest covered by plastic, using a mobile Neopuff with humidified warm gas, Starting with CPAP only awaiting the respond of heartrate and spontaneous breathing, ventilating only if bradycardia, delayed cordclamping. Incubator Close to the bed, connected to mobile CPAP/Ventilator. If intubation immediate Surfactant instillation. We have planned
    4 points
  38. Found this discussion on Researchgate! Did not know they also had a forum there. Lots of good comments. I was taught during my training that reducing dead space is the reason for vittring tubes. But as pointed out, the volume of the cut tub piece is so small that it would have no practical significance, even for an ELBW infant. But I still do it, it is in my ”auto-pilot”... https://www.researchgate.net/post/Will_it_be_better_to_cut_the_ET_tube_a_few_centimeters_after_tube_is_in_place_and_then_place_the_connector
    4 points
  39. For infants in need of follow up - criteria for our follow up program with neurodevelopmental examination at term, corrected: 3 month, 1 year, 2 year and 5,5 year - we do an examination according to Hammersmith neurological examination. At those intervals we then do Hammersmith, Alberta infant motor scale, Bayley and physical examination by a neonatologist and a physiotherapist and for Bayley a developmental psychologist. For infants with known cerebral injury we also do brain stem audiography and a refferal to an occupational therapist. / Stina, Karolinska University Hospital, Stockholm Swede
    4 points
  40. @Lenks Concerning hypercalcemia (total Calcium of 12 mg/dL is our cutoff for IV saline 10-20 ml/kg with 1 mg/kg lasix. A persistent hypercalcemia in-spite the lasix and total Calcium above 14 mg/dL we would consider glucocorticoids. No experience with bisphosphonates. Calcium intake should be thoroughly reviewed. Although day 7 is early for subcutaneous fat necrosis to cause hypercalcemia, but checking for sites of it could be advised, Further lab. data to know the etiology: ionized calcium, pH, albumin, phosphorus, alkaline phosphatase, PTH, urine sample for spot calcium/creatinine ra
    4 points
  41. Dear all, Karolinska University Hospital has published their tube taping practise on Youtube. @Karolinska and Anna Gudmundsdottir - thanks so much for sharing! Nasal tube fixation Oral tube fixation
    4 points
  42. This is a Spanish paper done in Mexico. A transversal research based in an electronic poll sent to Neonatologists and Pediatricians who work in NICU's in the country. We asked them if they were familiar to definitions about orthotanasia, euthanasia, limitation for the therapeutic effort and dysthanasia and which were their usual decisions with babies in end-of-life situations, their relations with families of this babies and then in the discussion we wrote about the changing in the way to manage this stage in terms of adequation instead of limitation in the therapeutic effort. RN etapa termi
    4 points
  43. Hi All, I am working as part of a student-team at the University of Cambridge on the idea of developing wireless sensor technology for neonates in the NICU. The overarching goal of this is to progress the technology to a point where it serves to reduce the barrier to kangaroo care. In addition it is hoped the lack of attached wires will have a positive impact on the delivery of care from NICU nurses and doctors in emergency situations. There is also potential to develop the technology to be useful to low and medium income country NICUs. As part of the development we are trying to get
    4 points
  44. This is an interesting dialogue. I just had a long disuccussion about fluid management from the delivery room with our neonatal response team nurses. They see quite a bit of variability from our physicians. When we talk about fluids on the first day, we are usually thinking of so much more than just the dextrose/ nutrition containing fluids. We have to consider the "to keep open" fluids running in additional lumens of our UVC and UAC lines. Premature babies are often on antibiotics the first 2 days. Some get saline boluses or blood products. It is very easy to give 20-40mL/kg/d of fluid above
    4 points
  45. Here are some articles which may help to decide initial settings for duopap on Fabian ventilator. Duopap in vlbw RDS china study 2014.pdf Duopap review article.pdf
    4 points
  46. Our guidelines in Sweden (infpreg.se) is to give oral acyklovir, 10 mg/kg x 4 over 14 days when VZIG is delayed. I guess the same would apply if VZIG is not available at all.
    4 points
  47. Here is a bundle we use for skin care in ELGANs below 24 wks. I will not be able to provide supporting articles to most of what is done for this population and written here below. Hoping you can find it useful for your team and ELGANs. Resuscitation: · Receive baby in OR sheet (pre-warmed) and place in plastic bag from the OR sheet. Plastic bag an opening to deliver the head from the bag (pre-made) and an opening to over the umbilical stump to be made. Try to keep the bag closed as possible. https://www.ncbi.nlm.nih.gov/pubmed/24042134 · Incubator to be pre-worme
    4 points
  48. Hello! 1. We have used HFO + VG for some years in our unit. We very often use HFO from start in extremely preterm and not as rescue-treatment. Our experience is good and they tolerate HFO well. I find it easier to control pCO2 with mild permissive hypercapnia in HFO+VG compared to HFO or CV. I think it is definitely an option to use HFO in the first place. But you should make sure that you and the rest of the staff is on the same level there and do some reading first. The frequency in extremely premature babies should be 10-15. We usually start at 10 and probably beneficial to the smalles
    4 points
  49. We for maternity ward stay for infants at 35+0 wks and onwards. I don't know the exact NICU admission rate for 35+0 -- 35+6 infants but the majority stays only at the maternity ward for ~4-6 days, until feeding works and till we know there is no signif jaundice. The midwifes usually add a followup visit after another few days to check weight, jaundice, feeding etc, and then the family only goes to the regular well-baby-clinics (as any other infant) But, we need to support (from the NICU) with planning etc, sometimes we invest relatively much time to make this work. But we feel that non-se
    4 points
  50. Caffeine has been used for over 30 years to treat episodes of apnea in preterm infants. Caffeine citrate is considered one of the most safety and effective drugs, with few or no side effects, used in our Neonatal Intensive Care Units (NICU). Many randomized studies describe the use and benefits of caffeine in the preterm population. Studies based on caffeine prophylactic use in preterm infants, as well as new indications out of apnea of prematurity have been recently published. Despite being one of the drugs most used in our NICU, are not yet available clinical practice guidelines and
    4 points
This leaderboard is set to Stockholm/GMT+01:00
×
×
  • Create New...