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. bimalc

    bimalc

    Members


    • Points

      5

    • Posts

      168


  2. Flavio Martins

    Flavio Martins

    Members


    • Points

      4

    • Posts

      6


  3. Stefan Johansson

    Stefan Johansson

    Administrators


    • Points

      4

    • Posts

      2,756


  4. rehman_naveed

    rehman_naveed

    Members


    • Points

      4

    • Posts

      156


Popular Content

Showing content with the highest reputation since 09/19/2021 in Posts

  1. We don’t deduct conjugated bilirubin from total, exchange is done based on total bilirubin. Exchange is not performed in pure conjugated hyperbilirubinemia , as it does not cross BBB.
    4 points
  2. Do you use Dialysis en extrem preterm less than 500 gr.? In context of anuria (but not after cardiac surgery). Is There an age limit, or a weight limit?.
    3 points
  3. Hi. I'm educational director at CEPS in Sweden, a concept for simulation spread throughout the country. Most of the mannequins used are the basic ones with no feedback. We have the most advanced as well but I find that the information I get from them doesn't give that much additional educational value. In Sweden the T-piece is the device used att neo resuss so I'm not that concerned about pressures. If we see the the chest of the mannequin is raising that is enough for me, they need to evaluate the heart rate in order to evaluate if their ventilation is sufficient. We use Simmon, an app, for simulating vital signs monitors, it's easy to use and totally mobile. You need two tablets. All the best
    3 points
  4. In our unit we categorise our babies into high-risk, medium-risk and low-risk for nutritional management of PN and enteral feeding. High risk, severe IUGR with absent or reversed EDF babies would be 10-20mls/kg/day. We also have guidance about how to manage abdominal distension and aspirates- but there is a definite movement in the research community around stopping "routine" checking of gastric residuals....
    2 points
  5. I have done this in our medical NICU patients who have become de-recruited for any number of reasons, but not routinely on preemies (I mostly work in an outborn NICU that, in many ways, sees pathology closer to a pediatric ICU just in neonates who may incidentally be premature and are often coming to us at or new term corrected or later). No protocol, just recognition that this is an issue and taking the fellow and RRT to bedside and performing a series of recruitment maneuvers either with vent or by hand bagging.
    2 points
  6. Hello everybody, Does anyone use lung recruitment maneuvers during CMV or CPAP to achieve optimal FRC and oxygenation? If so, do you have a procotol and/or any practical tips? I've read some articles and the Cochrane Review, but I'd to hear your opnion.. Thanks!
    2 points
  7. So I think there are two issues here: 1) Why do you think the child is anuric and what mode of kidney support therapy are you proposing to address the issue? (as an ancillary - what is the end point?) 2) Given the size, is your proposed plan even technically feasible? Assuming you mean PD and not CRRT/iHD, https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-020-02092-1 provides some experience and suggests that it may at least be technically feasible. Beyond that, I think you'd need to provide more details on the actual circumstances that led you to want to pursue PD for anyone to sensibly answer your question.
    2 points
  8. We use Coffein citrat 》 20 mg/ ml po/IV for some special individual cases. And we monitor Caffeine Levels, jitterness, tachycardia. We find no close correlation between caf. Levels and high doses. We succed in prevention of intubation most ofen in using doxaprame hydrochlorid.
    2 points
  9. Dear Dmitrij! As it comes to the most important skill, ventilation I would recommend the Monivent Neo Training which can be used with most manikins altough a few might need a simple modification to override the leakage they might have. The company has all info. I agree with Erik that very advanced high end manikins not always give so much additional value. My experience is that they are often too advanced=technical problems, difficult to handle, irritations etc. Regards Pontus
    2 points
  10. We all are aware ,that babies with severe IUGR have a higher risk of NEC, but I think,according to our experience,that this is probably a different type of NEC with different epidemiology and pathophysiology. for example,the onset of the disease tends to be very early, when the baby is NPO or in minimal enteral feedings. I have the impression enteral nutrition does not play a major role in these cases,as in "classical" NEC. we do not have a special protocol for these babies. in the studies of slow vs fast feeds advancements, babies with severe IUGR are frequently included. there is a single study that I remember where they compare IUGR infants with a control group, with the same feeding protocol. the incidence of nec was not different. Greetings
    1 point
  11. Thank you.. Although I haven't found much of a evidence for this approach, we do the same here..
    1 point
  12. We posted a short survey on Twitter about dosing of caffeine. Do you use caffeine (citrate) at a maintance dose of ≥20 mg/kg/day? Do you follow serum levels of caffeine? Take the survey on Twitter and/or share your practises here!
    1 point
  13. I remember a Former 25+2 weeks premie without severe complications who suffered (from insensible water loss because of cutan barrier disturbance) prerenal acute kidney insuffiency und later severe damage at age of 2 and a half weeks. 1150 g. The neonatal/ nephrological Team of an great south german University Hospital tried peritoneal dialysis (with Lot of improvising work on catheters, solutions, leaks, infection) and have succeeed in the end. Respect.
    1 point
  14. We do not use caffeine (citrate) at a maintance dose of ≥20 mg/kg/day. In our NICU, we can not monitor serum levels of caffeine.
    1 point
  15. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009969.pub2/full
    1 point
  16. Baby went home a couple of days ago. Wbc count at the lowest 26k and platelet count persistently above 120k
    1 point
  17. 1 point
  18. Just reading the NICE guidelines on exchange transfusion. This has Bilirubin thresholds for PT and Exchange. https://www.nice.org.uk/guidance/cg98 What it does not currently address is when the Jaundice after birth is predominantly conjugated. AAP guidance in yester years proposed taking off the direct Bilirubin when it exceeded 50% of the total but I have clinically seen cases in India develop Kernicterus even with a predominantly conjugated jaundice in Sepsis. We had a low threshold for exchange transfusion where we thought benefits exceed risks. I am just curious what the practice is in other units with regards to management of a baby with a conjugated hyperbilirubinemia (Conjugated Jaundice exceeding 50% of the total) where the exchange threshold is exceeded. I am aware aetiology and age as well as gestation and stability would govern management but I am talking about babies in the first 96 hours after birth who clearly are being investigated without ABO or RH incompatibility.
    1 point
  19. Dear Colleagues! We have mannequins, but they have no feedback. Does anyone use a medical simulation applications (TruMonitor, InSimu, etc.)? What solutions would you recommend for mannequins upgrade?
    1 point
  20. I think you need to contact the company to see if the versions you have can be upgraded or not . There are expensive advanced new simulators ,that mimics neonates ,that can be connected to the monitors ,and various scenarios can be applied for teaching
    1 point
  21. Repa A, Mayerhofer M, Cardona F, Worel N, Deindl P, Pollak A, Berger A, Haiden N. Safety of blood transfusions using 27 gauge neonatal PICC lines: an in vitro study on hemolysis. Klin Padiatr. 2013 Dec;225(7):379-82. doi: 10.1055/s-0033-1355329. Epub 2013 Oct 24. PMID: 24158888.
    1 point
  22. @Vijaykumar Do you mean that caffeine can lead to leucocytosis? If yes, I was not aware of it Could this be a neonatal leukemoid reaction? I am aware this is a "ruling out" diagnosis, but if all testing turns out negative, it would be a likely diagnosis.
    1 point
  23. I can only speak for Sweden, and to my knowledge, there is no trials ongoing here. In a recent journal club by the Incubator podcast, I heard about this study: https://fn.bmj.com/content/early/2021/06/09/archdischild-2021-321645 Personally, I think the next approach will be admin through an LMA - check out this recent report from ADC/FN: https://fn.bmj.com/content/106/3/336 and listen to this ADC podcast episode: https://podcasts.apple.com/nz/podcast/laryngeal-mask-use-in-neonatal-practice/id333278832?i=1000531465079
    1 point
This leaderboard is set to Stockholm/GMT+02:00
×
×
  • Create New...