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

      677

    • Content Count

      2,675


  2. AllThingsNeonatal

    • Points

      202

    • Content Count

      185


  3. Francesco Cardona

    Francesco Cardona

    Administrators


    • Points

      142

    • Content Count

      473


  4. bimalc

    bimalc

    Members


    • Points

      133

    • Content Count

      161


Popular Content

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

  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. It has to be one of the most common questions you will hear uttered in the NICU. What were the cord gases? You have a sick infant in front of you and because we are human and like everything to fit into a nicely packaged box we feel a sense of relief when we are told the cord gases are indeed poor. The congruence fits with our expectation and that makes us feel as if we understand how this baby in front of us looks the way they do. Take the following case though and think about how you feel after reading it. A term infant is born after fetal distress (late deceleration to as low as
    7 points
  7. 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
  8. the first 99nicu Webinar - assistant professor Nathan C. Sundgren will lecture on Delayed Cord Clamping, on May 14, 2020 16:00 (CEST) Nathan C. Sundgren, MD, PhD, is medical director of neonatal resuscitation education and assistant professor of Neonatology at Texas Children's Hospital, Houston, Texas, USA. He is concerned about all things related to delivery room care and has published quality improvement work and clinical trials related to delivery room team communication and performance of resuscitation. As an educator, he seeks to use global platforms to spread
    6 points
  9. 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
  10. 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
  11. 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
  12. It’s been some time since I last posted here. Many things have changed in my life since then- the most important transition being my decision to move to Finland to work as a research fellow with the Baby-friendly Ventilation Study Group in Turku. The life of a beginning clinical researcher deserves a separate post here (it may even come at some point). To celebrate my first anniversary in Finland I would like to share 3 things I wish somebody had told me before I moved here. Enjoy! 1.Get nylon pants. The weather in Finland is truly whimsical. We have had a kind spring, warm summer, and
    6 points
  13. 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
  14. Our tiny babies have very tiny tracheas. So far you are probably all with me. Putting that tube in the right position is therefore tricky. In particular avoiding the right mainstem bronchus, which is the wrong position, is important. So first of all; where should the tip be? That seems obvious, it should be in the trachea, high enough above the carina that the tube never slips into the carina, but low enough that it doesn't slip out. On a plain AP radiograph, however, it isn't always clear exactly where the tube tip should be. In general ,studies have suggested that on the radiograph the tip
    6 points
  15. We will shortly be changing our standardised lipid infusions from syringes to bags which will have a 48hr hang time. Several units in Ireland have already adapted to a 48hr (over several years) hang time for an aqueous bag and we have not noted any increase in infection. Theoretically it should reduce the risk as you are breaking the central line only once every 48hrs as apposed to every day. Despite initial concerns from the neonatal nurses they have embraced the change and are looking forward to changing the lipids to 48 hours as well. The biggest risk is that when the lipids are infused
    5 points
  16. From prof Takeshi Arimitsu, invited speaker at our previously planned Meetup in April 2020 (but cancelled due to Covid), I got an email about an interesting case report from their large neonatal center in Tokyo. They have published about a 268 gram 24-weeker with intact survival. I share the last sentences of the summary below. The publication is available open-access and in full-text here: https://www.frontiersin.org/articles/10.3389/fped.2020.628362/full Looking fw to follow the discussion about this extraordinary case.
    5 points
  17. Time really flies, and it now 15 years ago since we started to plan for the 99nicu forums, opening in May 2006. In many ways, this project has been a key part throughout my own neonatology carrier. I have learnt so much about the diversity of how to practise neonatology, and I have also learned to know many people around the world. I had not get to know you without this virtual platform. But with time comes age and I have started to think about how to future-proof the operation and development of 99nicu. I, @Francesco Cardona and @Vicky Payne have started to think about where to go
    5 points
  18. 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
  19. 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
  20. 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
  21. 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
  22. The professional communication during the Covid-19 pandemic really shows the potential to share expertise and experience through web-based channels. Journals, societies, regular news media, social media platforms etc-etc play an important role for us to keep updated, and many web sites have also opened up their content free of charge. We will learn many things from facing and tackling this pandemic, but one major change will certainly be our communication channels. Many are discovering the web-based possibilities to learn and discuss. We will do our best to facilitate profession
    5 points
  23. 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
  24. 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
  25. 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
  26. 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
  27. I must admit that it is a bit exciting to think about that 99nicu.org went live 12 years ago, at a time when Facebook and other “social media” web sites was yet to be invented. (@Zuckerberg, no offense here. Obviously, you created something far greater than 99nicu, still a grass rot project. BTW – could we apply for funding from you Foundation?) When starting 99nicu.org in 2006, we nourished an idea that experiences and expertise should not be hindered by geographical boundaries. In some sense, this was a statement, that we as medical professionals could help each other through other
    5 points
  28. 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
  29. I just want to share some brief news about our next Meetup, 7-10 April 2019 at Rigshospitalet in Copenhagen/Denmark. We (i.e myself, @Francesco Cardona @RasmusR @Christian Heiring , Gorm Greisen and Morten Breindahl) are currently working on the program lectures and workshops. I just want to share the first five confirmed speakers and their topics: Morten Breindahl: Neonatal transports – how to do them safe and easy Ola Andersson: Cord Clamping, 1.0 and 2.0 Ravi Patel: How to explain when NEC rates persist – even when a NICU does everything “Right” Ulrika Ådé
    5 points
  30. 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
  31. The lungs of a preterm infant are so fragile that over time pressure limited time cycled ventilation has given way to volume guaranteed (VG) or at least measured breaths. It really hasn’t been that long that this has been in vogue. As a fellow I moved from one program that only used VG modes to another program where VG may as well have been a four letter word. With time and some good research it has become evident that minimizing excessive tidal volumes by controlling the volume provided with each breath is the way to go in the NICU and was the subject of a Cochrane review entitled Volume-t
    5 points
  32. Originally posted at: https://winnipegneonatal.wordpress.com/ Facebook Page: https://www.facebook.com/allthingsneonatal/ As I read through the new NRP recommendations and began posting interesting points on my Facebook Page I came across a section which has left me a little uneasy. With respect to a newborn 36 weeks and above who is born asystolic and by ten minutes of age continues to remain so and has an apgar score of zero the recommendation that has been put forward is this: An Apgar score of 0 at 10 minutes is a strong predictor of mortality and morbidity in late-preterm an
    5 points
  33. On behalf of the 99nicu Team, I would like to invite you to participate in our 2nd Journal Club! The article we chose this time is a review article on "Safe emergency neonatal airway management: current challenges and potential approaches" by Joyce E O'Shea, Alexandra Scrivens, Gemma Edwards, and Charles Christoph Roehr. This artile is not Open Access, but I hope you can get it from your hospital library. The review article examines how to acutely manage the neonatal airway, and the challenges related facemask ventilation and intubation. Some of the key messages in this paper are:
    4 points
  34. Also there are papers now looking at "cooling outside criteria" which are interesting too e.g. late preterms, stroke..... This RCT was in adults but suggests worse outcomes in adults undergoing therapeutic hypothermia who have bacterial meningitis.....https://pubmed.ncbi.nlm.nih.gov/24105303/ A neonatal study (Jenkins et al 2013) has looked at immunosuppressive impact of cooling. Newer possibilities: cooling in NEC?!? https://pediatrics.aappublications.org/content/125/2/e300.short and lots of work now looking at adjunctive therapies like xenon and erythropoetin..... And perhaps
    4 points
  35. In our March Concord Talk, Prof. Arjan te Pas will educate us what the key success factors are when incorporating cord clamping into stabilisation of preterm infants and share the experiences of his clinic in practicing physiological-based cord clamping for over 4 years. March 2nd at 15:00u (CET). Register via: https://concordneonatal.com/concord-talk/
    4 points
  36. First off I should let you know that we do not do transpyloric feeding for our infants with BPD. Having said that I am aware of some units that do. I suspect the approach is a bit polarizing. A recent survey I posted to twitter revealed the following findings: I think the data from this small poll reveal that while there is a bias towards NG feeds, there is no universal approach (as with many things in NICU). Conceptually, units that are using transpyloric feeds would do so based on a belief that bypassing the stomach would lead to less reflux and risk of aspiration. The ques
    4 points
  37. 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
  38. 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
  39. 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
  40. We use this system on an ongoing basis. Very comfortable and does not damage the nasal septum.
    4 points
  41. 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
  42. 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
  43. If you are to read one paper on neonatal ethics this year, I'd argue that this is the one. Late last year, John Lantos, pediatrician and a leading medical ethicist, published a review in NEJM on the ethics around decision-making in the NICU. The paper is not open-access... but you can surely get it from within your hospital intranet or your university/hospital library. We have a fantastic toolbox in the NICU. We can provide live-saving treatments and support. Most newborns in the NICU survive to good long-term health. However, we also operate in a high-risk environment where som
    4 points
  44. 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
  45. 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
  46. 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
  47. different feeding regimens- How much and how fast/slow, gastric residuals
    4 points
  48. 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
  49. This has been a question that has befuddled Neonatologists for years. Get ten of us in a room and you will get a variety of responses ranging from (talking about caffeine base) 2.5 mg/kg/day to 10 mg/kg/day. We will espouse all of our reasons and question the issue of safety at higher doses but in the end do we really know? As I was speaking to a colleague in Calgary yesterday we talked about how convinced we are of our current management strategies but how we both recognize that half of what we think we know today we will be questioning in 10 years. So how convinced should we really be ab
    4 points
This leaderboard is set to Stockholm/GMT+02:00
×
×
  • Create New...