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Showing content with the highest reputation since 08/03/2020 in Posts

  1. 4 points
    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 )
  2. 2 points
    Considering hygiene you should not do it, but I do it 1. if I need a blood culture and the line may be responsible for the infection, 2. if I need blood and the PICC line is about to be withdrawn, 3. in emergencies. The technique is to withdraw with a 1 ml syringe using a constantly changing negative pressure of 0,5 ml maximum. Stop if the blood column does not move constantly (and slowly) and immediately flush with a prepared saline syringe. It works 90% of the time. Erythrocytes are a lot smaller (7,5µm) than the inner diameter of a PICC line (28G = 1Fr has 0,17mm = 170µm). A study has shown that you can give blood via a PICC line without hemloysis (Pediatr Crit Care Med. 2004 Jan;5(1):69-74. PMID: 14697112). See also nice experiments in https://chartermedical.com/wp-content/uploads/2015/09/TexasChildrensPDF.pdf. There it is stated that you should not do it with platelets because of clotting. In an emergency we gave 80 ml FFP via 28G PICC line with no problems. It needs a pump with pressure cut of set to max - you can not do it by hand.
  3. 2 points
    https://www.frontiersin.org/articles/10.3389/fped.2018.00088/full https://www.frontiersin.org/articles/10.3389/fped.2018.00086/full https://www.frontiersin.org/articles/10.3389/fped.2018.00084/full And one more fascinating article on cardiovascular supportive therapies for the neonates with asphyxia: https://www.frontiersin.org/articles/10.3389/fped.2018.00363/full fped-06-00363.pdf
  4. 2 points
    These are brilliant! Sent from my iPhone using Tapatalk
  5. 2 points
    My pleasure. Couldn't resist to share three of my most favourite articles on the same topic from Frontiers in Pediatrics. Might-be of your interest. fped-06-00088.pdf fped-06-00086.pdf fped-06-00084.pdf
  6. 1 point
    We sometimes culture infants for herpes simplex born through a normal vaginal delivery and maternal herpes simplex is discovered late during or after delivery (typically recurring herpes). In case of a positive herpes PCR, for example in the upper airway, but negative PCR in blood and cerebrospinal fluid - how would you outline management How do you reason around "colonization" vs "infection" with herpes simplex? My experience over the years, is that a more active management are now adviced from our virology consultants, i.e. iv acyklovir for a relatively long time period.
  7. 1 point
    I understand that it may be a long time ago you had issues w this baby but I would point out couple of things. Hope you weathered the storm and baby survived. It appeared that from the beginning baby had poor chance. It is important to have good recruitment of the lung before you give surfactant. You dont want it to go only to opened alveoli as the ones closed will be very stiff and eventually end up w PIEs. Undoubtedly Jet is superior to HFOV for PIEs. Jet doesn’t ventilate PIE alveoli allowing them to heal. Ask Dr. Keszler for advices when in question. Next, when you cant oxygenate, like last few CXR shown, and kid is hyperexpanded you are decreasing preload and at the same time obstructing pulmonary flow. You have to drop MAP on HFOV. You need to learn POCUS to look at the heart filling while managing tough cases like this. Also lung US helps a lot. Read Australian and McNamara studies on POC ECHO as well as Kurepa et al. paper on lung US. Finally using higher or lower Hz depends on each baby. See what works for your kid. Remember CXR is just one quick shot in time. All the best.
  8. 1 point
    POCUSNEO Canada is pleased to announce the first e-workshops in advanced hemodynamics starting from 1️⃣5️⃣ August 2️⃣0️⃣2️⃣0️⃣ https://pocusneo.org/e-workshops/ https://pocusneo.org/e-conferences/ Yasser Elsayed (University of Manitoba) Muzafar Gani (McMaster University) Emailing E-conference Flyer final R.pdf
  9. 1 point
    Here you are. Please find the attached pdf. Which inotrope for which baby.pdf Arch Dis Child Fetal Neonatal Ed 2006;91:F213–F220. N Evans. Which inotrope for which baby?
  10. 1 point
  11. 1 point
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