Darya

We do. We use lactobacterin and bifidobacterin for all newborns, enteraly fed.

Thank you!

Thank you!

Dear all! Tell me please, from what age do you give fat-soluble vitamins for TPN?

Thank you very much for translation. The situation is not good now. We have the new baby with the same clinics now. And today we saw the clinics of septic shock. We think that we deal with bacterial sepsis. But we don't know the microorganism and we can't choose the effective antibiotic.

Por desgracia, no comprendo el español

Вecause we had some similar cases during the short time. I think, it looks like infection

We looked for the following viruses: adenovir, coronavir, MPV, influenza and paranifluenzae, RSV, rinovir, parvovirus B19, CMV, Herpes. All children were premature. By the time of beginning of problems, all children recovered from a congenital infection or RDS. They looked rather well (not absolutely, certainly) , were on CPAP, some were enteraly fed . The first signal was a lactate acidosis always, then a neytropeniye and all the rest.

Hello, Stefan! We looked for herpes vir, CMV, enterovir, ECHO and some other. Thanks for the link fb, it is interesting. We have no vitamins for TPN at newborns in Russia, but the lack of vitamins doesn't explain a neutropenia and thrombocytopenia. What virus did you mean?

Dear all! I need an advice. In our NICU recently there were some newborns with the same clinic. At the age of 2-3 weeks they show intestinal problems , increasing of lactate. In laboratory indicators: a neytropenia, thrombocytopenia, at some - an eosinofilia, negative CRP, sometimes positive PCT, sometimes not. Blood culture is always negative, we don't register neither viruses, nor fungi, and bacteria (microbiology, PCR). The condition of newborns worsens, the lactate acidosis increases, we evaluate the situation as sepsis and use antibiotics, but we do not see effect. What can it be? Why antibiotics (we used imipenems, metronidazol, vankomycine, cephalosporines, linezolid) don't work? Thank you

Hello! I am very interested in this topic too. Tell me please, what is duration of course (one week, two weeks or until extubation)? Do you use diuretics with corticosteroids always or alone in any conditions? Whether there is a difference in your guidelines for BPD, is newborn ventilated or NCPAP? Thank you

Thank you very much. Unfortunately, I don’t read Spanish. But, nevertheless, what is the tactics in your clinic? Do you stop the breast feeding or pasteurisate the milk, or freeze it (how long)? How it depends on GA and weight? Thank you.

Dear colleagues! Share please your tactics if HCMV was found in breast milk by PCR? Do you know any RCT about it? Thank you!

Thank you! Very interesting presentation!

Thank you very much. Good article.

Hello! Could anybody share with me your protocol of umbilical blood sampling in delivery room, if you do it routinely? I wonder what do you check – lactate, pH or any other, in arterial or venous blood. What is your interpretation? What part of umbilical cord do you use? Is it important – the time after cutting the cord? We want to improve this procedure in our clinic. Thank you very much. Daria

Thank you very much! The classics would be a good argument in discussion.

Dear friends! Yesterday I had a discussion with my colleague about the late appearance of PDA. My opinion was – the reason in most cases is infection. But I couldn’t find any articles or researches about it. Could anybody help me with literature (if I am right, of course)? Thank you, Darya

Thank you very much! However, as I see, nobody has own experience in using HES?

:)Good evening ! I wonder about HES in neonatology. Does anybody use hydroxyethylstarch as volumexpander in your practice? What is your opinion about it? Do you know studies about advantages or disadvantages of HES?

Hello, colleagues! I have a question about therapy of PDA. We are not very experienced in drug therapy for PDA. Sometimes we can use ibu for it. And I wonder: if after the first course the duct remains open, but not significant (for ex. less than 1 mm, no murmur, no clinic), should we continue a therapy (the second course) or not? Thank you

Dear Marcello, we usually start with reducing glucose administration till 4 mg/kg/min. If patient need it for a long time, we administer insulin infusion 0,05-0,1 U/kg/h with increasing glucose administration. And check glucose level every 30 min. Routinely we estimate not only a glucosemia , but glucosuria too. Sometimes the reason of hyperglikemia in ELBW is lack of AA in PN. Best regards

Happy Birthday! The best wishes to the celebrations! It’s fine to feel myself as a part of the neonatology society. Nothing would be better for diagnostics and education than advices from a real practitioners and discussion with experts. Congratulate Stefan and Alexandr and all of us with 99nicu birthday!

Dear Stefan! We also do echoes ourselves and I’ve read about estimation of systemic venous return, but never do it. It’s time to try. And what do you think about evaluation of resistitive index in ACA as a marker of significant PDA? Do you use it routinely? Thanks a lot for your patience and detailed replies.

Thank you very much, Stefan, for your consultation and link (our clinic hasn’t free access, but I read an abstract). Our surgeons have closed the duct today, and it was really wide. We have a possibility to operate directly in NICU, without transportation. You wrote: "With regard to the example above - it seems that the duct is wide-open (3 mm in a small infant), although the LA/Ao-ratio is not very high" But I read, that LA/Ao ratio > or =1.4 is a marker of significant PDA. Absolutely agree with you, that LA/Ao very difficult to interpret when the baby is on ventilation. Would you be so kind to tell me criteria of PDA significance, using in your hospital. Thank you once more.