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99nicu.org 99nicu.org


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About mr_raider

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    McGill University Health Centre
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    Montreal, Canada
  1. we did our first run of HFOV this week on a 1 kilo baby, and we realize it needs some getting used to. The baby had PIE so we are using a low MAP (8 cmH2O), 11 HZ, 33:66 ratio, and amplitude between 40 and 45. Some questions: 1. what is the optimal Frequency (Hz) for different weights? 2. Is this a reasonable range of amp in a 1 kilo baby? It seems high, but that's in comparison to the 3100A 3. what is the preferred I:E ration in HFOV? 1:1 like the babylog or 1:2 like the 3100a?
  2. Yeah we've had ours in for a few months now, and we are going to order three more. I should add that the new software revision adds SIMV + PS capability. A great dedicated neonatal ventilator, and far superior to the cradle to grave hybrid jobs that Draeger, Viasys and Maquet have been peddling as of late.
  3. Have you considered acquiring aEEG monitoring equipment? It is cheaper than full EEG equipment, and neonatologits/pediatricians can be trained to read it. Seizure detection capability is inferior however to conventional EEG. As for duration of treatment for asphyxia, there is no consensus. Most people agree that once the initial insult has resolved, most babies do not need months of maintenance therapy.
  4. This was done in the original NICHD trial (sanakaran et al. protocol), because they found that hanging the 2nd blanket reduced fluctuations in water temparature. It is by no means essential, but we do it because that's how I learned how to do it
  5. We feed on low dose dopamine in stable infants. Of course, if the baby is stable and well enough to feed, does he really need dopamine?
  6. We use the Blanketrol II from Cincinatti Sub-Zero. Your hospital may already have it in the OR or intensive care. We use the NICHD protocol: 1 pediatric blanket for the patient 1 Adult blanket that is just "hung" on a pole 1 Esophageal probe for temp monitoring Servo-control to 33.5 C The main advantage of the Blanketrol is that temperature control is automatic.
  7. The babylog is fine for babies above 1.2kg. Our PICU uses them up to 2 months for bronchiolitis. The problem is that HFV module is inadequate above 1.5kg-2.0kg, but it works fine in conventional ventilation. We are currently using a Leoni Plus on trial, and so far I have been satisfied with it. In conventional ventilation, it does as well as the babylog, and uses a continuous flow mode. In HFOV it is supposed to be more powerful than the Babylog, but I haven't had the chance to try that mode yet. The mian criticism I have of the Babylog and the Leoni is the inability to combine SIMV with pressure support, which some of the other ventilators can do (Viasys Avea, Draeger Evita XL).
  8. We are looking at this unit in our NICU as a possible replacement for some ageing ventilators. CUrrently we use nothing but Babylogs. We had the Leoni on trial for a week and were satisfied with it's performance in CPAP, non-invasive and conventional ventilation. We did not get a chance to try the HFOV function, since no one was sick enough that week. Does any one have experience with HFOV on the Leoni Plus? My main concern is that it will be unable to vibrate > 2kg babies just like the Babylog can't. We don't have Sensormedics 3100 in house, so it's a big issue.
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