rehman_naveed last won the day on September 6 2019
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67 ExcellentAbout rehman_naveed
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Rank
Member
Profile Information
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First name
Naveed
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Last name
durrani
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Occupation
Hospital Neonatologist
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Affiliation
Hospital
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Location
Qatar
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Chest drainage and antibiotic prophylaxis
rehman_naveed replied to selja's topic in practical procedures
We usually don’t intentionally give unless they are already on. We discontinue as well early no matter chest drain is out or in. -
Maquet SERVO I Ventilator
rehman_naveed replied to zdravka pironova's topic in Ventilators and Care of the Ventilated Infant
Yes there is no VG, instead use PRVC for volume control ventilation -
Maquet SERVO I Ventilator
rehman_naveed replied to zdravka pironova's topic in Ventilators and Care of the Ventilated Infant
Hi only difference is PEEP is added to PIP while in others PEEP is separate. Meaning the PIP which baby get includes PEEP. Rest of concepts are same. -
For #1, you answered yourself dark lung fields, so no RDS, hence no surfactant, looks like vascular phenomena rather than parenchymal as your scenario. Treatment lung protective strategy, and pulmonary vasodilation. for #2, adequate coverage, can be discharge with follow up
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Microcuffed ETT in CDH patients
rehman_naveed replied to LIA GRAVARI's topic in Ventilators and Care of the Ventilated Infant
Yes our anesthesiologists routinely use cuffed tubes for any procedures not restricted to CDH We didn’t find any severe adverse events though sometimes mild post extubation stridor, also cultural acceptance in NICU community is an issue. Naveed -
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As Stefen Said there is no role of antacid while giving Ibuprofen. For first instance why you want to give antacids for Ibuprofen? if it is to prevent gastric irritation then answer is No. As far as RFT are concerned , all these side effects are transient and will resolve with time. all you need to do is to reduce fluids management and reduce if oliguria during therapy with ibuprofen.
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We usually do the same as what you mentioned, increase 20% fluids ad check Na frequently say Q6hrly. Once Normalize reduce TFI. Yes we replace free water with Na free solution but give maintenance Na which Baby any ways get from UAC heparin Saline ( 0.45% saline) and put 2mmol/Kg in TPN as acetate to tackle acidosis. We can go up as much as 200ml/kg/day and maximum Humidity to 95%. Never give saline bolus and NG drip with sterile water. I hope it helps
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We use nasal intubation to have stability, fixation is usual with tape
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The reason we use gel in term babies is to avoid admissions and transiently support feeds. On the other hand preterm <35wks is by default admitted to nicu so it doesn't make any sense to use gel in them plus you have to start IV D10w or formula NG feeds so gel has no role. Moreover gel is not 100% effective in preventing hypoglycemia same as vaccines are not 100% guaranteed. Having said that we use gels in terms because they have more glycogen reserves as compared to preterm and sustainability is more attainable in terms as compared to preterm.
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Neonatal MCQ Board Review
rehman_naveed replied to rehman_naveed's topic in education, organisation and evaluation
Hi Dr. Vira Thanks for the comments and I am glad that you like our book useful. The Frequency is not appropriate for this 630gm baby, change in frequency affect your tidal volume and hence CO2. Hz of 10 is too low for this baby and hence the first thing to change since PCo2 is too low, we need to act aggressively on it since the change in frequency affect PCO2 more than amplitude. Also as mentioned in the text, amplitude should never be changed by this number i.e by 6 but slowly in increments of 2. Regards Naveed -
Neonatal MCQ Board Review
rehman_naveed replied to rehman_naveed's topic in education, organisation and evaluation
Thanks @drnono for such a nice detailed answer, if u see the ECG in the question it is wide complex tachycardia, HR around 175, so not at all SVT by any means or even by definition. We can debate about lidocaine vs adenosine but I think from exam perspective I still stand that lidocaine is the answer and correct in book but @tarekhas a point and reference we can't ignore especially when there is VT and SVT aberency. Thanks for your comments. Don't know is there any pediatric cardiologist in this group who can comment to guide all folks. -
Neonatal MCQ Board Review
rehman_naveed replied to rehman_naveed's topic in education, organisation and evaluation
Thanks Tarek, will take a note of this and will amend it. -
Neonatal MCQ Board Review
rehman_naveed replied to rehman_naveed's topic in education, organisation and evaluation
Hi Tarek Thank you so much for the e mail and comments about Q2 of Cardiology. To my knowledge Adenosine has no role in Ventricular tachycardia. Here patient is stable with pulse and BP, so stable V Tach is treated with IV Lidocaine and pulseless V tach with defibrillation and not with synchronized cardio version. I am attaching a reference review article for our discussion.Unfortunately our site didn't upload >1.95MB files so as such I am sending DOI, it is free. Please see page 349. Please let me know what you think. Contrary what you said is what we do in Supraventricular ta -
Neonatal MCQ Board Review
rehman_naveed replied to rehman_naveed's topic in education, organisation and evaluation
Thanks so much. This is what I want, share and spread the knowledge. These mcq's are great asset for fellows in training. Naveed -
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