Francesco Cardona

Hi, I think it also depends on which frequency you are using. I would refer to these publications: Sanchez-Luna M, Gonzalez-Pacheco N, Santos-Gonzalez M, Tendillo-Cortijo F. High-frequency Ventilation. Clin Perinatol. 2021;48(4):855-68. https://www.ncbi.nlm.nih.gov/pubmed/34774213 Also helpful in this aspect (Hibberd et al 2024): https://www.ncbi.nlm.nih.gov/pubmed/37726160 On I:E ratio: The I:E impacts both inspiratory and expiratory VT, with ratios of 1:2 (inspiratory time half as long as expiratory time at any given frequency) or 1:1 (inspiratory and expiratory time equal) most commonly used. At any given frequency, I:E of 1:2 will deliver a lower VT, and PAW, than an I:E of 1:1 and introduces a variable PAW drop of 2–4 cmH2O between the airway opening and the lung, which may enhance gas transport (online supplemental figure S2).52 Clinical data on the setting of I:E ratio are lacking, but preclinical and bench studies provide a rationale to use a ratio of 1:2 when gas trapping is present. IMHO I personally would not be to worried about more atelectasis solely because of IE-ratio if you are using volume-guarantee. But probably there are smarter people out there who know more about HFO and may be able to help better.

Hi Pontus, agree with all comments before. we have lots of experience with US-guided central lines, less with peripheral (but some) and arterial lines. It is only done by doctors at our department. We use both approaches: out-of-plane and in-plane. Regarding the canulas: we use both, most commonly we use the neoflon/venflon. but personally I think the one on the left is superior as it is a lot sharper and has less issues with not being able to puncture the skin or vessels adequately. Though my favourite is the Jelco iv. Once you use it you dont want to go back - especially in kids with thicker/tougher skin. Although it needs some practice as it does not have the "wings" of the neoflon which allows for a better grip. We have some experience with the guidewire, it comes in handy at times, but needs some practice to handle optimally. Although aimed at adults, I think this article has lots of good practical advice: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886173/ or also here https://www.pocus101.com/ultrasound-guided-peripheral-iv-insertion-placement-and-access-made-easy/

You might have come across this editorial in the Journal "Nature Medicine". Most countries have implemented newborn screening and with affordable genetic testing available, there have been studies looking into screening with genetic tests. But what should be tested for? How do we handle markers for diseases that occur later in life? How do we deal with the emotional aspects for parents, children and care givers? And how do we deal with requests from third parties? https://www.nature.com/articles/s41591-024-03227-9

Very interesting, thanks for sharing!

Very interesting study. Looking forward to the results and further work on this topic!

We give Ampicillin / Gentamicin. Dose of Gentamicin is 5mg/kg first dose, then 36h later 3.5mg/kg @24h intervals. Step up from Ampicillin if there is evidence of other bacteria (resistant?) from mother

Done 🙂

Done

Irish colleagues airlifted Ukrainian patient to Ireland. https://twitter.com/transport_neo/status/1505611005312831494?s=20&t=fP2I3GwnBeaK60jwfwvomA

https://www.euro.who.int/en/media-centre/sections/press-releases/2022/who-is-working-day-and-night-to-keep-medical-supply-chains-open-and-preserve-ukraines-health-system

Please add any information or resources you have for transporting infants or pregnant women out of Ukraine. We have compiled lists of material for example. Here is a list of needed items for neonatal transport as recommended by Rosemarie Boland, Australian Neonatal Transport Nurse https://twitter.com/piatkat/status/1501482359748706305?s=20&t=RiFIoWIiu5ak4M6HUWYnhw https://docs.google.com/document/d/1vA1Ixm-j7LtbU5nrGULW5zZE5avklXLnRpv9ihsDBlk/edit?usp=sharing Equipment list for neonatal transport.pdf

Irish news have shared images of maternity ward / NICU in the basement of a hospital in Ukraine Twitter link

A report in Time magazine on the situation in the children's hospital in Kyiv https://time.com/6152374/children-hospital-kyiv-ukraine-russia/

What is the best way to contact travel nurses best?

UNICEF has also called for action to help children who are currently threatened due to the war in Ukraine https://www.unicef.org/emergencies/conflict-ukraine-pose-immediate-threat-children

One of the first reports was from a NICU in Dniepro, Eastern Ukraine, featured staff caring for babies in a bomb shelter during the first days of the invasion (feb 24 2022). https://www.nytimes.com/live/2022/02/24/world/russia-attacks-ukraine/newborns-at-a-dnipro-childrens-hospital-moved-into-bomb-shelter

Excellent!

It says Webinar 1 on both 🤔

Very good topic. I agree with Stefan. CLAMP -> X-RAY (after a few hours) -> PULL I would probably adapt the time frame if it was recurrent or there is concern of recurrence or the child is otherwise unstable. We almost exclusively use pig tail drains at this point. In our opinion they are also more comfortable for the infant and they are placed easily. Our surgical patients though often have straight tubes.

Hi we use the DART scheme as published and rarely change it. For select patients we have done a second round with precisely the same regimen after a couple of days in between. FC

This app might also be helpful in simulating monitors - it is free to download from the AAP (American Academy of Pediatrics) and available on OS, Android and PC https://play.google.com/store/apps/details?id=com.aap.vitals&hl=en&gl=US

Here is a citation that might help: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103976/ They used high dose with 9mg/kg - compared to standard dosing 1-2mg/kg for severe neonatal Kawasaki. May I ask in what clinical setting you are thinking about using it?

Very much appreciated.

Grand master - that sounds just about right for you, Stefan 😉

After reading this: https://rdcu.be/cqY8Y .. we decided to try for ourselves. It does work! Who uses ultrasound to guide lumbar puncture as well? Do you prefer to access out-of-plane or in-plane? Did you run into any unexpected difficulties? Have you identified any helpful landmarks?