Francesco Cardona

The definition of bronchopulmonary dysplasia that best predicted early childhood morbidity categorized disease severity according to the mode of respiratory support administered at 36 weeks’ postmenstrual age, regardless of supplemental oxygen use.

I hate push notifications 😛

Great feature!

I highly recommend the research group around Rebeccah Slater https://pubmed.ncbi.nlm.nih.gov/?term=slater+neonatal+pain&sort=date She presented at the 99nicu meetup 2017 in Stockholm, too. I think it is a wonderful introduction to the topic incl caveats on currently used scores.

We do not pause iron supplementation

Unfortunately we have seen a few cases, including some that needed further operations by our ENT. We think we see it more often with cuffed tubes we sometimes use (esp. for patients undergoing surgery). We treat if symptoms or if intubation was difficult and we fear swelling, mostly dexamethasone or prednisolone. Most resolves within 6h.

We have a few replies on twitter on the topic

do you mean HIV as in IVH (Intraventricular hemorrhage) or as in human immunodeficiency virus?

Here in Vienna, we use humidified heated air with our T-piece in preterms below 32 weeks with a Fischer-Paykel humidifier. Mode: normal.

Screening is not done in Austria. I am not aware of therapy during maternal primary infection.

Thank you so much for sharing. Where do you see room for improvement in your daily practice? What will you be improving to achieve better outcomes?

Thanks for sharing!

In suspected cases, yes.

We use the Neo TEE here in Vienna as an alternative for bag-mask-ventilation on our unit. It works, but is a bit more frail and I am not sure about reliability. In studies it does ok.

Do you use X-ray or ultrasound to determine position of UVC/UAC? Do you use a formula to determine distance? UVC: correct depth: tip at the level of the diaphragm on the lateral X-ray). UAC: Mid-descending aorta, at T8 level on X-ray (range T6-T10)

Here is a recent review by the Dutch group https://www.jpeds.com/article/S0022-3476(20)30978-1/fulltext#secsectitle0015 Here is the editorial https://www.jpeds.com/article/S0022-3476(20)31152-5/fulltext

And if you find time you might want to watch this webinar today (3.30pm - 5pm GMT): Preterm births in a COVID-19 world: Science, Systems and Social impact https://www.lshtm.ac.uk/newsevents/events/preterm-births-covid-19-world-science-systems-and-social-impact

The servo-i has the same modes as far as I know. At least with the new servo-i the modes are the same (we use this machine in our PICU). Older machines have slight aberrations of the names, but its possible to figure out. https://highlandcriticalcare.files.wordpress.com/2020/03/servoi-pocket-guide.pdf

The list we received from the company is as follows: SIPPV -> PC SIPPVVG -> PRVC SIMV -> SIMV(PC)+PS SIMVVG -> SIMV(PRVC)+PS PSV -> PS/CPAP, it additionally uses backup with PC in contrast to the babylog From our experience: we mainly use PRVC or PC mode with preterms. You will need an external flow-sensor if you want to use it reliably in preterms esp. below 1,5kg. The internal flow sensor is not sensitive enough. Our impression is also that registered Tidalvolumes (VT) are not necessarily comparable to other machines we have used in this population. The Servo often measures higher VTs. If you dont have external flow sensors it might be wise to use PC and watch TV closely (i.e. have close alarm ranges), so you are alarmed if compliance changes. Hope this helps.

Signed up!

http://www.leedsformulary.nhs.uk/docs/NNU clarithromycin monograph.pdf Dose: 7.5mg/kg every 12 hours

1c 2 no 3a - might though be different in special situations

What dose do you use? and what is your experience?