I would like to see some nursing topics at the conference. Any ideas?

Here is some literature on the subject:

http://www.ncbi.nlm.nih.gov/pubmed/27222450?dopt=Abstract

Quote

Int J Nurs Stud. 2016 Jul;59:51-9. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review. Bradford NK(1), Edwards RM(2), Chan RJ(3).

On 28.6.2016 at 10:12 PM, Stefan Johansson said:

 @fcardona Any ideas about speakers on those topics?

Predicting outcome - Either you could go for some neuropediatrician, neuroradiologist or ethicist - all choices could be interesting

I always find some topic on inborn errors of metabolism interesting, any new developments in this field?

Topic: Early prediction of preterm outcome - what do we know? what dont we know?

If we continue with low rate infusion, we add heparin to the infusion solution 2 IE/kg/h. I am not really sure that makes sense.

I am curious. Do you lock your central venous catheters which are not in use? How often do you change the lock?

Sounds great!

Will there be an android version, too?

Interesting topic. I have always wondered about the scientific base of the 5-IB approach. Would be interesting to find out more on the use of either method.

There is a study in rabbits comparing different flows with HFO which did not find any difference in effect with different bias flows (cant find the citation at the moment).

In a course on HFOV they mentioned that there is no evidence to say which ratio would be more efficient for ventilating patients (Van Kaam).

Thanks for the link!

We use I:E of 1:1 with the Fabian (we also used 1:2 ratio with Sensormedics). The company suggests to use 8 lpm of bias flow for HFO.

Thats what I had remembered as well - thanks for the link!

I did not find anything related to newborns and stress-related mucosal disease. There is weak evidence for PPI to prevent gastric bleeding in pediatric patients http://www.ncbi.nlm.nih.gov/pubmed/19770788

PPI at least seem to be effective in achieving higher gastric pH levels in neonates http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616221/ and http://www.ncbi.nlm.nih.gov/pubmed/17204951/ although best dosing advice seems elusive.

We have been discussing this on our ward. Should we provide therapy to prevent SRMD ( stress-related mucosal disease) in our neonates that are ventilated, do not get any feeds or are otherwise severly ill?

And what therapy do you believe is best?

If you know any current evidence please share it!

Interesting read indeed!

I wonder if that means that we will see placebo-controlled trials in PDA studies in the future..

I agree with the posts above. The first step is to recognize the possible etiology of malnutrition.

Possible mechanisms in the setting of cardiac patients are:

• inadequate intake
• poor absorption
• increased loss
• increased demand
• decreased growth potential
• extracardiac factors

The list is taken from here:

Nutrition and Heart Disease: Causation and Prevention

edited by Ronald Ross Watson, Victor R. Preedy

https://books.google.at/books?id=d8AzJo5FE3gC&lpg=PA260&ots=RqedD0iB1B&dq=cachexia cardiac infants&pg=PA255#v=onepage&q=cachexia cardiac infants&f=false

Interesting point on "early stylet removal", had not heard that before.

I cant talk about any own experience, but I know some physicians use these ventilators:

https://www.hamilton-medical.com/en_IN/Products/Mecanical-ventilators/HAMILTON-T1.html

http://www.acendis.eu/acendis/products/product.php?pid=68&cid=6&p=Heinen+%2B+L%F6wenstein&frompage=producers

This one is very basic (we still use it at our ward..) but cant ventilate in synchrony among other issues:

http://www.smiths-medical.com/catalog/mechanical-ventilation/pneupac/baby-pac/pneupac-babypac.html

We also have liberal use of CPAP after birth, so if in doubt about respiratory effort of baby we support (with Perivent). No sustained inflations either in this age group.

We use Accu-Chek as well, sampling is done by heel prick. Low values (<35mg/dl) are sometimes off, but always in the same ballpark.

Hi lmedina81,

We have used remifentanil in other indications in neonates with mixed results. Thorax rigidity seems to be a bigger issue compared with fentanyl.

Compare:

http://www.ncbi.nlm.nih.gov/pubmed/20231228

furthermore, at the last EAPS conference in Barcelona there was a Dutch group reporting their experience with remifentanil (I dont recall where in the NL) and they reported high incidence (up to 50%) of thorax rigidity as well.

Comment from our Facebook page

link

All Things Neonatal are you sure these are double PDAs and not MAPCAs? Would need to rule out the presence of other MAPCAs before deciding on whether prostin needs to be continued or not.

I am interested.

francesco.cardona@gmail.com

How do you deal with acute bleeding on your ward? e.g. gastric bleeding or pulmonary hemorrhage?

Have any of you ever used tranexamic acid? At what dose? I know our anesthesiologists use it every now and then?

We give max 3 doses of surfactant. The third dose would only be given if we had seen an effect with the second dose and oxygen levels, ventilator settings were creeping up again. Happens very rarely though

We do not have any guidelines for that though.

Interesting idea. We have on individual occasions given surfactant to our patients, mostly without any significant respiratory improvement.

Surfactant levels seem to be reduced in pneumonia http://www.atsjournals.org/doi/abs/10.1164/ajrccm.153.1.8542113#.U-I7bGNBl14

There seems to be some recent research on this issue though:

in mice: http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.1996.tb05580.x/abstract

possibly it is another phospholipid that is disrupting the function of surfactant during pneumonia: http://www.ncbi.nlm.nih.gov/pubmed/?term=20852622

Hi Robyn, I talked to our representative and got this link for training material:

http://www.draeger.net/local/products/babylog_vn500_trainer_multi/flashpage.htm?lang=en#id=A1100

Maybe you will find this helpful.