Dinesh N Patel

hellow

HFNC SOME TIME HELP Sent from my C6902 using Tapatalk

If baby gaining weight on Bf for last three day and mother is able to givebfherself wirhout supprt We plantodischage on kmcor we advise to maintain room temperature about 28 to 3 0 Advise close follow up 4 to 5days after discharge and than every wk till36 wk ga orcoss wt2.5 kg Than monthltly

Incaseof prolongedNBM without supliment of phosphatecan ecause hypercalcemiaasparental phosphorous iis not avaible in india

What about nutritional manage ment in this patient?

have you rule out inborn error of metabolism ?does baby is on oral feeding/parental feeding. IEM may present after starting oral feed same way as Sepis and improve transiently on parental fluid . sepsis like presentaion renal and hepatic involvement (direct sbil was high)

its really works , thanks

Epo , we use it first four wks of life in VVLBW.

we use heparin 1unit/ml of NS 0.5-1 ml/hr

Is it possiblble for you of actual procedure with plcture of securing ET. Fixation DINESH

NOVEL METHOD OF MIDSTREAM URINE IN NEW BORN COLLECTION ,I READ ON NET ,THE LINK IS AS FOLLOW FOR DISCUSSION AND EXPERIENCE OF OTHER MEMBERS http://www.medscape.com/viewarticle/779028_3 DINESH

aEEG is more simple in interpretation than EEG,became popular for cerebral function monitor in HIE . Here is a link for aEEG:http://www.neoweb.org.uk/CFM/CFM6000+manual.pdf NOTE NEUROLOGY MODULE is very good learning place on line learning for aEEG AND its role in neonatal HIE after perinatal asphyxia.continous cerebralfunction monitoring- aEEG after birth with h/o birthasphyxia helps to identify abnormal cerebral function in borderline case and early inclusion in selection for therapeutic hypothermia dinesh i

Der Saidy i was witness one pt in recent past.the FT infant had persistent FETAL bradycardia ,THE MOTHER was on ventilator for severe CNS hemorrhage with ,brain death.relative were offered for em cs to save baby.the baby resuscitated. spontaneous respiration established welL within 2min, cord blood ph 7 .BE , -12 APGAR 3/1 7/5,TRANSFER TO NICU FOR further care,baby satlled ON AIR and maintained spo2 on air .ABG also improved there was no apparent clinical sign. suggestive of HIE, AFTER 10 HR BABY HAD EXCESSIVE CRYING ,ARF, CONVULSION altered sensorium AND SIGNS OF HIE. WE DON'T HAVE CFM FACILITY.we OFFERED RELATIVE TH.TH GIVEN FOR 72 HOUR FORTUNATELY WE ARE ABLE TO DISCHAGED ON bottle feeding , CNS examination was normal on discharged .if we have CFM FACILITY THAT MIGHT HELP US IN THIS CASE TO PICK UP HIE EARLIER. dinesh

In PPHN THERE IS SHUNTING OF PUL BLOOD AT ATRIAL(PFO) AND PULM DUCT LEAD TO SEVERE HYPOXEMIA CAUSE TACHYPNEOA .AS LUNG IS NORMAL PCO2 IS MAINTAINED NORMAL

dear Stefen , I am willing to learn neonatal functional electrocardiograms aswell as neuro usg,can you suggest on line course or some good learning materials .in our hospital we have 5 usg for fetal echo.our management now ready to invest for neonatal echocardiography probe and head usg probe in one portable machine[logic5 from GE. dinesh

dear nashwa, U/O mean urine output.we try to keep U/O about 2-3 ml /kg /hr. In privios post i wrought day in place of hour.please correct it. sorry for inconveniency. dinesh

1 Humidifier add in total fluid intake.2 liberal fluid intake may increasing incidence of opening of PDA. I USUALLY set fluid intake to keep U/O about 2-3 ml /kg /hr. Dinesh

I have dragger 8000,Bear 750PSV VENTILATORs, Bubble CPAP Fisher and Pakle, lnfant flow drive Cpap. Somebody can give me the idea that how l can give nasal SIPPV with this set up or I have to buy dedicatd nasal SIPPV ventilator? Thanks Dinesh

Have you followed ABG while weaning?I feel that with 30% fio2 PIP/PEEP 12/4 is not appropriate and if ABG was o.k. while weaning with this setting then its a time to extubate and put on CPAP .Hypoventilation may be one of the reason for IVH,pul hemmorhage.treatment is increase peep, appropriate pip to maintain adequate ventilation(PCO2 45-50 mm of hg) and supportive care,maintain good circulating function, transfusion cautionary, FFP & vit K if PT/APT prolong .Treat PDA conservatively , restriction of fluid intake 120-130//kg maintained urin output 1-3 ml /kg ,minimum ET suction .Ibuprofen is contraindicated with Bleeding. Dinesh

We do cover baby trolly with clingfilm and give phototherapy from both side of warmer. we keep warmer on with close watch for hypo /hyperthermia. This is working with AC on. Dinesh

drkumar, which ventilator you r using fof nasal ippv mode ? dinesh

It looks like pleomorphic maculopapular rash - chicken pox in the picture

Wr use disosible spo2 probe. We also change the probe site every4-6 hrly depending the maturity of newborn infant.

In VLBW Infant and infant with H/O unfavorable fetal Doppler study , we consider more than 50%of previous feed is significant at the next feed and witheld that feed and reassess clinically. If there is no distention of abdomen, we returne the residual back ,And Don't give feed at that time and reassess before next feed. If thete is distended abdoman we discard the aspirate, make NBM for a day or two and reassess,if vitals are stable restart feedings Dinesh

Dear friends , I do agree with Stefan.for effective CPAP cooperation of baby is must.we use pacifier routinely in large baby ,some time a single dose of sedative will help .we use phenobarbitone 5 mg/kg once only.before that we ruled out hypoxemia and hypercarbia as well as over/under distention of lung by x-ray chest ,optimum CPAP help in reducing agitaton of infant. Dinesh