Stefan Johansson

Here we go, the DROPROP trial is now published. Relatively small, and "numeric" differences, but still promising 😀 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2852525

@tvedder do you have a typical dosing scheme for clonidine, or do you treat "as needed" based on changes in Finnegan scores? What other pharmaceuticals would come in as 2nd line tx? I admit I only have very limited experience from infants with non-opoid abstince. As I recall from one experience some years back, we also primarily focused on non-pharma strategies and oral clonidine in standard doses of 2 - 4 microgram/kg (x 4 - 6) (but I think we also used small x-a's of midazolam, on top)

We would also treat as needed with phototherapy and trust the servo-controlled temperature retain the hypothermia.

Hi @Bonnie , we rely on visual assessment by physiotherapist. They have made a parents’ folder called “Back for sleep, tummy for play.” I don’t have the PDF version, but would you like me to ask for it as a PDF? It’s in Swedish though 😀 And of course, when there is a back head asymmetry, the PTs give specified advice how to use back support, stretch torticollis (if any) etc. They also plan and do follow up themselves. Would be great to hear more about the more advanced technologies, are they in use in nearby units? And esp why/how they are used?

I would argue Yes. We analyse mothers own milk and all donated bank milk and fortify up to approx 4g protein/kg/d

AI is the new cool kid in town. While I get the principal impact of AI, and have some very limited experience (with free versions, and mostly as a Google replacement), I guess AI could have some applications in our daily practise as clinicians and researchers. So, I want to learn from you whether you use AI professionally as a clinician/researcher, and if so, what do you do, practically speaking? What tools do you use for what? Please share ⤵️ !

@Annika thanks for sharing about this! I am on vacation this week but will see if I can connect 😀

Thanks for sharing, just read your case report, great presentation of this rare complication. My experience is really limited, and is restricted to the first two columns (non-pharmacological and heparin-like anticoag)

Yes, as clinicians, we need to diversify the principles and the practices. And thats where I disagree with Prof Lagercrantz - while his reasoning is interesting, it offers little (or no!) guidance in the actual care of really tiny patients. And yes, we are indeed caring for minds in the making, what is the best things to do, we may never know, but we shall feel an obligation to keep looking for that.

Thanks @Mariana Oliveira for sharing this. Hugo Lagercrantz, neonatology professor emeritus at Karolinska, reasons a lot about when the consciousness is formed, like ~when you become a conscious person. He uses this chain of arguments also for how/when to practically define the window of viability, i.e. that infants at 22 weeks are not yet full-fledged individual (although the legal definition of "live born child" is 22+0 weeks in Sweden) While I disagree a bit on his reasoning, I think there are some points, and especially how to keep the normal trajectory for the developing brain.

Thanks for sharing a great post, it makes me think about how many of us think about families, and having children. Also when a singleton infant (or older child) dies, I often hear someone in staff asking/saying something about "was it the first-born?" "do they have other kids" etc I just recently heard it after a dramatic event in a NICU. IMHO I think the death of a child is an equally hard experience itself and as such, however the family looks like. And that there is no "economy of scale" in this.

Seems like a fantastic project! Will share in our clinical teams and try out.

Hi @Nicholas Embleton it is simply great that we can help sharing your writing here, you have so much experience and knowhow that deserves a wide audience. I hope we can help with a large outreach through our community. Looking fw to a lot of food for thoughts!

We also have these around, but very rarely used. We also simulate yearly, but rarely the use of IO-device, room for improvement there. IMHO though, in just newborn infants, there are enough option for intra-vessel catheters. But of course also good with a last resort technology. Given one knows how to use it 🙂 On special occasion was an infant in our late GBS sepsis outbreak some years back (published here: https://pubmed.ncbi.nlm.nih.gov/30152878/). Those very sick infants were all beyond the option for umbilical catheters, and once a colleague used our IO-device, I think a life-saving choice for that particular infant.