Stefan Johansson

Relevant questions indeed! I will check with our nursing care specialist also but I think our replies (Sachs Childrens, Stockholm/Swe) are regular hygien guidelines apply, i.e. cleaning with surface alcohol detergent on paper cloth our surface alcohol detergent (70% alc) nursing and our cleaning staff share responsibility for all cleaning (but parents commonly help out too)

Dear @Dr Khalil Ahmad, we would consider use up to ~14 days of life. I have some personal experiences of using it up to 21 days of life (relapses after early initial closure) but this was some 10+ years back. Nowadays we have a more conservative approach for late relapses.

Is there a history that the head was ”stuck” outside while the body was about to be delivered? If yes, watchful waiting sounds good.

Dear all, as @Hamed and @Rizalya figured out, our next Meetup is located to Copenhagen in Denmark, at the Rigshospitalet 7-10 April 2019. With regard to the clues provided: Denmark is (as always) scoring high in the latest World Happiness Report Copenhagen is a city with more bikes than people Rigshospitalet was the scene for the praised TV series Riget by Lars von Trier, where a main character was a choleric Swedish neurosurgeon The statue of the Little Mermaid is one of the main tourist attractations in Copenhagen. The Little Mermaid is a classical fairytale, written by HC Andersen Stay tuned for more information! We'll get back with a lot of details about the Meetup during the autumn, and plan to open the registration in November.

To the best of our knowledge, we won’t risk problems from any neurosurgeons at the venue (3rd clue)

Bookmark the dates 7-10 April 2019 (fact)! See you in a happy place (clue)!

Our guidelines in Sweden (infpreg.se) is to give oral acyklovir, 10 mg/kg x 4 over 14 days when VZIG is delayed. I guess the same would apply if VZIG is not available at all.

Have discussed this principal question before IRL - generally we'd probably use the BW-adjusted doses and follow s-conc as usual (for aminoglyc or vanco), and dose-adjust accordingly.

This is a practical question that surfaces in my hoods from time to time - whether to routinely recommend an apnea monitor when discharging extremely preterm infants, and use it during the first months of life (or not!)? Would be great to see how you would do it? Do you have guidelines, or do you decide from family to family?

To the best of my knowledge, I don't think this is used in Sweden. What are the indications for lavage in Japan? Meconium aspiration? Or also preterm RDS?? Would be great to hear also HOW you do this and your experience.

@yangw126 but do you change NG tube every week also if the infant is postop esofageal atresia? We also change tube every week in preterm infants in general. But, postop esofageal atresia, our surgeons want us to leave the NG tube as long it is needed, i.e. take it out when the infant can feed orally

We had the discussion recently about long-term use of anti-reflux medications after esophageal atresia repair. Drugs like lansoprazol can really clogg the NG tube (like concrete!)... and from what I read in this systematic review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899117/) it seems that there is no clear benefit. Although the quality of evidence is classified as low, and that "more research is needed". Do your pediatric surgeons advocate the use of anti-reflux medications after esophageal atresia repair? If yes, for how long? If the infant needs NG tube feeding for a longer period time (like 4-8 weeks), how often do you change the NG tube? Asking for a friend

Although it seems more simple with one antibiotic, it may not be the best strategy, for reasons related to resistance development. Carbapenems (like meropenem) are typically used as the treatment option when other antibiotics fails due to (known or assumed) resistance. So, depending on the bacteriological context, it may or may not be a reasonable 1st-line choice. And carbapenem resistance is worrysome thing for health care beyond the NICU. So, a reasonable bottomline would be along the lines "If it works, don't fix it"

@Abdul kasim jaleel ahmed I guess you are thinking about the Kaiser Newborn Sepsis Calculator. Here http://newbornsepsiscalculator.org