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Stefan Johansson

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Stefan Johansson last won the day on October 16

Stefan Johansson had the most liked content!

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About Stefan Johansson

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    99nicu Team
  • Birthday 06/20/1966

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    consultant neonatologist, associate professor
  • Affiliation
    Sachs Children's Hospital
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    Stockholm, Sweden

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  1. 1c 2 No 3 depends on the context (pre-birth history, antepartal course, gest age etc-etc) but non-invasive startpreferable. In preterms, we apply nasal prongs and CPAP directly after birth (and soon, there may well be a nasal prongs/device for nasal ventilation, and connected to the NeoPuff/similar )
  2. Check this classical paper out: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60197-5/fulltext It does not refer to your actual scenario but Maybe findings can be extrapolated
  3. For #1 - from a pathophys view (decreasing pulm vascular resistance is the key goal) so iNO would certainly be my option. For #2 - given a completely well infant at 24h, we would be OK with discharge at 24h.
  4. I am very glad to welcome Concord Neonatal as our latest Supporting Bronze Partner. Concord Neonatal is a pioneering neonatal care company. They provide the Concord Birth Trolley® , enabling neonatal caregivers to provide lifesaving care with the umbilical cord intact for as long as needed. Close to mom, the baby gets maximum benefit from the blood from the placenta, up to the moment it is breathing on its own. We are very happy for this partnership. With its unrestricted educational grants to 99nicu, Concord Neonatal will help us cover costs for maintenance, development and technic
  5. This is a good guideline from NZ (The ”Starship” Univ Hospital) https://www.starship.org.nz/guidelines/potassium-chloride Save the index to their guidelines Web! https://www.starship.org.nz/guidelines/browse/?index=P&type=see_all&cat=newborn_intensive_care
  6. As calcium varies by pH, I find it myself a bit tricky to interpret levels in asymtomatic babies. as we get ion Ca on our blood gases, that is what we usually assess. here is a relatively good web page with normal reference values: https://www.bettersafercare.vic.gov.au/resources/clinical-guidance/maternity-and-newborn-clinical-network/normal-laboratory-values-for-neonates
  7. In milder hyponatremia (due to increased losses common in preterm infants) we typically supplement orally with NaCl and start with 4mmol Na/kg/day, split into four doses/24h (so 1 mmol Na/kg/dose x 4). In cases of higher losses (like use of thiazid diuretic) one needs to supplement more, sometimes we end up with ~10 mmol Na/kg/day Found this protocol from the UK, we do similary: http://mm.wirral.nhs.uk/document_uploads/shared-care/SodiumChloridesharedcare guideline14.pdf
  8. I’d say it depends on the underlying pathogenesis. If the reason is iatrogenic or true Na loss. Generally we aim to correct S-Na during 12-36 hours. We calculate the sodium deficit and administrer that amount during this time. We do never use undiluted sodium solution, always add to a larger volume (typically 8 or sometimes 16 mmol/L)
  9. Join our webinar - Unpicking the evidence for nurse staffing in the NICU: What is optimal and what is the impact? With two leading experts in this field, Chiara Dall’Ora at the University of Southampton / UK, and Eileen T. Lake at the University of Pennsylvania School of Nursing / US. Bookmark Wednesday 14 October 16:00 CET. You can register for the event here. Many of our 99NICU subscribers will have experienced first-hand the challenges of staffing the NICU, being aware of the short-term impact nurse staffing can have both on patient care and staff morale. During thi
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