Stefan Johansson

This is our new needle, a sharp 22G needle with stylet, 38 mm long (Vygon product but guess there are several suppliers).

Interesting read about PDA treatment https://jamanetwork.com/journals/jama/fullarticle/2676110

We for maternity ward stay for infants at 35+0 wks and onwards. I don't know the exact NICU admission rate for 35+0 -- 35+6 infants but the majority stays only at the maternity ward for ~4-6 days, until feeding works and till we know there is no signif jaundice. The midwifes usually add a followup visit after another few days to check weight, jaundice, feeding etc, and then the family only goes to the regular well-baby-clinics (as any other infant) But, we need to support (from the NICU) with planning etc, sometimes we invest relatively much time to make this work. But we feel that non-separation and "non-medicalization" of this group of infants works best in the maternity ward.

@RasmusR In fact those needles do not have a stylet that's why we are shifting to a stylet-equipped atraumatic needle. Will post a photo once I get back on clinical service!

We are mainly using regular needles (used for sc injections), a "blue" needle that is 23G (0.6 x 30 mm). Don't know if this truly makes sense, but we teach to direct the "eye" of the needle in 90 degrees angle to the back of the infant, to cut the dural fibers as little as possible. We recently got an atraumatic needle on our shelfes though, but have not had the chance to test it myself - but will post a picture of it in after the Future of Neonatal Care (in case someone misunderstands the "Future...", after the Vienna meeting next week)

Tricky question. This review paper may give some insights (into the limitations of the topic...) https://www.ncbi.nlm.nih.gov/pubmed/24477225 We would probably also get the advice from our transfusion medicine dept to give low-molecular-weight heparin (LMWH) for a limited time while performing repeated ultrasounds. If the inferior vena cava flow is not clearly obstructed when the thrombus stabilize, my (limited) experience is that the long-term outcome is good. Although the likely explanation is a previous intra-vessel catheter, I'd follow the advice by @rehman_naveed to screen for abnormalities in the coag system.

Our conference the Future of Neonatal Care is now only a 2 weeks away, and we are really looking forward to welcome everyone attending. We expect around 130 delegates, Faculty members and Partner representatives, as of today representing 32 countries around the globe. A truly international group of people, from East to West, from North to South. We are excited and truly honoured to welcome you all to Vienna! And yes, we still have a few seats available. But only a few. Click here to see if one is available for you

@bimalc Thanks for further input in this topic. Well yes, your setup seems to be great and to me, proving that you in the US have understood the importance to invest in time for research and development. Around here, positions combining clinical work and (hospital-funded) academic work is rare. Unless it was such a big thing to become accredited as a clinician in the US, I'd be happy to take the leap over the Atlantic (given that family could be convinced), with a luggage of clinical epi skills and top-notch ideas

@Amir Fassihi Thanks so much for your kind words. Let's hope we as a large community can support your venture to create something very innovative! Looking fw to meet up, in Vienna in April or at our 2019 meeting

We have a relatively large simulation unit inhouse and we practise on a regular basis. If you come to our coming meetup in Vienna, you should participate in their workshop (led by two neonatologists and two neonatal nurses) 99nicu.org/meetup/program/workshop-simulation/

Many diff diagnoses to consider... Check this open access summary in PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921882/ I'll see if I can find a PDF also to email to you (check your inbox!)

One of the more interesting trials to wait for is Baby OSCAR (UK study): https://www.npeu.ox.ac.uk/baby-oscar/information-for-hospitals