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Stefan Johansson

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Everything posted by Stefan Johansson

  1. Hi Flavio, sorry no other had given their input yet, but here's mine: per our feeding guideline, feeds are advanced w 20-40 ml/kg/d, and of course tailored per tolerance and infant. The more immature and IUGR, we are def in the lower range or even below it, at least the first few days. So, practically speaking, we are more careful with IUGR infants, but how it is actually done depends on both baby and team
  2. We posted a short survey on Twitter about dosing of caffeine. Do you use caffeine (citrate) at a maintance dose of ≥20 mg/kg/day? Do you follow serum levels of caffeine? Take the survey on Twitter and/or share your practises here!
  3. Hi Flavio! I would generally not, but work work with ventilator pressures such as PEEP/CDP to achieve FRC. But I think others may do, let’s hope more people join the discussion.
  4. @Vijaykumar Do you mean that caffeine can lead to leucocytosis? If yes, I was not aware of it Could this be a neonatal leukemoid reaction? I am aware this is a "ruling out" diagnosis, but if all testing turns out negative, it would be a likely diagnosis.
  5. I can only speak for Sweden, and to my knowledge, there is no trials ongoing here. In a recent journal club by the Incubator podcast, I heard about this study: https://fn.bmj.com/content/early/2021/06/09/archdischild-2021-321645 Personally, I think the next approach will be admin through an LMA - check out this recent report from ADC/FN: https://fn.bmj.com/content/106/3/336 and listen to this ADC podcast episode: https://podcasts.apple.com/nz/podcast/laryngeal-mask-use-in-neonatal-practice/id333278832?i=1000531465079
  6. Hi @ali, I must admit I am not sure about how we do this... but I think it goes about like this. Registrations are first stored on the hard drive of our aEEG machine, and the electrophys depart then "tanks" them over somehow to interpret our tracings. I suppose the electrophys dept keep the aEEG tracings with all their other tracings (EEGs, EMGs etc-etc),i.e. so it complies to legal frameworks.
  7. We are very happy that MONIVENT extends its Supporting Partnership with 99nicu! @Monivent is a medtech company dedicated to improve the emergency ventilatory care given to newborn babies in need of respiratory support at birth. About 3-6 % of all newborns end up in this situation, where healthcare personnel today are lacking tools to determine how effective their manual ventilation really is. Monivent® Neo is a non-invasive monitoring device to be used during manual ventilation, measuring the air volume given to the baby with sensors wirelessly built-into the face mask, providing the caregiver with continuous feedback on several critical parameters. A target volume is presented and any volume given outside the recommended interval is clearly indicated by a color change on an intuitive display. MONIVENT products are Monivent Neo Training to be used within simulation training on a manikin, and Monivent Neo100 for use in clinical settings. Learn more about MONIVENT on: http://monivent.se/
  8. This looks unusual indeed, have not seen this before. I would recommend an echocardiography and a regular ultrasound of the abdominal organs to start with, to look for any apparent anomalies in the "venous geography". If those investigations turns out to be normal, I really don't know. I suppose we would offer clinical followup and wait and see. Will follow this topic with great interest!
  9. Great to this topic re-surface after 10y! We switched to an AccuCheck apparatus (not the small patient device, a more bulky white/purple device for hospital use) since a few years back. It works reasonably ok in my experience but we still see false positives for hypoglycemia (for example, the AccuCheck results indicates like 1.9 when our blood gas machine gives 3.1) My feelings around this super-common test: in those times when everything becomes better, why cannot someone invent a point of care device that WORKS for newborns... 🤔
  10. Thanks @tarek for sharing. We do the same. I personally think that the attention brought up around the diseased twin has a great value for us how we approach the family and also for the family to muddle through their tough experience. And the butterfly, there could not be a better symbol IMHO.
  11. @Francesco Cardona Thanks! 15 Years of posting made it happen You Will soon follow!
  12. After the latest update of the software that runs 99nicu.org, there is a new Ranks feature. From registration and through your activity (like starting threads and posting replies, and giving likes to posts), you collect points that upgrades your rank through 14 levels, from "Newbie" to "Grand Master". Check out your current Rank in your profile Even if this is a new feature from this software version, all your activity since you registered is counted. Best wishes from a Grand Master 😎
  13. We look forward to welcoming you to the 4th 99nicu webinar on the 24th August at 17:00-18:00 CET, this time about the Butterfly Project, a framework that helps parents and staff to signify that a surviving infant has had a deceased twin or triplet sibling. Most women who have a multiple pregnancy (twins, triplets or more) do not have complications, but sadly, death of one baby from a multiple pregnancy is more common than many people appreciate. A group of clinicians and researchers in Newcastle, UK, wanted to start to understand what it felt like to be a parent who has had to face such a difficult challenge and conducted a series of research studies. They spoke to parents who had lost one or more babies, and had a least one surviving baby from a multiple pregnancy, and they also spoke to midwives, doctors and nurses to hear about their experiences. During workshops, one of the parents suggested that a Butterfly cot card could signify the twin status for the surviving baby. Through the Butterfly project, these Butterfly cot cards have been made freely available to several hundreds of hospitals worldwide including the UK, North, South and Central America. The guidelines describe how to work with the Butterfly project in the NICU and has been translated into many languages. Speakers / panelists Nicholas Embleton, Consultant Neonatal Paediatrician, and Professor of Neonatal Medicine, Newcastle upon Tyne UK, having completed paediatric and neonatal training in Newcastle upon Tyne, UK and Vancouver, Canada. Professor Embleton helps lead a broad portfolio of research based in Newcastle, UK see www.neonatalresearch.net The research group includes the unique Great North Neonatal Biobank and studies include large-scale NIHR nutrition trials, and studies of immune, microbiomic and metabolomic development. Professor Embleton also leads a series of qualitative studies exploring the experiences of parents (and the staff who cared for them) who suffered baby loss, recently completing a project with staff and parents where one of a twin pair dies. This led to the creation of a educational film based website www.neonatalbutterflyproject.org Professor Embleton coordinates the UK based Neonatal Nutrition Network (N3) www.neonatalnutritionnetwork.org , and has >200 peer reviewed publications in addition to numerous educational articles and book chapters. Alex Mancini-Smith is a senior neonatal nurse with over 30 years’ experience and is the National Lead Nurse, leading the National Neonatal Palliative Care Project in the UK, the first innovative post of its kind. This is a unique role developing the training and education of staff nationally across neonatal, maternity and children’s palliative care teams. She has been instrumental in developing national and international guidelines and frameworks, including robust complex and palliative care pathways. Building on her educational work over previous years, Alex Mancini-Smith supports and works alongside teams in embedding palliative care within routine neonatal care by training professionals across the UK and Europe in a variety of settings. Alex Mancini-Smith has published widely and is the Lead Editor for the ‘Nurses Textbook in Neonatal Palliative Care’, the first textbook of its kind, published January 2020. Current work includes the national review of the British Association of Perinatal Medicine’s palliative care framework for practice, previously published in 2010. Date and time 24 August, at 17:00-18:00 CET Registration Click here to register!
  14. I just finished listening to a most interesting interview with Dr. Horan in the Incubator podcast about field work with Medicine San Frontiers (Doctors without borders). Insights, laughters and tears about NICU work under challenging circumstances (to say the least!) I can only recommend listening to this interview. Would be great to hear if you have experiences and advice to share for those wanting to take on a similar mission. https://www.buzzsprout.com/1739595/8806860-010-dr-katherine-horan-a-neonatologist-without-borders
  15. Looks like a great tool! I voted "Not yet, but interested" above I remember a special case some time ago where we really wanted to get CSF for herpes-PCR, and the LP failed x several. We asked our radiologist for support and ultrasound showed a hematoma after the first puncture attempts, completely compressing the the dural sack. So, getting CSF seemed just impossible. But... a new ultrasound (day after as I remember it), showed that hematoma was smaller and with guidance, we performed a succesful tap. Shared the poll also on Tw
  16. I would love to, but we mostly work per the outdated approach
  17. Thanks @dramitkan for posting! We don't do such challenges. And, added a poll here and also on Twitter where we promoted your topic:
  18. Do you mean the BPD diagnosis set by need of resp support at 36w? https://www.atsjournals.org/doi/10.1164/rccm.201812-2348OC
  19. @Lisa if you have an Iphone: open Safari go to 99nicu.org press the "share" click on the option "Add to home screens" If you have an Android, it seems to be very similar - check out this guide: https://browserhow.com/how-to-add-to-home-screen-shortcut-links-with-chrome-android/
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