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Stefan Johansson

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Everything posted by Stefan Johansson

  1. 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
  2. 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
  3. 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)
  4. 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
  5. Hi! I don’t have any personal experience but only know this can be a challenging problem. Did a search through Google Scholar , maybe you find some relevant references/ case reports here: https://scholar.google.se/scholar?q=bronchopleural+fistula+management+preterm&hl=sv&as_sdt=0&as_vis=1&oi=scholart
  6. @Peter Odion Ubuane The cooling trial in Australia was done with a low-tech solution, they used regular cooling "gel packs". If I remember correctly from a lecture long ago, they sometimes also used a table fan bedside, if they had problems to reach the target temp. I found this photo below and local trial info on the web here: https://www.bettersafercare.vic.gov.au/resources/clinical-guidance/maternity-and-newborn-clinical-network/therapeutic-hypothermia-for-hypoxic-ischaemic-encephalopathy-initiation-in-special-care-nurseries The trial publication is available free in full-text her
  7. (Another) Great video! Many thanks for sharing!
  8. We don’t use non-invasive NO so the poll does not work out well for me (required fields / questions are based on Yes in the first question)
  9. 👍 thanks for sharing and congratulations to you and your team! Keep up the good work!
  10. @Salman @Narasimha Rao I suggest you get in touch w a 3M rep where you are based, should not be rocket-science for a multinational company to get this where you are based!
  11. Check out the , now for the first time as a Virtual Meeting. More info on the attached PDF. Visit the web site for more info and to register: https://www.epiclatino.co/in-english
  12. until
    Check out the 5th International Epiclatino Meeting - "Crossing Frontiers in Neonatology", now for the first time as a Virtual Meeting. More info on the attached PDF. Visit the web site for more info and to register: https://www.epiclatino.co/in-english
  13. @K. S. Gautham Thanks for sharing! @all - here's the direct link to the paper by Patil et al: https://www.nature.com/articles/s41372-020-0765-3
  14. We sometimes culture infants for herpes simplex born through a normal vaginal delivery and maternal herpes simplex is discovered late during or after delivery (typically recurring herpes). In case of a positive herpes PCR, for example in the upper airway, but negative PCR in blood and cerebrospinal fluid - how would you outline management How do you reason around "colonization" vs "infection" with herpes simplex? My experience over the years, is that a more active management are now adviced from our virology consultants, i.e. iv acyklovir for a relatively long time period.
  15. More from Twitter! @Aedi Budi Dharma - as reply to your question about blood products, we don't use PICC lines for plasma or blood, the lumen of our PICC lines would clot.
  16. We practically only use our PICC lines for parenteral nutrition. The small diameter (28G) only makes it possible to infuse only.
  17. We use a Siemens sequia machine (~10y old), don’t know the model number by heart (on vacation). For CNS imaging we use a 10Mhz probe.
  18. This is indeed a valid question - I have also thought this myself, We also change every 24 hours BTW. Thanks for sharing that paper, was not aware of it. Would be great to bring this question into a research context (i.e. like large collaborative observational study, presumably with historical controls + some experimental "sham" work). I'd be in such an project
  19. we don’t have a written guideline, but if the infant is doing well, and passing urine normally, we’d don’t do renal investigations per routine. However, in infants smaller than -3 SD in weight, we tend to screen more, often also blood and USG for renal morbidities.
  20. Hi, how is this baby doing? Sounds like there are multiple problems, although they probably have a common (syndromatic) cause. Did you come further in genetic/syndrome diagnostics? intestinal signs and symtoms of ileus , do you now know the cause (malrotation, obstruction, vascular/ischemic etc)?
  21. I know the Sensormedics well, it is a great machine and with few buttons I am not aware of any VG addon. The hyperinflation may be related to the PIE as such, maybe you could even reduce the CDP slightly more. My experience with decreasing the Hz is mostly related to management of CO2-retention, but I would def try to lower Hz in this case. Just keep an eye on CO2-levels so you don't end up in hypocarbia.
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