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Stefan Johansson

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Tutorial Comments posted by Stefan Johansson


  1. @Rola alzir thanks for your comment. I am not aware of any data supporting the use of ranitidin (or other anti-acid drugs) with ibuprogen.

    In general, the use of anti-acids seems to have few (if any) positive effects, but side-effects. Read the blog post below by Keith Barrington (from 2013 but still relevant) and when it comes to GERD, check out the document by ESPGHAN

    https://neonatalresearch.org/2013/12/06/acid-suppression-doesnt-work-and-its-not-safe-phunny-how-we-got-here/ 

    https://www.ncbi.nlm.nih.gov/pubmed/29470322


  2. 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.

    • Like 3

  3. @Hamed we give mostly therapeutic, but that means that virtually all infants <28 weeks get it, and we are very liberal to start it up till week 32. We tend to continue it until week 35-36 (although my personal take is that we should discont it in very stable and well infants around week 33-34, to avoid any side-effects).

    We do not measure serum levels, but increase up to 10 mg/kg if apneas persists 5 mg/kg. We usually keep the same dose once an infant is stable and then let infants "grow out of the dose" (which is not 100% rational as the turnover of caffeine increase with postconceptional/postnatal age)

    My personal opinion is also - caffeine is not a magic bullet, and some apnea tendency will be there in most cases if you surveille infants closely. I am mostly convinced that there is a BPD-risk-reduction among the most immature infants (see Schmidt / the CAP-study in NEJM)

    • Thanks 1

  4. @wackdi Great feedback, I add the review you suggest, it is great!
    The concerns about interactions with chondrocytes is also very interesting and is def one more reason to be restrictive with the use of furosemide.
    BTW, thanks for commenting, this is exactly how we want this Pharmacopedia to evolve, like an interactive NeoFax :) 

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