Stefan Johansson

@piatkat - check this out!

Tricky question. Do you have access to dried blood spots from PKU-testing, or bio-banked blood/serum from the infants, from some around time of delivery? Or is therer bio-banked maternal serum from antenatal blood testing? If either are availabel, you may be able to check serology status from those time points, and such results may guide you.

Check this out on #NeoTwitter

Hi Juan, we would start per the ESPGHAN recommendation at 80-100 ml/kg/d and increase by ~15-20 ml/kg/d depending on weight, sodium-levels and urinary output. I agree with @Rossana that the ideal weight loss is rather small, but we often see larger weight losses and hypernatremia >145 mmol/L in practise... We also use very high humidity initially and we focus more on hydration/water losses than sodium supplementation the first week, we supplement similarly as described above. High urinary output, we do not replace exact volumes but consider it may adjust total volumes ~12 hourly when needed. We routinely check for u-glucose in those circumstances, just in case we have missed hyperglycemia and osmotic diuresis.

Good question! We have such CO2 sensor caps in all our resusc trollies. Nice to have or need to have? I have not had an occasion to use one during the scenarios I have been engaged in, but know colleagues who have thought it to be useful help. Anyone else with feedback? @Erik Borgstrom or @Vicky Payne?

Thanks @Joe , but the back side of this coin is that the curve is population-specific, so less great to use in research. For example, I was just engaged in a small study where we categorized growth per Fenton Z-scores than using our own reference curve. There should be a formula for calculating exact SD/Z-score, the graph must be drawn up from a formula. The formula for the previous curve was published, but I am not sure about this one. There are some fancy mathematical formulas in the paper (here), but nothing that can be simply added to XLS (as I understand the Appendix). I am sure you can email to the first author Aimon Niklasson in Gothenborg (aimon.niklasson@vgregion.se) and ask about a formula.

As with many things in Sweden, we do it our own way* so we use a reference curve based on the births in the Swedish Medical Birth Register. So population-specific. You find the publication here and the growth curves for girls and boys, here and here. *I mean this a bit ironically, as many Swedes think about Sweden as the Center of the World. BTW, the Center of the World is Karolinska Institutet in Stockholm 😎

Dear @gmustafa, there is a relatively recent Cochrane meta-analysis and their Conclusion is pretty negative, I paste part of it below. You find it here: https://pubmed.ncbi.nlm.nih.gov/31222841/

I was not involved myself in a case some few years ago but as I understood: 1) prenatal assessment of the tracheal gap (MRI) 2) elective CS with ENT team doing tracheostomy while the baby was on the placental circulation

Well, kind of yes As a "runner up" we are planning an webinar series starting in the autumn (stay tuned for some info over email relatively soon), and just today we discussed a regular conference some time during 2023.

Hi and thanks for posting this very interesting question. I must admit I am having any good answer, was trained and used Sensormedics (actually, a lot!) in my level-3 years, so the times before there was VG and tidalvolumes to be measured in HFV. As you write, the traditional reasoning around HFV frequence was that a higher frequence reduced CO2 washout. We sometimes utilised this feature with Sensormedics but for the opposite purpose, i.e. we reduced frequence to increase CO2 washout in tricky cases. If the VG-function during HFV manages to keep a defined tidal volume, then it also shifts the "mechanics of thinking". I mean, in that case frequence and CO2 should correlate and change as during "normal mechanical ventilation", i.e. higher frequence -> more CO2 washout and vice-versa. But, as said, I have limited experience using HFV on new / more sophisticated machines, so lets hope more people join this discussion. I ping some experts I know are around here: @Francesco Cardona@Martin.Keszler @Padkaerand @Vicky Payne

We do skin-to-skin phototherapy with our new device (which name I do not recall now), and do not protect parent's eyes. Will be interesting to see if others do differently! 😎

Thanks for putting this together. Have done it now. Will you publish? Great if you can share results back when available

I wanted to share a new fund raising campaign started by the UK-based charity British Ukrainian Aid. They run a dedicated campaign to supply equipment and medications to the Ukrainian maternity centres and NICUs. https://www.justgiving.com/campaign/saving-babies-lives-in-ukraine

I wanted to share a new fund raising campaign started by the UK-based charity British Ukrainian Aid. They run a dedicated campaign to supply equipment and medications to the Ukrainian maternity centres and NICUs. https://www.justgiving.com/campaign/saving-babies-lives-in-ukraine

Update! The Practical Ultrasound programs by Prof Nick Evans are now available for Windows and MacOS, and the link to the online store is changed to https://payhip.com/PracticalNeonatalUltrasound Check this out - indeed a great learning tool!

I would not be too sure, hemochromatosis can go with conjugated hyperbili, so that diagnosis needs to checked into with s-ferritin etc.

@nashwa I suggest you check iron status (s-ferritin and s-transferin), we had a case some many years back with neonatal hemochromatosis. If I remember correctly, this patient presented with early conjugated hyperbili, a crazily high s-ferritin helped us to set the diagnosis.

This is an interesting blog post by prof Keith Barrington https://neonatalresearch.org/2022/04/22/does-knowing-the-genetic-abnormality-change-management-and-should-it/

We would also probably go with bensyl-Pc and Amikacin, the latter dosed every 48 hours (and with checking serum-konc of amikacin before the 2nd dose)

Hi and thanks for posting! Great idea! One thought when I visit your web site - I suggest you add some content on the starting page about the "what's, why's and who's", text/content to encourage registrations, also including a contact email / form. I think many would be hesitant to register an account on a web site (i.e. share personal info) on a site that feels anonymous.

We got this email from colleagues in Cambridge UK, looking into novel ways to monitor vital signs and would like to ask all 99nicu members to join a short survey. Please consider to take this survey here: https://cambridge.eu.qualtrics.com/jfe/form/SV_23RCMdtgVhYaFAG

This is just barbarian. What is wrong with a world where things like this can happen?