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Everything posted by Stefan Johansson
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This is an very recent article on the subject I got emailed from a hospital hygien specialist. https://www.ncbi.nlm.nih.gov/pubmed/27887754 This is a nice commentary (taking off in the REDUCE MRSA trial, which was in adult ICU's), where you probably find lots of interesting articles in the reference list: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152419/
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Greetings from Sweden First of all, I think I am biased by the very liberal practise of using FFP in the level-3 unit I trained in, we even referred to FFP as "Vitamin P" (as in Plasma). But times have changed to the better, i.e. a more sound and restrictive use. ELBW - I would say most would give FFP on clearly abnormal coagulation tests alone, and of course, in cases of clinical scenaries like lung bleeds. But of course, there are commonly situations when coagulations parameters are not so clearly pathological but also not within expected normal ranges - if an infant is a candidate for hemodynamic fluid support, FFP is commonly choosen as the fluid. I personally think the table is good, but we do not use PT but INR.
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Great videos 👍!
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As planned before the end of 2016, we have completed the program for the 99nicu Meetup in June 2017. You can find the program on this page, where we will also post the registration link around the 20th of January 2017. However, we have already the first two members registered who wanted to spend remains of educational funds for 2016 I look forward very much to this meeting, the program is great and it will be a joy to meet you IRL!
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@spartacus007 we currently use "Freestyle light" (https://freestylediabetes.co.uk/our-products/other-meters/freestyle-lite) and it performs poorly... as it often under-estimates the true value (shows a hypoglycemic value when there is normoglycemia. We are currently validating Accucheck and Freestyle Pro against our blood gas machine (ABL90) that has accreditation as reference for glucose measurement. We plan to publish of course, but my impression (without statistical testing) is that both seem to perform reasonably well.
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Not from Sweden Is this the same link? http://newbornsepsiscalculator.org/- 5 comments
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- early-onset sepsis
- eos
- fever
- gbs
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Tagged with:
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Hi! I'd say it depends on who the patient is. We sometimes see relatively well term infants who may suffer from hypertonic dehydration due to lack of established breastfeeding - those cases usually resolve with enteral feeding (by breast of bottle). I guess you refer to typically preterm infants that commonly get hypernatremic due to negative water balance. I can recommend this post on eMedicine : http://emedicine.medscape.com/article/976386-overview The trick to avoid hypernatremia the first few days in life is regular checkups (electrolyte balance, urine output etc) and tailoring fluid administration from those.
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@Urban Rosenqvist do you use the Freestyle Pro?
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And here... the program as of today! There will be smaller changes and updates over the coming few weeks. We will open a registration link early January PrelProgram.pdf
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@JoannieO i think this thread has become a bit confusing, sorry for that. So you use sugar gel as treatment of diagnosed hypoglycemia? I thought the sugarbaby-trial was a prevention trial incl risk groups at the maternity ward (i.e. Risk groups for hypoglycemia), but I may be wrong by memory. For infants sdmitted to the nicu, Will gel also be usually succesful so you can spare a baby an iv infusion of glucose? The feeding pump discussion is a separete topic from gel admin, but I think an attractive mode of admin compared to iv infusion of glucose (and very much OT - our main concern is our glucose measurement apparatus...)
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To improve how you can see and browse updates, the landing page on 99nicu.org is now a feed of all new content, in forums, blogs, Pharmacopedia etc, presented in a Facebookish way. You will not only have an updated timeline to browse, the web server will create it for you (i.e. reducing our work load to keep a first "News" page updated) What do you think about the new Activity Feed?!
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@Urban Rosenqvist yes, a feeding pump is exactly what I was referring to. Sounds great to hear you have experience with this - maybe we should consider to make a trial (that something we would like to do, randomize to feeding pump vs iv glucose)
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@Urban Rosenqvist sounds great! We still have project plans... Did you find a protocol somewhere that you translated or did you make your own protocol? Would be great to see the protocol if you want to share it. We also use fortified milk/formula with Duocal - and sometimes have success with that. But I think your strategy is probably the best.
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The mOm incubator is a collapsible infant incubator that is being designed to provide a level of thermoregulation that meets the standards set for conventional incubators. The product is a result of a student project, and is under development.
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Read the full announcement here: For information, speakers, and an abstract form or brochure please visit http://www.mproveonline.com/conference -
An academic start-up company wants to interview you on off-label use of intramuscular vitamin A in the NICU: You are a doctor, nurse, nurse practitioner, nutritionist or pharmacist You work in a NICU in Europe You are using or / have used one of the following Vitamin A medicines: "AQUASOL A" or "Vitamin A Nepalm" or "Axerophtol Biotika". The interview takes about 15 minutes, and your invested time will be financially compensated with 200 €. Further, 99nicu will be granted with 50 € per interview, as an independent grant for web site maintenance and development. If you are able to participate in an interview on intramuscular use of vitamin A, please forward your name and contact details to me (stefan.johansson@99nicu.org) and I will connect you with the start-up company. -
@wackdi great suggestion! But, this time a little late - the programme is being finalized. But-2, there will be a new meetup 2018/19 and new opportunities will come ("How to feed a preterm baby?" is a great title BTW)
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I have finally come across a probiotics product, produced in the UK (?), and classified as a dietary supplement in the UK. However, the regulatory aspects seem a bit complex. For example, it seems that we would need permission from the Swedish Medical Product Agency Authority before we could start to administer it to preterm infants in the NICU. It is possible that the authority would not approve it as a dietary supplement but consider it as a pharmaceutical, which means that a more complicated regulatory framework kicks in. My question to you - how are you able to use probiotics in your units? Do you have pharmaceutical classification of probiotics or are the products used classified as dietary supplements? Do you use probiotics "off-label" without permission from authorities?
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Just got an email from IPA that the petition is now closed. They recieved in total 1400 signatures!
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The "European Consensus Guidelines for management of RDS" has been updated and is now published in the journal Neonatology. Although the title much refers to RDS, this document has a wider scope and is really about stabilization of a preterm infant, ventilatory management included. Other aspects covered are temperature control, hemodynamic stability, and sedation. It is a pity that the full document is behind the paywall of Neonatology - but I guess you will be able to get it through your library. Here's the link to the reference on Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/27649091
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I would like to high-light a Petition by the International Pediatric Association, that children deserves hope and a safe environment. I ask you all to sign it. Every day we are reached by horrifying news from wars around the world, through news agencies and social media. Children are among the most vulnerable in today's military conflicts. Despite a public and political awareness what's going on, the civic society has yet been unsuccessful in its peace-making efforts. However, there is no alternative to peace. Not only children and their families, but all civilians in war zones deserve hope and a safe environment. The current situation in Aleppo in Syria is a prime but not the only example of a military conflict where civilians are victimized. Further, health care premises are not only struggling with limited resources, but have also become ”accepted” bomb targets. This new military strategy to target hospitals, against international agreements, must come to an end immediately. Health care professionals in war zones should be able to work in their facilities without risking their own lives. Although cynical ones may argue that words carry no "weight" in today's war zones, the public opinion supports countries and organisations like the UN. The community of health care professionals working with children and families, neonatal staff included, can add to the public voice that action is needed. That's why I think the Petition of the International Pediatric Association is an important initiative. The petition reads: Please sign it here and share widely in your own networks and work places.
