Rizalya

Yes, Copenhagen 😁

What we do here is open the cord as well, but we tied it with no 1 or 2 silk (which is kind of rough, so it would not move). Without any stitches, just tied it firmly it.. We made flags to stick and stitch the silks, without bridge.. Just a small tape to fix it at abdominal wall.. It works all along.. [emoji4]

We also use plastic bag for babies in the incubator.. Not routinely, only when it temperature becomes unstable, it happens particularly in a single walled incubator.. Sent from my iPhone using Tapatalk

HFNC 2.0 indeed.. 😆😆

I have read about Nasal HFOV.. I'm still wondering though.. How can such a tiny tidal volume (in a HFOV) give through the nose and hoping it will open the lung? I think the tiny pressure will be just lost in the way, particularly if the baby open its mouth.. Please enlighten me.. ☺️☺️

And by the way, the formula is not V1M1 x V2M2 but it is V1M1 + V2M2 = V3M3.. Sorry typo.. :-p

Acetic acid would not going to the baby, it is only in the cpap generator (the bubbling bottle).. It won't irritate anything.. :-)

Dear. Dr. Nashwa, In our unit, oxygen blender is out of reach, it's too expensive.. We use this formula to lower our oxygen concentration. V1 is volume of the first gas (oxygen), times M1 (which is oxygen concentration of the first gas, central O2=100%).. Added to V2 (volume of the 2nd gas, which is air), times M2 (21%).. Equal to V3 (volume of the 3rd gas), times M3 (the new concentration). For example : 1 L O2 100% + 6 L Air (21%) = 7 L. M3 (new gas) So the equation becomes : 1.100 + 6.21 = 7.M3 100 + 126 = 7.M3 So M3 (the new gas concentration) is 226/7 = 32.3% This is how we lower our oxygen, so the baby would not receive 100%..

Too bad we still have no NO in our unit.. We use sildenafil, magnesium sulphate, inotropes and high setting of conventional ventilator (sigh.. We still don't have HFOV).. MgSO4 works though.. It's a sistemik vasodilator, dilate the pulmonary vessel too, but it need inotropes for back up, otherwise it'll drop the BP..

We use Dextrose (plus calcium) from the first day. Electrolytes start from the third day. We use 6% of aminoacid solution (we don't have the 10%) and 20% lipid.. Which are commercially available.. We don't have any special unit for making TPN solutions..

Not really ours actually, but there is guidelines from the hospital where we learned before and some guidelines from the health ministry.. But we're working on our own guidelines, with some modification, according to our situation right now..

We use Maquet servo-i non NAVA, for almost 5 years without any problem.. Recently we tried SLE 5000, it keeps on alarming every time we put on the baby (we also tried the HFO mode on it).. Not succesful, so it retire right now.. Please share the experience with this SLE 5000.. Some friends also have the same problems.. We also have GE, but not satisfied with it.. It always show apnoe in the monitor, eventough the baby is breathing.. The technician said that we should put off the flow sensor if we use PCV mode (really???).. We also used to use AVEA, but the problem is also with the flow sensor.. It's easily broken.. For me, servo i is the best..

I have had 2 cases of neonatal ascites (from birth).. The first one was much like your case.. We don't do anything.. Just close observation.. Serial US, the ascites disappeared in 3 months of age.. The mother n baby was IgG positive for CMV, but not IgM.. The other was companied by severe edema and hypoalbuminemia.. It was revealed a spontaneous perforated of distal ileum due to microcolon (long segmen).. Ascites and edema dissappear after albumin infusion and ileostomy.. It has a short bowel syndrome after that.. ;( Btw, how do you reveal a chilous ascites, do you aspirate them?

We use probiotics only for non breastfed preterm, after half feed (50 ml/kg).. We're just have a liquid probiotics here, given 3-5 drops a day..

Got it.. Echo assessment (if possible), NS, n dobutamine (first 24 hs) or dopamine.. Or both... But are there in any sircumstances should we use adrenaline? Or should we add adrenaline after dobu/dopa fail to give a good BP? Or after resuscitation/bradicardiac state in a previously in dobu/dopa baby?