Bernhard Bungert

Find great to gearbeitet about - preventing NEC - ultrasound of the lung - CMV, pasteurisation yes or No. - Mother Milk Banking, ist it worth

We dont use HFNC as a Initial Support For Premies under 32 Weeks. Therefore was a lot of unreflected use as CPAP-Weaning Strategy: since we started with "the Todd-Procedere" Premies loose CPAP earlier without the need of HFNC. We use HFNC instead of CPAP For late preterms with TTPN with heavy breathing to lower our Airleak rate.

In all of our PIE Cases HFO With Low Volume strategy (HFO Peep = Mean Airways pressure of conventional Ventilation minus 1) were Superior. We never achieved any comparable effects in any CMV setting. We tried a lot. And: we often See onesided PIE: so dont forget to lay PIEside downward.

There's a Lot of calculating so Long. I started with an article about possible pathophysiology. Interesting. http://neoreviews.aappublications.org/content/16/7/e420. After Reading that there are a Lot of pointe for a debate.

Thank you very much Maegan. Is there any considerations how to applicate for better resorption. Any pitfalls? Sounds like a silly question, but ....

Long time gone since last post. We start to develop a visiting policy. But - the deeper the insight - the greater the Problem. Peluso AM J Perinatol 2015 Aug; 35 (8) 627-30 described increased rate of RSV-Infections during RSV - Season in the "visiting Group": worth reading. We thing about medical checks of the young visitors, complette vaccination, single room visits only, Age-restriction (only > 6 years), written parents consent, Time Limitation for those under 12 years. Sounds a Little bit too elleboratated but in time of high hygienic susceptibility and bad expierences of German NICUS with "outbreakes" of MRGNs we have to be carefull. We have no place for careing for siblings at the time parents visit the preemies (an aditional Problem). there are People anywhere with written policies and/or expierence?

Hello Maybe you find out I'm a little bit silly, but i have to ask: "Whats fumigation?"

Dear Collegues. The Subgroup of the German Robert Koch-Institiut has puplished a 40 page Paper about (I translate because it is in German): "Prevention of nosocomial infection in Very low weight babies under 1500 G". There is a lot of small but interesting details and aspects of prevention. You can find the article on: http://www.rki.de/cln_091/nn_201414/DE/Content/Infekt/Krankenhaushygiene/Kommission/Downloads/Neo__Rili,templateId=raw,property=publicationFile.pdf/Neo_Rili.pdf (copy it, it works). There they prefer Octinidinhydrochlorid 0,1 % without Phenoxyethanol. Bernhard Bungert

Dear Prof. Haque Im sorry that i cant add superior insight to your question. In my own expierence i found that to determine whether a baby is infectet CRP (like a lot of other markers) is a mess: On one side it comes late, on the other side I see about 20 newborns who are susceptible to infection (because of apnea, Temp 38 °C, maternal history) which develop a CRP over 50 g/l, and if you have the nerves and wait: crp is normal after a few days, and the babies are doing well. From my teachers i have learnt to treat this babies, but we changed practice whithout RCT. Bernhard Bungert

Hi we calculate osmolarity for every TPN-solution (we means a self constructed of our pharmacologist) whether used peripherilly or central. Max 800 mosml/l for periphery.

Hi The only time when we have needed such a amount of fluid the baby has had antenatale Bartter-Syndrom with Polyhydramnion and iu hydronephrosis on both sides. How`s the Na-Exkretion? I cant believe the reason of this problem depends to the amount of Protein or lipids in TPN. If there is to much loss of fluid over skin try to use plastic bag.

Hi We use no med in the delivery Room. At "home": Atropin/Morphin/Thiopental (slowly) sometimes parlaysis. Works fantastic. Morphin against acute pain. No fentaly because of thorax rigidity (30% in our own expierience), no midazolam cause of seizures. An other scenario: a blue, alert child (bec of congenital heart desease), your are 100 km away from home, and you have to use prostaglandine . No medication for intubation? no intubation? No risk no fun?

Hi for elective Intubation on Nicu (or changing tubes because of blocking or leakage) we use atropin, morphin 0,1-0,2 mg/kg, Trapanal 4 mg/kg, and (depending to doc) pancuronium. Works well, infants are stable, easy to intubate. Greetings Bernhard Bungert:)

Hi We use AG once a day in term infants and check 30 minutes before using the third dose (but we wait for the result). In terms and preterm infants with compromised renal function (asphyxia, hypotension) we checked it sometimes earlier and more often. in preterms dosing is more difficult so depending to gestational week and age there are different doses and time periods (36 hr, 48 hr) to use. We always have good expierences and no toxic side effects. Always remember AGs needs, because of there properities, time with low blood levels for full action. Greetings Bernhard Bungert