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Bernhard Bungert

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    Germany
  1. We detected an Echovirus Typ×? Meningitis of an 39 week old female newborn on 4th day of life. Symptoms: apnea and mild liver failure. Mother hast had headache and mild neckstiff es at Time of birth. After 10 days everything wenn out fine. Treatment: Nippv, Fluid, Vit K.
  2. I think others has shown the ways to diff between congenital or postnatal aquired CMV. Right now the other question is: if there is CMV in the Urin or serolgical Evidence for CMV without CNSdesease: treat (with VGV) or follow up?
  3. Gentamycin / Ampicillin. Intervall and Dose acorrding to Neofax. Through Level measuring before second Dose (who determine also peak level?). No 3. Generation Cephalosporines because reported higher appearence of ESBL bacteria.
  4. We started a few years ago with testing every cord blood for DCT change than to analyse O and rh neg. Now we only analyse rh neg. There were only positiv effect on our daily work, less confusion and less painfull blood sampling for our patients. Never missed a Problem.
  5. Vicky, Interesting point: We use caffeine citrat once a Day (makes sense pharmacologically): on the other side: sometimes we See more Apnea at the and of a 24 hour period. Then we change to twice a Day. But sometimes we stop caffeine at 34 weeks post conc. and recognize apnea appearing again after 36-48 hours. So there mich be an Individual or biochronical diversity. Mich = Might
  6. We Start with high IV protein on first Day, give colostrum as much as avaible. Give oral G5% til Mom is avaible. Aditionally Start at the second Day of life with rectal enema (til 10 ml warmed NaCl0,9% /kg) so we Thing we prevent mucus plug. Seldom we use Erythromycin (4 mg/kg 3 td). We ignore gastric residuals after Day 7. (No evidence, but good expierence). No abd. Massage. Low flow Natal canula.
  7. I remember a Former 25+2 weeks premie without severe complications who suffered (from insensible water loss because of cutan barrier disturbance) prerenal acute kidney insuffiency und later severe damage at age of 2 and a half weeks. 1150 g. The neonatal/ nephrological Team of an great south german University Hospital tried peritoneal dialysis (with Lot of improvising work on catheters, solutions, leaks, infection) and have succeeed in the end. Respect.
  8. We use Coffein citrat 》 20 mg/ ml po/IV for some special individual cases. And we monitor Caffeine Levels, jitterness, tachycardia. We find no close correlation between caf. Levels and high doses. We succed in prevention of intubation most ofen in using doxaprame hydrochlorid.
  9. 1. Anticipation: a. Was Intubation difficult? B. Is there a measurable Leak before extubation? C. Cuffed tube. D. Longtime Ventilation. 2. Preparation A. And or C and or D pos: Steroid 1 hr before Extraktion. Always prepared for reintubation: stuff, medication, Equipment. Take Extubation seriously as Intubation.
  10. Check this out. I like this neoreviews http://neoreviews.aappublications.org/content/18/6/e357 . Sende a message of you cant get it.
  11. You are in the right way. HFO fq 5-6 Hz, Amp as high as you see Vibration. Lower MAP as you did, but try do use less, Oxygen max 70%. Permissiv hypercabnia ok. Lay your patient on his dummy. Both sided PIE, equal? If not: best side up.
  12. Remembers me to case of Surfactant protein Mutation. Done well After Ltx At age of 7 month. But me need more information: what Kind of Ventilation you use. Which Setting? Oscillation? NO? Echo Shows pulmonary hypertension? Please look for CMV in tracheal aspirat.
  13. We use gastral tubes with 5ml/KG NaCl0,9% rectally in the second day of life if a premie (《1500g) to stimulate mekonium release (because changings of enteral feeding regimes depending on mek rel). With this procedere we stimulate bowelmovment. It works most everytime. We don't wait for problems. I believe most Effect depends to the distending fluid As long as premies stay in incubator temp is measured with rectal probe. Later with Thermometer (without plastic wrap). We do no Stimulation. For Colic gas seldom we use small airwaytube 3 cm inserted for 30 min.

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