Bernhard Bungert

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.

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?

Done, one lead ecg. Interesting

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.

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.

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

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.

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.

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.

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.

Thank you very much. Will try it

Check this out. I like this neoreviews http://neoreviews.aappublications.org/content/18/6/e357 . Sende a message of you cant get it.

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.

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.

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.

Interesting Subject. And More literature than we would believe, including YouTube Videos. We have primed a few years ago but we stopped because non of our problems were resolved. Despite a lot of tricky literature there are to many variables (tube and line materials, Insulin measurment (Timing, method) wanted Insulin concentration, dont forget filters)... .. to finde the right answer. Hard work for chantalnicu.😊

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.

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.