Sameh779

Dr Mir, thanks for your input. Just to avoid subsequent similar incidents; how many babys are looked after by a nurse (nurse/baby ratio)? I am worried that f the baby was left that long; someone may have taken the baby and ran away. You can always use doctors in internship to give hands and also nurse students. The other aspect is how to avoid rats, other insects from reachnig that holy area. Use mehses, use rodenticides outside the unit. and please please please continous monitoring regards Sameh

It is very tricky to treat and stabilize resistant cases with PPHN . Now as mentioned earlier; our targets are : a) Maintain OXYGENATION (we aim to maintain above 95%) to maintain systemic pressure (we aim to maintain above 55-60 of mean). Now again as requested we are talking about term babies. It is a big challenge; so bypassing the high pressure (which can frequentely cause air leak) and high FiO2 on conventional ventilation. Nitric is really of great help. We usually start at 20 PPM. We do not use Sildenafil that frequent. Higher maps in HFOV can help but again with caution. When we come to the point where Oxygenation index exceeding 45 to 50; we start to think about ECMO.