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marcydf

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  • Content Count

    29
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  • Country

    Italy

marcydf last won the day on July 21 2016

marcydf had the most liked content!

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About marcydf

  • Rank
    Member

Profile Information

  • First name
    Marcello
  • Last name
    De Filippo
  • Gender
    Male
  • Occupation
    Neonatologist
  • Affiliation
    Hospital
  • Location
    Grosseto, Italy

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  1. When i was in troubles I did blood samples through 24G lines. Then I washed with 2 U of heparin/ml saline. Never used for any transfusion.
  2. Ampicillin (200 mg/kg), gentamicin and metronidazole even if no perforation.
  3. Hello to everybody, I wonder if in your NICU you add parenteral nutrition in the first days of life in premies >1,5 kg who are in good conditions and tolerate oral feeding to reach the high protein intake that s usually is considered. If I feed a premie with human milk in first days of life, I'm very far to obtain the proteic and caloric intake that are recommended, but it's very difficult for me (ethically) to find a central vein in a healthy premie (actually, I'll never reach the protein intake of parenteral nutrition feeding newborns with fortified human milk). Many thanks
  4. Thank you, here is a picture. It's a little out of focus but it's possible to see the colour and the particular look of the skin. The phenomenon interests also the opposite leg and, less, superior limbs. We think it's a benign (but impressive!!) vasomotory response (benign because was less frequent day after day and now it's disappeared). Sorry, I told you an wrong information: he's a late preterm (36 +3) Marcello De Filippo II level NICU Grosseto (Italy)
  5. I need a little of your help. We have a term newborn in our NICU in which we observed a particular skin reaction on both legs: it begins as a cutis marmorata and ends with blanching of the skin with appearence of "orange skin/goosebump skin". It lasts more or less 10 seconds. Initially we suspected an early onset infection (the baby initially was moderately tachypnoic) but all tests were negative. The newborn now is going well: he's breastfeeded and he's growing up, but we're seeing this reaction frequently in the baby. I think it's an exaggerated "Cutis marmorata" pnenomenon, but the bla
  6. I think that we all are not surprised about new indications.....
  7. I think lung echography is very useful in RDS diagnosis (I love it because it's possible to confirm or rule out Transitory Tachypnea, and save a Surfactant administration). Diagnosis of air leak is less easy than it's written on Sciptures and it's impossible to detect a pneumomediastinum. You can find more pleural effusion than X-Ray, but we use US in this case to check the evolution of pneumonia rather than primitive diagnosis. Anyway, I' think there are so many articles in literature about diagnosis of RDS by US that a legal problem it's not so real.
  8. Hello, I wonder if do you use CPAP at birth in apparently healthy (with good inspiratory efforts) preterm newborns (32-36 weeks G.E.,) to improve lung recruitment or "to prevent" RDS and how (for e.g. do you use sustained inflation?). Thanks for your answers Marcello De Filippo Neonatologist II level NICU - Grosseto - Italy
  9. Dear Dr Johansson, Many thanks for your replay. I think it's the most logical (and CLINICAL) approach. I don't think that "bombing" every 2.700 grams newborn by ultrasound is a good practice (and I'm an echographist). I would be glad to receive more protocols of others units.....I'll try to ask beyond the ocean. Marcello De Filippo NICU, Grosseto Italy
  10. We are updating our policies for Term SGA in our unit. I wonder if you routinely perform head and/or renal US scan in such babies and if you investigate for CMV. With best regards Marcello De Filippo II level Neonatology Unit Grosseto, Italy
  11. Hello, i'd apreciate to know when do you use preterm formula at discharge in babies with no breast milk Do you use it either in late preterms and term sga newborns? When do you begin to use term formulas? At which weight? Thanks for your help Marcello De Filippo II level Neonatology Unit Grosseto, Italy
  12. I don't remember about contraindication (I didn't check new literature)...usually HFOV (and its high maps) helps in a pulmonary hemorrhage. Usually I treat a persistent respiratory acidosis with HFOV, of course it depends on etiopathogenesis of acidosis and if patient needs ventilatory support or not... ....but I suppose that your question is more complicated than my answers... Marcello De Filippo Grosseto, Italy
  13. a PIP/PEEP 12/4 means that lungs are ok. If the baby breaths normally when awake I could consider a S. of Ondine, but the symptomps remember me a severe form of Spinal Muscular Atrophy. Did you check blood ammonia? Marcello De Filippo Grosseto, Italy
  14. Just my opinion to your question: The baby is pink? 2. I don't think that it's important how to obtain the score: if I need epinephrine to have a HR >100 bpm, the score for HR will be 2. Doesn't matter if i need the drug. The same for colour: if I need O2 to have a pink baby, the score for colour will be 2. Again: I need to intubate the infant: if the newborn is apneic and i need to ventilate, score will be 0, but if the baby is crying (i can't hear the cry, but i can SEE it) the score will be 2 etc etc Sometimes I have to explain to postgraduates that they must assist at birth a baby f
  15. Hello, I need your help in a case of Congenital Nephrotic Syndrome. The baby, female, is 2 months. We are waiting for genetic diagnosis, but we suspect a finnish form. We are administrating a very high dose of albumin (2-3 g/kg/die divided in three doses) by a Broviac CVC. We are administrating also Tiroxine, Furosemide, a low dose of captopril (0,015 mg/kg three times per day) and indomethacin (0,4 mg/kg twice per day). We didn't obtain an improvement about proteinuria with these two drugs. We are feeding her with fortified human milk We would offer a better quality of life to the baby and
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