jesreinholdt

In Copenhagen we use doxapram for apnea. It is usually very effective and we use it as an alternative for mechanical ventilation. Some infants get jittery and elevated bloodpressure. I think doxapram should be used exclusively when mechanical ventilation is the alternative. Jes Reinholdt

Extravasation of TPN is a problem in our unit. We try to use central lines (longlines) but sometimes it is not possible to have a central line. When we experience extravasated lipids we take out the i.v. line and try to press out as much of the lipids that is possible. Necrosis is a problem and sometimes we have to use skin transplants because of necrosis, but it is only few infants. Jes Reinholdt Rigshospitalet Copenhagen

Nice to hear from you Hesham. The problem in our unit is perhaps due to the obstetric department using Ampicillin and Metronidazol for mothers with PROM. Interesting to hear that other NICU´s are using Meropenem for empiric treatment. What is your choice for early onset sepsis?? Jes Reinholdt Staff Specialist NICU Rigshospitalet Copenhagen

In Copenhagen we are right now discussing our choice of antibiotics. We have a problem with ampicillin and gentamycin resistent gram negative bacteria. Our microbiologists wants to use meropenem and gentamycin for both early and late onset sepsis, but we are worried about the danger of resistent bacteria. Our choice now would be ampicillin and gentamycin for early onset and cefuroxim and gentamycin for LOS. I think that 48 hrs is the appropiate time to differ between early and late onset. Jes Reinholdt Staff Specialist NICU Rigshospitalet Copenhagen