mmerocru

Hi. Somebody use PCT before PCR in neonatal screening of infection in neonates with prenatal risk factors? Actually we use first PCR, and I think it is OK. Some young collegues are very entusiastic with PCT, but I¨m not so sure. Thank you

Total body cooling: skin and renal complications Subcutaneous fat necrosis (SFN) is a rare, self-limiting panniculitis mostly reported in infancy and childhood. Newborns and infants have a greater saturated to unsaturated fats ratio in their subcutaneous fat compared with older children and adults, causing an increased tendency to crystallise with cold stress.1 A full-term baby suffering hypoxic ischaemic encephalopathy (HIE) and treated with total body hypothermia is reported. SFN was fi rst noted on physical examination at 35 h of life, presenting with a very painful erythema on the upper back area and evolving into fi rm erythematous nodules within a few days (fi gure 1). A spontaneous skin recovery was observed in the following weeks. Hypercalcaemia is the most commonly recognised metabolic complication of SFN.1 2 During the hospital stay calcium plasma levels were normal. Despite weekly blood analysis after discharge, the baby was evaluated in the emergency paediatric department at 6 weeks of age with vomit and weight loss. Severe hypercalcaemia (17 mg/dl) was observed. Abdominal ultrasound scan showed hyperechoic foci involving all pyramids in both kidneys, with normal appearance of the cortex, consistent with nephrocalcinosis (fi gure 2). Total body cooling has recently become a widely available therapy for HIE3 4 but it is likely to increase the risk of SFN.5 Thus, neonatologists should be aware of these potentially emerging complications. Monica Fumagalli,1 Luca A Ramenghi,1 Silvia Pisoni,1 Irene Borzani,2 Fabio Mosca1 1NICU, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy 2Institute of Pediatrics-Pediatric Radiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Correspondence to Dr Monica Fumagalli, NICU, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 12, 20122 Milan, Italy; monica.fumagalli@mangiagalli.it Competing interests None. Patient consent Obtained. Provenance and peer review Not commissioned; externally peer reviewed. Accepted 12 March 2011 Published Online First 16 May 2011 Arch Dis Child Fetal Neonatal Ed 2011;96:F377. doi:10.1136/adc.2010.207886

Think about lesions due to hypotermia in your cooled baby.

Hi. I`m very interesting in bibliography about discharge nutrition plans in preterms. Thank you. I need information.

Is about a new aproach of nasal ventilation. (non invasive ventilation). With short nasal prons.

Sorry, i asked about non invasive high frecuency ventilation¡, not about nasal high flow!

Some new about DAP ?? My collegues don´t believe in Nicks Evans guidelines ¡¡¡

Hi Urban, Do you have bibliogrphy?

Ok.. Nasal hfvo. We use non invasive ventilation, CPAPn, and lisa/mist, and high flow nasal canulas. I have read some reports about nasal HFVO, but with little numbers of Newborn.

Again from spain¡¡ helow¡¡ Has anybody experience in nasal VAFO?. Thank you.

What do you think about Medin CNO ? Is a CPAPn generator with benveniste sistem. Has anybody expirience with nasal VAFO. Any guidelines?

We don't use sedation. They don't show disconfort.

In surfactant topic, you have de references of LISA and MIST. We use it (since a year ago 15 preterm) and we have good results

About CPAP machines: dose anybody use medijet vs infant flow sipap? If you have to buy a new CPAPn machine, what is your opinion?