According to me,if no risk factors no need of antibiotics at start.ttn will resolve in 24 hrs.if no response or any evidence of poor perfusion,inotropes requirement,send cbc crp blood culture n start antibiotics.if cbc crp normal,ct.antibiotics till culture negative.if no adequate response then ct antibiotics for 5-7 days.
We also give repeat surfactant dose if fio2 requirement above 40% or persistanly increasing.most of babies who required repeat surfactants are extreme preterms.as such no guidelines to wait for particular time.we repeat if no response in next 2-3 hrs.n max.3 doses.
In that case,try gentle ventilation with permissive hypercapnea,use min.PIP n PEEP,n. Low ti.avoid further VILI.n if single lung involved try selective single lung venti.or affected lung lobectomy at end.
Sorry.prev.msg.half typed.if u want this strategy to eliminate co2 .HFO is better option.on convention venti.u can keep rate max.60. To avoid air,trapping.n min I time 0.3 and i/e 1:2 for effective ventilation.
Its simple.just find out cause of shock by echo.if IVC small/ underfilled, use fluid and dopamine.if cardiac contractility poor but still BP at higher side use milrinone.u can not use milrinone in any type of hypotention if BP low.
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hello everyone,I want to know what is your practice in newborn screening test.when and what diseases you screen? Its routine for each baby or only for high risk newborn.?
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We also practice in same way in India as Dr.Stefan mentioned.unless n until purulent eye discharge with redness ,nothing required.
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