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Andrej Vitushka

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  • Content Count

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    Belarus

Andrej Vitushka last won the day on October 29

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About Andrej Vitushka

  • Rank
    Member
  • Birthday 07/19/1978

Profile Information

  • First name
    Andrej
  • Last name
    Vitushka
  • Gender
    Male
  • Occupation
    neonatologist
  • Affiliation
    National Research Center "Mother and Child"
  • Location
    Minsk, Belarus
  • Interests
    Premature infants, prevention of brain lesions (IVH, PVL), cardiac support and monitoring of hemodynamics, management of persistent pulmonary hypertension of the newborn, aEEG and EEG in neonatology

Recent Profile Visitors

1,150 profile views
  1. Andrej Vitushka

    Infusion calculations in premature infants

    Dear colleagues! Many thanks for nice and fruitful conversation!
  2. Andrej Vitushka

    Infusion calculations in premature infants

    Bimalc, thank you for your suggestions! Regarding dry/birthweight. Until what day will you use it in VLBW infants? 10th? 14th?
  3. Andrej Vitushka

    Infusion calculations in premature infants

    Nathan, many thanks for your suggestions. It is really true that additional fluids for catheters and drugs (incl. Dopamine and vasopressors) have considerable contribution to the daily volume. Interestingly we also do not have consensus even in our NICU about daily fluid requirements. Frankly speaking we are not very restrictive -- we start from 80-90 ml for premature infants with D10, quite liberal in boluses and excessively sticking to the numbers of median arterial pressure on monitor (we love to see MAP 30 mmHg at least and do not like less even if there are no acidosis and other signs of hypoperfusion). We have plenty of BPD and quite many PDA. Sticking to the birthweight until edema is resolved -- it is very good idea.
  4. Andrej Vitushka

    Infusion calculations in premature infants

    25th percentile sounds good. Thank you!
  5. Andrej Vitushka

    Infusion calculations in premature infants

    Thank you Nashwa and Naveed! What about the weight for calculation for infant with sepsis? Which one do you prefer? Or maybe another variant?
  6. Dear colleagues! Please share your experience regarding 2 issues about infusion in preterm infants. Unfortunately there are no solid guidelines but questions of fluid supplementation and parenteral nutrition are obviously important for premature patients. There are considerable differences in proposed volumes of fluid requirement per day in literature. For example, Avery’s Diseases of the Newborn (10th edition from 2018, freshest one) provides following numbers: From the other hand, European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2016 Update states that “Typically fluids are initiated at about 70–80 ml/kg/ day and adjustments individualized according to fluid balance, weight change and serum electrolyte levels”. From the third point of view, National Guidelines for Parenteral Nutrition of Neonates in Russian Federation has following recommendation for daily fluid requirements: Bodyweight, grams Daily Fluid Requirements (mL/kg/day) 0-24 hours 24-48 hours 48-72 hours >72 hours <750 90-110 110-150 120-150 140-200 750-999 90-100 110-120 120-140 130-180 1000-1499 80-100 100-120 120-130 120-160 1500-2500 70-80 80-110 100-130 120-160 >2500 60-70 70-80 90-100 110-160 Which numbers are closest to yours? 2. 2. Second question. Clinical case J Premature infant with sepsis on Dopamine with edema because of boluses and severe condition. Now there is a beginning of the 3rd day of life. When calculating infusion for him what bodyweight we consider: 1. actual one (plus 15% of birthweight) 2. minus 3-4,5% from birthweight (ideally we need at least 1,5% of weight loss per day) 3. birthweight 4. something else? Thanks a lot!
  7. Andrej Vitushka

    iNO Administration via nCPAP- any experiance?

    We do not have iNO either yet. But when I was on observership in NICU of Medical University Hospital in Graz (quite close to you ) in 2015, they did iNO to the infant on CPAP. It was a complicated heart defect with persistent pulmonary hypertension. INO was titrated according to SpO2 and daily heart ultrasound. As far as I remember they in increased sildenafil per os aiming to withdraw iNO eventually. Not so much but hope it helps.
  8. Dear Dr. Pillers! Thank you very much for this wonderful opportunity!
  9. Dear colleagues! Many of you know how could be diffucult for neonatologist from developing country to get an opportunity to see on own eyes work of busy NICU in developed country. Especially to spend several weeks in large university clinic. There are many reasons for this, mainly financial, but also a lack of appropriate contacts. I want to apply to the Fulbright Visiting Scholar Program -- non-degree, post-doctoral award program for researchers and experts from Belarus who wish to conduct post-doctoral research, lecture, or pursue combined lecturing and research in the United States (you can read about it here https://by.usembassy.gov/application-period-started-for-the-fulbright-visiting-scholar-program-2019-2020/?fbclid=IwAR2qktBr88cqeZqKvWXTwsz1B1Qe4bSSexNyvSXvwvs8ZDbyGS4kl1ce_nc). The program is nice and allows to spend 3-6 months in U.S. institution, covering many financial issues. As program states: The Fulbright experience should be of value not only to the scholar, but also to the scholar’s home university, as well as to the host U.S. institution". So I need contacts in NICU of tertiary (preferrably university) U.S. clinic which could be a spot for this study-visit. There are 3 interests in this scholarship -- 1. to delve deeply into daily routine of busy U.S. NICU (modern approaches to management of different cases (extreme prematurity, cooling for HIE, iNO use, hemodynamic instability etc), 2. to get tips how to make and maintain up-to-date local treatment' protocols 3. to understand how modern neonatal research looks like and how it is connected with practice. For the application I need letter of invitation from a preferred U.S. host institution. Maybe someone from 99nicu community work in such clinic and ready to share clinical and research experience with me? Any suggestions of clinics with strong NICU and research? How to get an invitation letter? Ofcourse I can use some rankings in Internet like this: https://health.usnews.com/best-hospitals/pediatric-rankings/neonatal-care, but recommendation form colleagues is far better source. Many thanks!
  10. Andrej Vitushka

    Where to measure hemoglobin and hematocrit

    It is very useful information, Stefan. Thank you. I would ask our lab people about validation.
  11. Andrej Vitushka

    Where to measure hemoglobin and hematocrit

    But what do you think about Hb provided in Acid-base analysis by Radiometer ABL? Anyone use it as guidelines for transfusion? Rarely we do this especially in VLBW infants with obvious bleeding. Thanks
  12. Andrej Vitushka

    Where to measure hemoglobin and hematocrit

    Dear colleagues, many thanks for useful suggestions and remarks.
  13. Andrej Vitushka

    Where to measure hemoglobin and hematocrit

    Hamed, thank you! Is there any difference between venous and arterial Hb/Ht?
  14. Dear colleagues! Could you clarify for me please where you measure hemoglobin and hematocrit for transfusion? Central or peripheral lines (venous, arterial) or in capillary bed by heelstick? I failed to find much info about that. For example this paper https://doi.org/10.1053/j.semperi.2008.10.006 (pretty old one 2009) states that "central measurements are preferred". If so is the any difference between UAC and UVC hemoglobin and hematocrit? Many thanks!
  15. Andrej Vitushka

    Dose of antibiotics for infant with hydrops fetalis

    Thanks, Hamed. We use Dopamine plus Epi or Dobutamine (sometimes). Interestingly I didn't even thing about NO because we don't have it 😊. Pulmonary hypertension is treated by Milrinone and bicarbonate in our settings. As well we don't use vasopressin as well.
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