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Andrej Vitushka

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Andrej Vitushka last won the day on March 2 2019

Andrej Vitushka had the most liked content!

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About Andrej Vitushka

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  • Birthday 07/19/1978

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  • 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

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  1. Dear colleagues Just a naïve question. Endotracheal, nasopharyngeal and oral suctioning in infants -- what first, second and third? My idea was 1. Trachea 2. Oropharyngeal 3. Nose. But some colleagues told that oropharyngeal suctioning first because we need to clean upper airways in order to avoid risk of microaspiration by ETT during the endotracheal suctioning. For example guidelines from Ireland https://www.olchc.ie/Healthcare-Professionals/Nursing-Practice-Guidelines/Suctioning-Guideline-Sept-2017.pdf support my opinion. But the other opinion sounds reasonabl
  2. Nice suggestion! Especially if you have a appropriate ultrasound machine and relevant knowledge to use it by yourself or possibility to invite specialist to do it. Definitely bedside echo must be a standard. Must be, but not now yet universally (unfortunately). So sometimes also clinical criteria help as central cyanosis, refractory arterial hypoxemia and pre/postductal SpO2 difference more than 20%. Also "quite healthy" looking non-edematous lungs together with persisting hypoxemia, low SpO2 (heart defects should be prenatally excluded). But all these are not reliable. So May the Ec
  3. Dear colleagues! Hope you all are doing well in 2020 :). Maybe anyone has an experience of using nebulisers in SLE 6000 and Leoni Plus ventilators? Some of our old machines need to be replaced and we have to make our choice about new ones. In good old and simple Newport E100 (reliable as Kalashnikov rifle by the way) there is a special port for nebuliser, making additional flow in circuit when activated. You only need a tube with medication's camera attaching to the Y-piece of the circuit and to switch on the particular button. How is it working for SLE 6000 and new Leo
  4. We use LISA for 2 years and have about 40 patients less than 1000 g of birthweight already. Data are still collecting but preliminary results are reassuring -- only 2 deaths in LISA group (including one because on NEC on third week of life), only 1 IVH III and much less days on ventilator. Out method is close to one used by Dr. Cardona and colleagues (they were very kind and shared the method with us). Non invasive ventilation (Pin 20-22 mbar, PEEP 5 mbar and Flow 10 l/min, about 20-30 breaths per minute) via mononasal cannula by NeoPuff-like device is used. Frequently we do not even use Ma
  5. Bimalc, thank you for your suggestions! Regarding dry/birthweight. Until what day will you use it in VLBW infants? 10th? 14th?
  6. 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
  7. Thank you Nashwa and Naveed! What about the weight for calculation for infant with sepsis? Which one do you prefer? Or maybe another variant?
  8. 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 –
  9. 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.
  10. 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
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