Andrej Vitushka

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!

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.

Keeping in mind that the patient had low contractility and mild pulmonary hypertension (sorry I don't remember numbers) what do you think would be the best option for this baby -- Dobutamine + Milrinon, Dopamine + Milrinon, Dobutamine + Dopamine or maybe some other? Many thanks.

Thanks for the answer, Hamed. Dobutamine was given because of relatively low cardiac contractivity. But frankly speaking, issues of cardiotonic/vasopressor support are still not well solved in our unit.

Dear colleagues, Are there any differences with antibiotics' dosing for infants with hydrops fetalis. Today having a boy 37 weeks 4340 g weight with profoung edema of head, neck and upper part of the trunk. About 200 ml was evacuated from both sides of the thorax. What bodyweight should we use to calculate antibiotics' dose -- 4340 g or 4130 g (minus fluid from thorax) or something else? He is on HFOV. Blood pressure is stabilizing by 10 + 10 mcg/kg per minute of Dopamine and Dobutamine. Diuresis is good and no signs of impaired periferal perfusion. Many thanks.

Unfortunately we do not use any pain scales. Still failed to find the best one 😊 Astrid Lindgren is cool! 😊

Dr. Meddela, what is septic screen? Thank you!

Thank you, Tarek!

Dear colleagues! What clinical scales or scores do you use in NICU (exept Apgar score:)) ? Silverman, Downes, GCS pediatric, Sarnat? What else? We are rethinking our approaches and willing to be more precise. Thank you in advance.

@tarekwow! It's cool! Thanks!

@tarek could you please specify the method more extensively? Thanks

@tarekI am also think that is diaphragmatic eventration. But I know no way to prove it without operation 😊. Thanks for suggestions.

OK, @Stefan Johansson. I've got the point. Thank a lot. Patient now is in the surgical center preparing for the operation.

Many thanks. Birhtweight is 2140 grams. About 7 hours after my post CPAP has been withdrawn because respiration and blood pressure were stable. We decided not to feed enterally before surgery. Referring to surgical center scheduled for tomorrow. I wonder is it mandatory to switch to mech ventilation in this case if RDS was decreasind and it is known that only liver is thorax? Would it be more harmful for the baby?

@Hamed, thanks a lot!. It is a tricky case. CDH wasn't detected prenatally. CPAP was started because of mild RDS and CDH on Xray was somewhat surprising. As the baby was doing well on CPAP we decided do not intubate. Feeding tube was corrected and now CPAP is withdrawn.

Dear colleagues, We have now 34 weeks girl with mild RDS and right-sided congenital diaphragmatic hernia. Her vitals is stable, RDS is managed well by nasal CPAP. There is a liver in right thorax proven by CT. The Xray is below. My question is should we feed this baby enterally and how? Many thanks.

Ok, thanks. And what about severe umbilical cord acidemia cut-off -- 7.0 or 7.1?

Dear Dr. Johansson. Thanks for the great job and sharing it with us. What do you think how elective C-section will influence the umbilical artery pH? What cut-off for cord blood acidosis do you use in practice -- 7.1 or 7.0? Sometimes we conflict with obstetricians about severity of acidosis, so in the light of this trial does it make sense to say that for example pH withing lower 5 to 10th percentile is a moderate acidosis? Many thanks.

But how long do you use bag? First 3-5 days or longer?

No. Just standart Neopuff-like ventilator included in Giraffe warmer. PEEP 5-6 mbar, Flow 10-12 l/min, FiO2 from 25%.

Thank You, Francesco! Your Team gave us knowledge and shared LISA experience. So we are especially greatful to our colleagues from Vienna. Please give them our warmest greetings!

Thank you, Dr. Johansson!

Dear colleagues! Friday January 20th 2017 the first successful LISA procedure was made in NICU of National Research Center "Mother and Child", Minsk, Belarus. I guess we were the first in the country :). Baby girl 27 weeks, 990 grams from mother with chorioamnionitis. Still on CPAP (no ventilation), no Dopamine, looks well, few apneas. I know that nothing is certain but it is a step towards the right direction. Congrats to our team! Maybe it is too naive, but share our happiness, please :)!

Thanks a lot dear colleagues :)!

Dear colleagues! Maybe someone knows about similar courses in Europe (preferably Poland, Germany, Baltic or Skandinavian countries, but not mandatory)? How is possible to get and brush up echo skills for neonatologist? Unfornunately, I missed seminar from neonatalechoskills.com in Netherlands but currently there is no information about next seminar in our continent. Many thanks!