Pontus Johansson

Thank you all for very valuable input that also gives us and especially the nurse in question who knows this and is the only one so far doing it motivation to proceed with this, trying to educate others. We´ve tried US guided UVC and UAC on occasion and could definately get better there. We still x-ray for position. Really grateful for your help!

Dear all! Do you on your ward routinely use US-guidance for putting PVC, PICC-line in and if so do only doctors do it and/or nurses? Experience? Also, any experience on so called "deep access canula" 32 mm vs 19 mm. Do they last longer? Any problems?

Hello all! Just briefly wanted to pop the question if anyone out there have experience in using LDH as a marker for tissue hypoxia and assessment of for instance birth asphyxia, TTN, other? Have seen plenty of studies and some development of different tests, point of care use and would be very grateful to your opinion on if this is something we ought to use? All the best! //Pontus

Hello! I have contact with a nurse who is going back and forth between Norway and Ukraine where she works in the field. Right now they have raised some money (about 4000 €) to help with equipment for enabling phototherapy of neonates in Cherson hospital. Does anyone here have contacts; industrial, hospitals knowing of used (but working) material or anything in this area that might help? Regards Dr Pontus Johansson

completed!

To all pediatricians/ neonatologists out there!! Do you have specific guidelines for when you practise neonatal CPR 3:1 vs Pediatric 15:2 concerning infants who are not newborn or on the NICU? Some colleagues use 3:1 until 28 days post 40 weeks, some think as soon as having left the labour ward or are discharged from the neonatal ward you do 15:2 even og the baby is 39-42-44 weeks. In some hospitals it differ depending on where the baby is brought and what the staff there are most used to… Grateful for any comments on this😀

Dear Dmitrij! As it comes to the most important skill, ventilation I would recommend the Monivent Neo Training which can be used with most manikins altough a few might need a simple modification to override the leakage they might have. The company has all info. I agree with Erik that very advanced high end manikins not always give so much additional value. My experience is that they are often too advanced=technical problems, difficult to handle, irritations etc. Regards Pontus

Hello all! I just wanted to pop the question if you use moisted and heated air to your T-piece device/ BVM/ other device when ventilating/supporting respiration in the delivery room? We do in GA < 30 weeks with a Fischer Paykel humidifier. If so, what kind of moister/heater? Do you have various modes "normal", "invasive"? Do you use it in just ELBW infants or all? ...or do you use normal, dry air/O2 and wait with the moist and heat until in the NICU? Thanks for your input! //Pontus Johansson

I´ve never used the Neo tee, but other T-piece resuscitators which work fine, especially in preterm babies but I was a bit concerned reading this article showing that some devices do not deliver set PIP at all times https://fn.bmj.com/content/104/2/F122.abstract A so called PEEP valve on a bag in my opinion does not create a sufficient (or any...) PEEP. You need some kind of device with a flow. Maybe in a term baby using a 500 ml bag and slowly squeezing the bag keeping FRC, but still you don´t know the amount of PEEP. A good adjunct in this situation could be to to use a Respiratory Function Monitor as whatever device you use you don´t know the leakage or more important the tidal volume. Even if the PIP is set the compliance changes and suddenly you might ventilate with to large VTe harming the baby.

Dear collegaues! I´m very curious if things have changed and wanted to ask you all around the globe three questions on ventilation in the DR and also in the NICU? 1. What device do you mostly (only) use? a) Self inflating bag b) Flow inflating bag c) T-piece like Neopuff or other d) Ventilator 2. Do you also use some kind of respiratory function monitor and in that case, what parameter(s) do you primaly take in consideration for adjusting your actions (PIP, PEEP, Ti, Vte, Rate, leak%, other)? Yes/No 3. What adjunct to your ventilatory device do you prefer to start with? a) mask b) nasal prongs c) LMA d) ETT Any other comments? Thank you!🙏

The baby was more hypotonic/ floppy than you usually see in a child with ”only Mb Down”. We also tested extensively for muscle diseases, metabolic abnormalites and other but this was what came out.

Dear Colleagues! Just a brief question if anyone (more than me) has met a baby with concomitant Mb Down and Prader Willi syndrome? This baby born at GW 30+1, initially severly sick with chylothorax which eventually resolved. Now at about 1 month corrected age with low flow O2, can´t really get off diuretics, feeding only by NG tube, hypotonia, normal heart. Just got the result about PW today and was curious about any other similar child "out there"? Regards Pontus

Dear collegaues! I just wanted to hear your opinion doing continuous compressions when the baby has an LMA or do you always synchronize 3:1until intubated? In our national webeducation programme they say that you can "choose whether to synchronize or not" regardless of mask or LMA. Regards Pontus

Strange if nothing was seen from the start? Else I agree on that having nevioid lesions, lipomas or hemangiomas centrally etc one should rule out CNS-defects.

I´ve learned to cut in order to "optimize" VTV-mode so that the ventilator can read correctly and adjust to the Vt I want. I´m not sure though if it really matters... https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.20954