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piatkat

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Everything posted by piatkat

  1. until
    I would like to warmly invite you to a webinar about the auditory environment in the NICU. Chairman: prof. Liisa Lehtonen, Turku Program: 1. Influence of the NICU auditory environment on the preterm infants (30 min) Pierre Kuhn, Strasbourg 2. Event-related potentials reveal neonatal brain processes of communication (30 min) Minna Huotilainen, Helsinki and Paula Virtala, Helsinki 3. Discussion (15min) Registration: https://forms.office.com/Pages/ResponsePage.aspx?id=ibTRgNZawkW3Vw74nqAsW7Gocpw_AwpMlSi9hMZFNp1URUM2TVhaRlA3SU5TRTVNT0hFRDk0MzVYQi4u This online event is organized with the support from Chiesi company. 21-1333_Inbjudan_webinar_7Sept_NO.pdf
  2. Recently I've participated in a small scientific meeting with the neonatal team from Uppsala, Sweden, and from what I understand they are trying to involve parents in a more meaningful way to care for their infants during therapeutic hypothermia. I know that so far they have published this qualitative study https://onlinelibrary.wiley.com/doi/10.1111/apa.15431 and a bit earlier this study https://pubmed.ncbi.nlm.nih.gov/31084824/ :"Being unable to hold the infant skin-to-skin during HT has been shown to be stressful [10], and although skin-to-skin contact has to be limited due to thermoregulatory constraints, infant holding is indeed feasible [23]." I hope this gives you some fresh perspective I have no idea if we have anybody from Uppsala here, @Stefan Johanssondo you maybe know?
  3. The Incubator Ben Courchia & Daphna Yasova Barbeau A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible.Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.
  4. @Stefan Johanssonshal we make a folder "Podcasts" in our Links directory?
  5. Hi Tarek, I wish I had the knowledge and the experience to dispel your doubts here, but I can offer only a bit of text, sorry!😅 In the metanalysis Sucrose for analgesia in newborn infants undergoing painful procedures the Authors conclude : "Sucrose is effective for reducing procedural pain from single events such as heel lance, venipuncture and intramuscular injection in both preterm and term infants (...). Investigators should be cautious when utilising existing evidence to answer questions on efficacy in other painful procedures that have been minimally addressed to date (e.g. lumbar punctures, peripherally inserted central catheter insertions, endotracheal intubation, chest tube insertions)." So what I understand is that the sucrose (with or without pacifier) can be beneficial for heel lance, venipuncture and intramuscular injection, because when used, it was causing favorable changes in pain scores (I think that the highest quality of evidence comes from studies that used PIPP (premature infant pain profile, includes heart rate assessment, oxygen saturation, facial actions). "There was high‐quality evidence for the beneficial effect of sucrose (24%) with non‐nutritive sucking (pacifier dipped in sucrose) or 0.5 mL of sucrose orally in preterm and term infants: Premature Infant Pain Profile (PIPP) 30 s after heel lance WMD ‐1.70 (95% CI ‐2.13 to ‐1.26; I2 = 0% (no heterogeneity); 3 studies, n = 278); PIPP 60 s after heel lance WMD ‐2.14 (95% CI ‐3.34 to ‐0.94; I2 = 0% (no heterogeneity; 2 studies, n = 164). There was high‐quality evidence for the use of 2 mL 24% sucrose prior to venipuncture: PIPP during venipuncture WMD ‐2.79 (95% CI ‐3.76 to ‐1.83; I2 = 0% (no heterogeneity; 2 groups in 1 study, n = 213); and intramuscular injections: PIPP during intramuscular injection WMD ‐1.05 (95% CI ‐1.98 to ‐0.12; I2 = 0% (2 groups in 1 study, n = 232)." The question is- does the improvement in pain scores actually mean less painful stimuli for the brain. Or maybe what happens is that the baby just gets calmer, but the painful stimuli still harms the brain? Maybe some SENIOR physician could pitch in and let us know what is their practice When do you use sucrose and when you prefer to go with a painkiller? SO MANY QUESTIONS!
  6. until
    The aim of this SCENE Symposium is to share the new research findings related to closeness in the neonatal environment (day 1) and to start collaborating in research projects aiming to improve care culture and increase infant-parent-family closeness (day 2) Registration is closed, but if interested, the main event can accommodate a few additional participants. Write directly to the Director of the SCENE research group Anna Axelin to receive your links for the ZOOM (anmaax@utu.fi) Page: https://sites.utu.fi/scene/scene-symposiums/nextsymposium/ Program: https://sites.utu.fi/scene/wp-content/uploads/sites/191/2021/05/8th-SCENE-Symposium_program_May_14th.pdf
  7. @Francesco Cardona and @Sutirtha Roy thanks!!! The number of people quoting yesterday the Cochrane metanalysis to me was TOO damn high! I get it, it is a high level of evidence, but these studies were (all or mostly all) looking at pain score scales! And somebody very wise once told me "If we have several scales to asses the same thing, it means that none of them is actually very good" 😅 I don't want to fight with windmills there, but I am going to just post this video and hoping I won't get assassinated in the comments section 😂
  8. Great comment @bimalc! I have discussed this topic also with one of my very experienced coworkers. Since our hospital trains also pediatric trainees that then leave to work in rural areas, she was strongly leaning towards intubation being a mandatory competency. She motivated her point of view saying that somewhere up in the North there might be nobody else to perform the intubation, so the trainee has to be able to intubate. But then I asked, "is intubation the goal, or securing the airways?". I think we need a shift in thinking- intubation is not the only way to secure the airways. Saying that I know that not many colleagues in the unit have had experience with LMA (basically only those who have had some experience in the surgery dept.). We would need to change the way we think and we teach-but it might be that currently the teachers might not have enough experience with the LMA to act as confident instructors. Many things to consider!
  9. Hi, I'm digging up this topic- yesterday I got myself into a conversation with some colleagues about soothing pain in neonates with glucose gel. Of course it's a widely spread method, and I am not questioning this practice here with this post. I remembered however some article claiming that although glucose was soothing the symptoms of pain, in the end it did not mitigate the brain alterations that happened in the brain during painful stimulis ( I think this was the article https://journals.lww.com/pain/Abstract/2018/03000/Procedural_pain_and_oral_glucose_in_preterm.14.aspx). Have you encountered more studies supporting this? I am wondering if this was the article I had read, because vaguely I remember the authors concluding that glucose is nice, but avoiding painful stimuli is even nicer. Or maybe it was all in my head 🤔
  10. Great resources, thanks Vicky!!!
  11. I think I found an interesting study about antepartum and intrapartum risk factors of neonatal encephalopathy. A bit old, but I think still very relevant when discussing the causes of hypoxic ischemic injury with parents! https://www.bmj.com/content/317/7172/1554.long https://www.bmj.com/content/317/7172/1549.long
  12. Ooooh! Cool, thanks!!!
  13. Hi, I would like to learn more about hypoxic-ischemic encephalopathy (HIE), can you recommend your favorite articles in the topic? I can totally read some reviews, or also original research papers if you think they are well written and relevant animal studies can also be interesting! Thanks!
  14. @M C Fadous KhalifeWhat about the paper itself? How do you evaluate the evidence there?
  15. A one day virtual course providing the essential skills to perform and interpret neonatal cranial ultrasound scans on the neonatal unit. This course will cover: · How to use an ultrasound scanner and get the best quality images · Standard images and normal anatomy · Germinal matrix and intraventricular haemorrhage · Linear measurements of ventricular dilatation · Preterm white matter abnormalities · HIE and Doppler measurements · Perinatal stroke Fee: full rate - £50.00 Register here: http://training.ucheducationcentre.org/home/viewcourse/515/
  16. @Vicky Payne- this is a really good question. It has reminded me of a blog entry I "committed" some time ago- not about intubation in presence of family, but about intubation on parent's chest 🔥🔥🔥 link is here below ⬇️⬇️ Of course, the level of evidence is anecdotal, but it's just a reminder for me that the impact on parents could be related to their very unique situation in the Unit. Are they only infrequent visitors there, or maybe primary caretakers? I think that might change their perspective a lot!
  17. On behalf of the 99nicu Team, I would like to invite you to participate in our newest initiative- a Journal Club. The objective of this club is to share and discuss articles of interest to all neonatal healthcare professionals. The article we chose this time (https://fn.bmj.com/content/early/2021/01/20/archdischild-2020-319709) describes the current practice regarding family presence during intubation of their infant in the NICU and examines association with the outcomes (e.g. success rate within the first attempt). Some of the questions we would like to discuss are below. What is current practice on your ward? What do you think are the strengths of this study? What do you think are some of the limitations? What are the key risks of “bias” in this study design- do you think that has influenced the results? What “confounders” might there be? Is the population similar to your own clinical area? Does this matter? We are looking forward to hearing your thoughts and opinions!
  18. @Chris van den AkkerI've just found this thread! Seeing you had posted this question some time ago already, I wonder how did it go- have you changed your PN regimen? Please let us know what are your thoughts about it! Any suggestions for units trying to implement this model?
  19. I don't know where to draw the line for ELBWs infants of course, but there is a really nice lecture from our 99nicu Meetup in Vienna about infants surviving at the limits of viability. I have listened to it several times already! I like it because it draws attention to brain alterations that are much more subtle than "injuries" we clinically monitor in the NICU. It clearly shows the need of sustainable research efforts to find more or better ways to protect premature brain in order to facilitate a well-rounded development of structural networks.
  20. Human Donar Milk: Not a Panacea (Prof. Josef Neu) Registration free of charge, register here: https://mcaevents.eventsair.com/webinar-uenps-1st-module-nutrition/registration/Site/Register
  21. Human Milk Lipids (Prof. Camilla Martin) Registration free of charge, register here: https://mcaevents.eventsair.com/webinar-uenps-1st-module-nutrition/registration/Site/Register
  22. Human milk the importance reaffirmed (Prof Riccardo Davanzo) Breast feeding the COVID era: any concern? (Prof. Hans van Goudoever) Registration free of charge, register here: https://mcaevents.eventsair.com/webinar-uenps-1st-module-nutrition/registration/Site/Register
  23. Hi, do you have a valid link to this app? I cannot find it online.
  24. Contains good quality images of both normal and abnormal findings in newborn. "This material was compiled by Janelle Aby, MD for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials for educating those who care for newborns is permitted with proper citation of source." List of covered systems: General Head Eyes Ears Nose Mouth Neck/Clavicles Lungs/Chest Abdomen Umbilical Cord Hips Genitourinary Extremities Back Neuro/Reflexes Skin Dysmorphology
  25. until
    This webinar will examine the wider impact of COVID from a range of perspectives. Speakers will cover what has been learnt during the pandemic and what we do next. The even will feature a live Q&A. Introduction from the chair Ms Hilary Cruickshank Clinical Specialist Neonatal Physiotherapist, NHS Lothian Parental perception of visiting on the NICU during Covid Dr Hemananda Muniraman, MBBS, FAAP, FRCPCH Neonatal Unit Medical Director: Quality Improvement, St Joseph's Hospital & Medical Center Affiliate Assistant Professor of Pediatrics, Creighton University School of Medicine, Omaha Impact of Covid and mask wearing in the NICU Mrs Beverley Curtis Senior Speech and Language Therapist, University Hospital of Wales GIRFT update and progress Ms Michelle Sweeting Neonatal Speech and Language Therapist, Mid & South Essex NHS FT Adapting follow-up during a pandemic Mrs Suzanne Offer Clinical Specialist Neonatal Physiotherapist, NHS Highlands Q&A Dr Cora Doherty Consultant Neonatologist, University Hospital of Wales Event: free for members, for non-members £10.00. Registration and more information here: https://www.bapm.org/events/187-bapm-webinar-the-wider-impact-on-neonatal-services-during-covid-the-evidence
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