Rola alzir

Like to reactivate this question as it is really from our daily practice .. so like to read more about it . What I can share from our practice To change ration 1:2 to be 1:1 is when I have a baby washing CO2, badly with highest frequency possible ( 15), and lowest amplitude with which wiggles can still be evident( we use no less than 15) , so here 1:1 is my next step, in order to limit the CO2 washing , as well help oxygenation, but consider that the case is not already with hyperinflated lungs 🫁, as 1:1 can worsen this part . Again physiology and ogysiodynamics of this depends on the absolute tidal volume delivered..

Worth looking at ..

It doesn’t damage the nasal septum ... I like this statement . nasal bridge as well and nostrils as they are a concern in the unit where I’m working . Liked theis Stephan tools . Skin friendly , like to watch a demo about the attachment to forehead/ head .

In our unit our concern with the permissive hypercapnea is the higher risk of IVH. We do practice the IVH bundle that main role is to minimally handle the baby. The point of adding acetate is part of our practice , as if the baby - and this usually the case - is in TPN , it’s considered. If there is a UAC - in babies who need close eye in hemodynamic monitoring - the UAC fluid running is Na acetate at a rate of not lower than 0.8ml - 1 ml / hour. We do start with PEEP of no less than 6 . And the Vt that allows to ventilate and oxygenate within targets . PH is the main point we look at in then blood gas as we allow for no lower than 7.25 , and PCO2 of no more than 75. we have for some time used VIVE as addition mode to the current main mode of AC + VG, but it’s role doesn’t really work with all ( meant to eliminate the CO2) but no strong evidence . once kidneys ability of concentration matures within the DOL 6-9 we do recognize a sudden change in the PCO2, which is now been compensated by the kidneys . I do concur that sedation sedation sedation is a core management point with it , some ventilation issues are solved , in our unit, we do use fentanyl as infusion , midazolam as scheduled doses and dexmedetomidine if needed as infusion especially when baby is extubatable and we plan for use of CPAP immediately post extubation . Hope this helps

Why do we call it NAS not drug withdrawal syndrome in neonatal age group ?

Wonderful video for teaching purposes