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Rola alzir

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    United Arab Emirates

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About Rola alzir

  • Rank
    Member

Profile Information

  • First name
    Rola
  • Last name
    AlZir
  • Gender
    Female
  • Occupation
    physician neonatologist
  • Affiliation
    AQWHC- UAE
  • Location
    Dubai -UAE
  • Interests
    Neonatal sedation neurology , use of ultrasound point of care

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375 profile views
  1. 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
  2. Hello every body 

    what is the practice regarding administration of surfactant ? Prophylactic or rescue surfactant you use ? For the age groups below 32 weeks and more than 32 weeks . 

    1. varady

      varady

      We use preferable the prophylactic administration  of surfactant especially in infants under 30 weeks.

    2. Rola alzir

      Rola alzir

      What’s the rationale behind your practice !? Any link that supports your input ? To share !?thanks

  3. Rola alzir

    Withdrawal

    Why do we call it NAS not drug withdrawal syndrome in neonatal age group ?
  4. @Stefan Johansson I have been through the link attached . It’s interesting reading. Still I would like to know more about acetaminophen which we used to use sin my unit , as in extreme preterm where RFT is of concern we do go with acetaminophen with ECHo repeat on D4 of treatment . We do give total 7 days , providing that initial baseline LFT is reassuring. Q please : you do start ibuprofen even if baby is not yet fully fed ? As you have mentioned it’s been given early in first 14-21 days . Means at 7DOL it can still be initiated.
  5. Thanks @Stefan Johansson This explains the issue of antacids with suspected GERD . What I was wondering about is the combination of the ranitidine with the use of ibuprofen in cases where PDA was hemodynamically significant , mandating medical closure . If this topic is been touched or investigated or the combination is been practiced . To hear from those who have any input about it . i will share these provided links with my colleagues as the use of Esomeprazole is practiced here for neonatal GERD cases. Thanks a lot for the the rich input
  6. Thanks @Stephan . How about the use of ranitidine meanwhile the ibuprofen is used, especially the PO administration. Is there any evidence that it decreases the side effect of ibuprofen in regard to gastric irritation !? Does it interfere with the effectivity of the ibuprofen. In my unit after a day 1-2 if any deterioration of the RFT we do switch to paracetamol course. And the deterioration we detected it in case of extreme preterms 24-26 weekers . Our observation - personal experience- that paracetamol has closed the PDA, in couple of cases where ibuprofen was started but then stopped, and switched to use of paracetamol .
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