Peter Franczia

Some thoughts from a former pathophysiologist: the aim is to restore skin microcirculation. You surely tried to modify most of the components of edema formation, phlebohypertension (RF? HF?), oncotic/hypoproteinaemia, membranogen (sepsis? etc), but what can we do with the lymphatic component? At first, lymphatic insuff is dynamic, more efflux than the capacity, but beyond a point mechanical component (compression by the edema) becomes also important. Can we help the lymphatic system to bring back the excess fluid, to give space for the microcirculation? Lymphatic massage is well known in adults, but is there anybody practising it in NICUs as a therapeutic tool?

We uploaded these data in the drug library of our Alaris pumps. (Fix composition method.) It is extremely simple to use: you order e.g. 5mcg/kg/min dobutamine - the nurse prepares the fix composition infusion (using the printed table) - enters the BW of the baby in the pump - enters the dose - and the pump calculates the infusion rate. You can use the table for individual calculations as well. If you have Agilia pumps, you may find the other file useful. You will need the special SW of Fresenius to modify it and to upload the drug library in the pumps. (It contains the lower BW range only, but for transport it was enough for us.) Peter _NICU infusions v6.4.0 EN.xlsx NICU infusions Agilia.bib