M C Fadous Khalife

i would like to answer Dr Bachy about the reversed pre-post ductal pulse oximetry The most important is to focus on the PPHN; those cases not only seen in TGA but also in aortic arch interruption or CoA and they only represent less than 1% of the PPHN so very very very rare

No but we double check our calculations in the neonatology unit

I just can give you the link to our local study ( Published in BMC in february) https://www.ncbi.nlm.nih.gov/pubmed/32066413

Ampi and genta first line

I don't have a good experience with needle thoracocentesis especially in ventilated babies

This is very important to disseminate. We experienced 2 cases of cavernomas; my question is would you be for systematic hepatic echography when taking off UVC?

When no pulmonary hypertension sildenafil is useless Meta-analyses support the association between Ureaplasma spp. infection and the development of long-term lung disease in preterm infants hence, the use of antibiotics such as azithromycin, erythromycin, and other macrolides in clinical practice.102,103 Macrolide antibiotics also have immunomodulatory properties, suppressing lung inflammation.104 In clinical trials, intubated infants receiving erythromycin did not have reduced risk of BPD.105 Treatment with azithromycin, a newer macrolide, has shown promise in a meta-analysis demonstrating reduction in BPD and BPD/death in preterm infants when given prophylactically.106 Clarithromycin treatment was also associated with lower incidence of BPD in premature infants with a BW between 750 to 1250 g in an RCT.107 Studies combining use of all macrolides in Ureaplasma-colonized ventilated preterm infants did not show reduction in BPD or the composite outcome of BPD/death, and routine use of the macrolides for the prevention of BPD is not recommended.https://dx.doi.org/10.1177%2F1179556518817322

For me, definitely this baby must be closely observed and basic lab tests are essentials;

Thank you for sharing

Our Caffeine is the same, IV and oral; ours is from alpha laboratory

If parents are not well prepared for the dangerous situation, I prefer to follow transport and get help from the arrival unit team if I already prepared the parents and they know how dangerous is the situation, I stop all, get back to my original departure cause usually it is our hospital and explain everything.

This is not common; in 5 years just saw 2 cases; effectively good response to diazoxide

I agree! We do same as well

https://www.ncbi.nlm.nih.gov/pubmed/29579758

We use cafeine from birth and never had any problem