NHowold

Sufentanil is a very potential pain killer with very little side effects (except cummulation and withdrawal). Morphine has not such a high analgetic potential and a lot more side effects (very emetic, reduced bowel movements)

In extreme small preterms we don't use any sedatives only for the ventilation. We adjust the mechanical ventilation that the baby is comfortable. We use sedatives only if the babies have severe ventilation issues (dyspnea) or painful procedures.

Chest drain is very painful. Opioids are no problem on a ventilated baby. And before Cpap we want to be sure that there no second pneumothorax occurrs. So I would remove chest drain first

@Stefan Johansson scanning the 80 pages of the EU regulation a biobank software which creates barcodes is basically what you need. I know a lot of donor banks using blood biobank softwares (because they have them anyway). Commercial blood bank software is unfortunately very costly. Our hospital has to pay the running costs for the milk bank out of our own pockets - there is no funding, no Ops-code, so also no payments by the health care system. We strongly believe in the benefit of the donor milk, but buying a commercial blood bank software is just a huge financial issue.

Dear colleagues, We are a medium sized hospital in Germany with a donor milk bank. We are managing the procedures manually right now and are looking for a digital /software solution. Any suggestions for a usable software? Yours Nele Howold

Dear Mo7, If Albumin gets below 25 g/l we consider replacement.

Mct rich, otherwise low fat diet. We start with parenteral nutrition, but use breastmilk if feeding starts to get possible. Just store the milk in the fridge, remove fat before feeding and replace with MCT oils.

We tried to implement glucose gel in our delivery room. BUT there simply was no need. We teach antenatal breast expression to high risk mums and practice early breast feeding along with uninterrupted skin to skin contact. I really haven't seen a hypoglycemia in a healthy newborn for years.

What dosage do you use? 0.25 or 0.5 mg/kg?

Hi there, For Lisa we use the rather rigid Lisa catheter from Vygon. Magill forceps are not needed then.

We use Levetiracetam as a first line after cutting the seizure with benzodiazepines. Works very well for us. Levetiracetam does not impair the vigilance and Eeg as much as phenobarbital

Dear Narasimha, We use the in stream system for the Philips monitoring. They have a newborn probe. It's definitely not as accurate as transcutan measurements, but gives an estimate. We usually use it in toddlers or newborns with edema. Yours Nele

Hi Gustaf, We have used the old Freestyle system a few years ago in I think three preterm and newborns with a weight of 2500 or higher. We did place the sensor on the outer upper leg or buttock above diaper level and inserted the "feeler"? only about half of its length in a pretty flat angle. It worked great. When established, we only take blood for demanded calibration. Yours Nele

@KatjaKatja thank you for bringing up this topic. We are currently in the process of implementing a pdms. We have not been able to find a ideal solution for the Nicu. Copra at least works well for pediatric patients @Wigand I am really interested in a Obis based solution. To my understanding there is no Nicu modification! There is a rumor that they are working with a company in France who might be able to provide a add-on in the future. We did research and Icu Manager is running at the Bult hospital in Hannover - at the Picu. There is no Nicu working with Orbis Icu manager!

Ampicillin/Gentamicin Gentamicin 5 mg/kg every 48h hours according to the dosage handbook of the American pharmacists association

I am a neonatologist in Wolfsburg, lower Saxony in Germany. We are a level 1 (highest level in Germany) perinatal unit and could take neonates or preterm babies from the Ukraine. All preterms except babies with congenital heart diseases who need immediate surgery or neonates who need dialysis. The number of patients we can take is dependent on the seriousness of their illness. We can offer accommodations for the mother as well. I am able and willing to assist with transportation. If our transport incubator and vehicle can be used is evaluated at the moment. Please feel free to contact us Nele.howold@klinikum.wolfsburg.de

Does anyone know if an evacuation would be possible? I have seen a heartbreaking video with neonates beeing ventilated manually in a basement. How can we help? What is needed where?

In Wolfsburg, Germany we wear N95 facemasks whole day. Two weeks ago we were almost closed down due to infected staff. So we basically wear the mask to prevent the patients getting infected by personnel (and vice versa). We have yet not seen a positive newborn (all patients are tested if admitted to the hospital)

Is the mother severely sick? If the baby is healthy and the mother can care for her baby, why should the baby be isolated? I thought it is conses that mother and baby should not be separated and the mother should breastfeed her newborn. If mum is severely sick the baby should be discharged to the father.

We also start with 100 ml/kg/d with a sodium (and potassium) free tpn. We do liquid balancing every 8 hours with the goal of plus 10 ml/kg, replacing liquid lost by urine and stool. As replacement with use Ringer Acetat solution. We start adding sodium to the tpn as soon as the levels drop and accept sodium levels of 150 mmol/l without any intervention. I don't have the feeling that we had any problems with too high sodium counts in preterms.

It works very well. We extubated two patients against CPAP under ongoing iNO therapy. Both patients did fine. CPAP and iNO is probably no option in a severe respiratory failure, but ongoing iNO therapy shouldn't be a reason for no extubation. I'm very sensitive to iNO exposure, so I can tell iNO on CPAP with less than 10 ppm are possible, but keep the windows open and the flow as low as possible.

Alternative medicine - part of a modern nicu?