Vicky Payne

Also there are papers now looking at "cooling outside criteria" which are interesting too e.g. late preterms, stroke..... This RCT was in adults but suggests worse outcomes in adults undergoing therapeutic hypothermia who have bacterial meningitis.....https://pubmed.ncbi.nlm.nih.gov/24105303/ A neonatal study (Jenkins et al 2013) has looked at immunosuppressive impact of cooling. Newer possibilities: cooling in NEC?!? https://pediatrics.aappublications.org/content/125/2/e300.short and lots of work now looking at adjunctive therapies like xenon and erythropoetin..... And perhaps

I have only come across this thread too! We (UK) have 48 hour hang times for vamin, and 24 hour lipid change. The lipids are infused on a separate syringe driver, and the vamin run through different fluid pump. We were looking into using orange light protecting giving sets for the lipid which a different colour to our standard giving sets for bags of fluid. We have standard manufactured bags of PN in stock on the unit, and then we can also get special bespoke bags made via our aseptic pharmacy team if the patient needs fluid restriction or careful electrolyte management. Our nurses chang

Do you think the evidence provided in this paper would change your practice @Francesco Cardona? @bimalc makes a good point about parent choice and options- has anyone asked them (parents) what impact this might have on them?

I am really excited to see what the @99nicu.orgcommunity makes of this paper, and look forward to hearing everyone's comments! Lets start a conversation and share examples of practice, or what we might think future practice should look like 😍

Useful resources on managing a difficult airway developed from the British Association of Perinatal Medicine....practical flow charts and equipment to have to hand! https://www.bapm.org/resources/199-managing-the-difficult-airway-in-the-neonate

We do not currently use any heated humidified air in the delivery room.....we do this once we get back to NICU. I would be interested to hear what others do?

Hmmm I didn't even realise this had posted from the app!! ooops! Interesting you use saline only. What are your infection rates per 1000 CL days in this particular cohort of babies????

What do you mean by placing them incorrectly? What is interesting is that the original formulas developed in 1960's were developed to have the catheter in the right atrium, what we now know to be unsafe- recent review on methods to calculate insertion length here: https://www.tandfonline.com/doi/full/10.1080/14767058.2020.1838478?casa_token=yLqwwr0MfEUAAAAA%3AJxsgcDBkqa3owb5sDwdIOtr-tITC-MA56taD1smV0xqhNdjOjjJX50HekBWaE-ck1FgZrDb5tZPz I agree with @Francesco Cardona that POCUS is the way forward here, though we are not currently using it routinely either....

Dear all- I am posting this via the 99NICU app to test it!! But I am also interested to know what strength Chlorhexidine people use prior to central line insertion in ELBW infants and 23 (?22?) to 25 weeks??? Thanks in advance! Best wishes Vicky x

Signed up too!! I think this is going to be a great step for the 99NICU forum 😊

Thanks- we do some of these things (in principle!) 1. Change TPN using "surgical ANTT" but not with a hat or mask. We have lots of "traffic" in our nurseries, though recently we have moved to preparing the fluids in a separate room to avoid this traffic (doesn't appear to have made much difference to our rates so far) 2. Yes, we have these 3. We try to do this, though I am not sure how well it is adhered to. We do try to avoid putting any medications via central lines i.e caffiene, fluconazole but I think that infusions such as morphine/KcL piggybacks, inotropes e.t.c may get ch

Hi! Thanks for the tag Stefan. I think on the whole we would put up brand new TPN onto a new long line, though on some rare occasions other fluids may be switched from UVC to Long line. Central to central generally accepted as ok, peripheral to central a clear no, no! However, we are lucky to have standardised stock TPN bags kept on the neonatal unit, so we have easy access to this, and once warmed we can attach immediately with no waiting around - we only have to wait till the evening for bespoke TPN. We have salt free vamin for first few days, and then we have a preterm and term