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Narasimha Rao

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Posts posted by Narasimha Rao

    Premedication for LISA/ MIST

    in Practical Procedures

    Posted

    Do you use premedication for LISA/ MIST procedure? What combination do you use? We have started our LISA procedures successfully, but a lot of concerns from our faculty that we should be using premedication as we do for intubations. Any advice much appreciated.

    We started off with 28-34w and for those on neonatal unit only (plan to include delivery room once unit confidence builds up). For this category we use sucrose + swaddle only. However we’ve been facing an occasional vigorous baby, who we have had to revert to premedication and ventilation. We need to find a middle ground for these babies. Maybe LMA/ fentanyl/ ramifentanyl?


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    Less Invasive Surfactant Administration Tips

    in Resuscitation

    Posted

    [mention=7787]Florian[/mention] I would love to use the catheters you are talking about, but they are not available in the United States. I specifically spoke to a Chiesi rep and they don't see making the effort to get FDA approval here anytime soon. 
    [mention=7331]M C Fadous Khalife[/mention] Glad you liked it.

    My colleagues here at a tertiary unit in England, seem to have taken a liking and preference to the vygon surfcath. It’s definitely worth considering


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    • Like 2

    Hyperkalaemia - Insulin with dextrose

    in Metabolic disorders

    Posted

    At my new institution, we have fixed ratio "K-cocktail" available during codes with (I believe) Insulin, glucose, calcium and bicarbonate.  I can get the exact concentrations/doses on Monday when I am back in the unit if you'd like.

    Yes please. The dose and concentration of dextrose with dose of insulin would be helpful.
    Thank you


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    ET tube fixation methods

    in Practical Procedures

    Posted

    Hi [mention=3]Stefan Johansson[/mention]
    I can't seem to source these in UK. Only coming up on 3m US website. Any idea how I can get them? Anyone else from UK who is using these can guide me please
    Thanks

    I couldn’t find it being marketed here in U.K.. Maybe worth contacting the representative?


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    Inotropes made simple (FOAMed)

    in Cardiovascular Problems

    Posted

    I just wanted to share a link about inotropes, a blog post on a British FOAMed* web site: https://www.paediatricfoam.com/2017/01/inotropes-made-simple/
    Managing circulatory failure with potent cardio- and vasoactive drugs can be a challenge, and it is necessary to understand the pathophysiology of the problem to choose the right set of interventions and drugs.
    *FOAMed = Free Open Access Medical Education

    Article appears to have moved. Here’s the fix
    https://www.paediatricfoam.com/2017/05/inotropes/


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    • Like 1

    Echocardiography _ultrasound

    in Respiratory Support & Monitoring

    Posted

    Thank you for asking this question! 

    We use a Philips Affiniti 70 device in our unit (we are tertiary NICU in England). We are on the lookout for a second scanner for pure cardiac ultrasonography purposes. 

    Few other tertiary units in our region use a GE Vivid S70N.

    Would be good to know what others use and do kindly share your experiences please. 

     

    Drug infusion calculators

    in Medication & Pharmacology

    Posted

    Anyone using safe and time-efficient ways of calculating common infusions, such as morphine/ muscle relaxants/ inotropes/ prostaglandin etc?

     

    I’ve come across spreadsheets with weight as variable and some stickers.

     

    But looking for ideas and to gain from other good practices too!

     

     

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    • Like 1

    Long term management of children with bronchopulmonary dysplasia (European guidelines 2019)

    in Respiratory Disorders

    Posted

    Nice summary . Thanks stefan for sharing.Any new medication or strategy for BPD management as we are stuck with a 25 weeker baby  now almost 38 weeks corrected gestation age with severe BPD , ROP , Osteopenia/metabolic bone disease of prematurity. Strangely this baby has a very high VITAMIN D Levels. We are providing inhaled furosemide, budecort, vitamin A ( oral) , Caffeine, hicalorie formula ( 150 Kcal/day) . What is the role of tracheostomy in such cases? Suggestions are welcome.
     
     

    We tend to involve paediatric respiratory team/ consider corticosteroids/ rule out pulmonary arterial Hypertension/ consider alternate day azithromycin. If oxygen requirement persisting beyond 40-42weeks, we would have MDT to transition to paediatrics where depending on effectiveness of above measures, they would consider tracheostomy and home duopap.


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