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About ammar

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  • Occupation
    pediatric intensivist
  • Affiliation
    children's hospital
  • Location
    Tunis/ Tunisia
  1. yes we do it for high and low flow cannula and for all other kind of NIV thee is severe kinds of Fand P heater, sometimes yhe sevo do it automatically and other times you should define temperature and minimal différence of the gradient between proximal and distal point
  2. extubate him to NIV nowwwwwwwwwwwwwwwwwwwwwwwww
  3. echocardiographic assesment if PCA: dobutamine + ibuprofène if not PCA, Lv dysfunction: dobutamine if No PCA and good LV dysfunction : NS 10-20 ml/kg over 40-60 mn and HSHC 4-5 mg/kg/j in IV route
  4. Hello, Ammar. very interesting your comment about PEEP. You have to hand literature? . Thank you. mbarbaglia mbarbaglia@tiscali.it

  5. On the Stephanie machine, you have the most used modes of ventilation that you need (conventionnel, HFO, Volume modes ...) with well graphical representation. problems concerns: Hmidification++++++++++++++++, the lenght of the circuit, setting of alarms and complicated materiels to be cleaned. We used also the SLE2000+, less than modes of ventiation, trigerring ventilation go fail usually, frequently rearming of alarm and HFO less effective than STE or sensor medics.
  6. all kinds of mode ventilation on the LEONI+ are limited and controlled pressure. But you have the possibility to use the option (if it is installed on the machine!) of Guarented Volume. you set the desired volume and you set else the high inspiratory pressure limit. So the machine will try to give the fixed volume with the minimal pressure that can never be more than the limit set.
  7. We use a solution that the name is SULFANIOS (i did not have the regular composition now) and that was apprved before use by the manufactoring societies of our incubators. many parts of the incubator are treated alone in the "autoclave" and cleaned before with the same disinfectant.
  8. We use Orogastric tubes that will be changed once a dsay. A verification of the placement must be done before every enteral feeding. for fixation we use the same materiel used to the tracheal tube.
  9. we use in case of alveolar desease PEEP with a value that depends directly to FiO2. So if patient O2 requirement is high, >40-45%, you need to use PEEP>5 cm H2O, and in neonate (preterme, Weight dependent) you can use 7-8 cm H2O. When you have not Lung desease (PPHN....), PEP is Usually 0-2 cm H2O. you must control the effect of PEEP, 30 mn after change and without aspiration to make Sure that there is not ALS (PX, PM, PPC, IE or overdistension). Other thing, you must care to the hemodynamic effect of PEEP in newborn with hypotension.
  10. Thank you Hady I think that the idea is very good and original. but i have some interrogations about why the use of theophylline as control group the total number of patient is little the outcome included in the study period (time) is very short the difference (statistics) is very little and perhaps not exist if number of patient was slightly higher than 42 preterms.
  11. Hi we recieve frequently newborns of diabetic mother for respireatory distress of various causes. Echographic assessing shows frequently signs of hypertrophic myocardiopathy with a variable alteration of the Left ventricular function. I would like to ask about prescription of Propanolol in this patients (Indication, acess, posology, therapeutic period and contre-indications). Thanks Khaldi ammar Children's Hospital of Tunis PICU
  12. Hi I would like to review with you, what kind of central vascular acess in neonates in managing preterm or term infant with severe RDs/PPHN. sometimes we have difficulty to make central un ombilical venous KT, so we remove it immediatly and we place either jugular or femoral acess for term neonate and Epicutaneocava KT in preterm. But as you know, especially in term neonate with severe PPHN, the time of catheterism is a usual occasion for oxygenation loss. So what do you do in such situation. Thanks Khaldi Ammar Children's Hospital of Tunis PICU
  13. Darya, we used it for 2 years for children's with septic shock. but not in neonate, we use Noraml Saline.
  14. Thank you very much Jack and Stefan. i will give you results about prevention. Your idea? Jack is very useful regarding our situation. I will write some clear words to my collegues. Thank you again.
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