Natascha Pramhofer

Dear colleagues, do you see post-extubation stridor regularly at your NICU? We recently had 2 quite severe cases of late preterm babies who at that time already were around 40+0 and that only had been on the ventilator for a few hours (1 for minor surgery and 1 for an MRI). They were treated with nebulized adrenaline and corticosteroids and luckily got better pretty fast. How do you treat it? Do you have any protocol on that and do you have a protocol or guideline on how to prevent it like some of our PICU colleagues (i.e. https://secure.library.leicestershospitals.nhs.uk/PAGL/Shared Documents/Post Extubation Stridor UHL Childrens Intensive Care Guideline.pdf )? Thank you in advance!

We normally use Dextrose 10% within the first 3 days of life and start with - 60ml/kg/d for full-term, AGA, - 70 ml/kg/d for 1500-2500g birth weight, - 80 ml/kg/d for 1000-1500g birth weight, abd - 90-100 ml/kg/d for 500-1000g birth weight. The fluid intake is then beeing increased every day by 10ml/kg/d.

We've been doing LISA/MIST for a few years now, but there is still no clear guideline in our hospital concerning premedication. Almost every attending and fellow uses some sort of narcotic, though everybody uses different medication, and some use no premedication at all (most of the time). I'm wondering, does anybody use Propofol for LISA/MIST currently? If so, what is your experience with it? Which dosage do you use?

For preterm infants born before 32 weeks postmenstrual age the point of assessment is at 36 weeks postmenstrual age (or at discharge, whichever comes first). For preterm infants born ≥ 32 weeks postmenstral age you assess at >28 days (but <56 days postnatal age or at discharge home, whichever comes first). Then you have to consider the treatment with oxygen >21% for at least 28 d plus for mild BPD: Breathing room air at 36 weeks postmenstrual age/by >28days (<56 days) age or at discharge, whichever comes first for moderate BPD: Need for<30% at 36 weeks postmenstrual age/by >28days (<56 days) age or at discharge, whichever comes first for severe BPD: Need for ≥30% oxygen and/or positive pressure(PPV or NCPAP) at 36 weeks postmenstrual/by >28days (<56 days) age or at discharge, whichever comes first So the preemie you talk about would have a mild BPD by the NIH workshop definition. I hope this helped you.

Dear colleagues! There is a burning question on my mind. Has anybody done one oft these two part-time distance learning MSc programs - MSc Neonatology (University of Southampton - https://www.southampton.ac.uk/courses/neonatology-masters-msc) or MSc Neonatal Medicine (Cardiff University - https://www.cardiff.ac.uk/study/postgraduate/taught/courses/course/neonatal-medicine-msc-part-time)? If so, what was your experience with it? Would you do it all over again? Was it worth its money? Was it compatible with working full-time? Initially I wanted to join a PhD program, but unfortunately this is almost impossible right now and probably for the next few years at my hospital as there are almost exclusively neonatal clinicians working here although it's a (relatively new) university hospital. That's why I am searching for academic alternatives and found these two already mentioned programs.