drprasadrao

Greetings from Hyderabad India We use Sildenafil with good outcomes

Happy Birthday to all of you at Virtual headquarter may your tribe increase!!

Hello friends, Greetings from Hyderabad India,I have a preterm baby (28-30 weeks) with resp.distress mother PPROM 3 days born by SVD mother received 2 doses of steroid. how to manage in a level III NICU setup since the parents are poor.

Wish you very many more escapades if they arise in future! but I think we have happy days ahead!! With best wishes and good times.

Persistent pulmonary hypertension of the newborn is a disorder of vascular transition from fetal to neonatal circulation, manifesting as hypoxemic respiratory failure. It's a common pathway of vascular injury activated by numerous perinatal stresses. As with other multi factorial disorders, the optimal approach to the treatment of PPHN remains controversial. Although, inhaled NO therapy is currently regarded as the gold standard therapy about 30% of neonates fail to respond adequately to iNO. Further decreases in the morbidity and mortality associated with PPHN are possible with specific strategies to correct the imbalance between the vasoconstrictor and vasodilator mediators that play an important role in the regulation of the transition from a high to low pulmonary vascular resistance state and strategies to reduce lung injury.Sildenafil is being tried in many centres in India with fair results.

Hello!! greetings from Hyderabad India what sedation or anaesthesia do you use in neonates for procedures like MRI.

NEOCON 2009 at Ahmedabad during 10-13 December 2009

Bicarbonate is not being used here in our NICU in resuscitation of a neonate and later unless used for documented metabolic acidosis as stated earlier,

We have been using Ciprofloxacin judiciously in our NICU's since 9 years and it has been of immense help in Bacterial meningitis, culture sensitive sepsis.Dose 10mg/kg/day bid

Routine gastric lavage is unnecessary we do it only in case of ceasarean sections where there is thick pasty meconium to prevent aspiration after regurgitation. Do you do the same? Or some of us believe in generalisation & not sure of preventive medicine?

Hello Neonatologists, Is routine nasogastric aspiration of the stomach done by you, if so why?

we do encounter tongue tie regularly but all we do is leave it alone till it causes any speech problems (usually it does not) we leave it to the ENT surgeons for further action

We have been using oral ibruprofen in our neonates with good results till date

Minimal Entetral Nutrition (MEN)should be avoided in infants with severe hemodynamic instability, suspected or confirmed NEC, evidence of intestinal obstruction/ perforation or paralytic ileus. Recommended volume is 10-15 ml/kg/day. This should be divided into equal aliquots and administered by gavage feeding in a 3-6 hourly feeding schedule. In VLBW infants born with antenatal diagnosis of problems in umbilical arterial blood flow (reverse or absent end diastolic flow), MEN can possibly be delayed for 2 to 3 days. Advancement of feeds should also be slow and carefully monitored in these infants. Monitoring The infant should be monitored for any evidence of feed intolerance including abdominal girth, gastric residuals or clinical signs of necrotizing enterocolitis (NEC). If the abdominal girth has increased by 2 cm, gastric residual volume (GRV) should be checked. Feeding should be stopped in the presence of significant aspirate (>25% of feed or >3ml whichever is more) and/ or bilious or blood stained aspirates.

Mininmal Enteral Nutrition or trophic feeding is practised in many NICU units all over India.Early introduction of oral feeding accelerates the transition time from tube to all oral feeding. This not only allows earlier attainment of all oral feeding, but it also provides practice opportunities that enhance the oral motor skills necessary for safe and successful feeding.

http://www.indiana.edu/~pietsch/joubert.html Please follow the above link for more info Dr Prasad Rao

We use Apgar scores for every newborn, even for premature. It's not a ideal score, but for now, it's the best we have". It is done by the obstetricians & Pediatricians in our place not the midwives. Dr. Prasad Rao Pediatrician & Neonatologist Hyderabad India