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Care of asymptomatic newborn Covid PUIs
Nice informative articles Of course everything changes so fast - Always check online for updates Neonatal Resuscitation and Postresuscitation Care of Infants Born to Mothers with Suspected or Confirmed SARS-CoV-2 Infection (https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0040-1709688 ) ( Full test access is free Also some nice resource - updated continuously ( https://www.allthingsneonatal.com/category/covid19/ ) Keep checking online - things get outdated within days in this Pandemic
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Are masks mandatory in your NICU during coronavirus pandemic?
Universal masking - has pros and cons. You will find those who swear by it and those that find fault in it. Nice perspective here: https://www.nejm.org/doi/full/10.1056/NEJMp2006372 But just a personal viewpoint - i often see that those who wear face masks throughout the shift often tend to touch their faces more.
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HFOV settings on Fabian Acutronics Ventilator
Thanks for the information. Just out of curiosity, will it be sub-optimal or even harmful to run the fabian at flows of 20 like the sensormedics3011A. And if the I:E ratios were set at 1:3 or 1:2 instead of 1:1 would it affect ventilator performance with effect on patient respiratory function? BTW, a nice comparison: http://www.prhoinsa.com/images/pdf/sle/bibliografia/Harcourt_Comparison_8_HFO_ventilators_2014.pdf Harcourt, E.R., John, J., Dargaville, P.A., Zannin, E., Davis, P.G., Tingay, D.G., 2014. Pressure and flow waveform characteristics of eight high-frequency oscillators. Pediatr Crit Care Med 15, e234–240. doi:10.1097/PCC.0000000000000111
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HFOV settings on Fabian Acutronics Ventilator
Dear fellow 99nicu members, A warm Hello ! Having been used to the settings on the 3100A, I was wondering how do you set the HFOV in the fabian acutronics? In the 3100A sensormedics, we were setting Bias Flow at 20 L/min, I:E at 1:2 ( 33%). However the fabian HFOV can work from 8 till 20 L/min of Bias flow. What is your usual starting Bias flow and where is your comfort zone ? Also since the Fabian can accommodate I:E of 1:1, 1:2 and 1:3 , what do you usually start with?
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NRP 7th edition
NRP - 7th edition is here !!! http://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3373D.full.pdf+html Pediatrics-2015-Perlman-peds.2015-3373D.pdf
- Use of Chlorhexidine in NICU
- Use of Chlorhexidine in NICU
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Use of Chlorhexidine in NICU
Dear fellow 99nicu-ites ! A Warm Hello !! I wanted to know how many of you are using chlorhexidine in your NICUs? In what form? What packaging? At which steps in the newborn care? Any contra-indications for use? Do you use chlorhexidine alone or with isopropyl alcohol ? We are using chlorhexidine swab sticks while inserting central lines. We recently came across chlohexidine wipes but do not know if they have a role in NICU. I was alarmed when I read this :Doctors-warned-using-antiseptic-wipes-premature-babies-infants-suffer-burns-effects Have you come across such burns in your unit? What precautions do you take?
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WHO issues recommendations on interventions after preterm birth
Hello Stefan... am back after a short (!!!) break Great resource. Use the link - bit.ly/whonicu to track how people are downloading it to see details - bit.ly/whonicu+ Will study it and get back
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Neo-BFHI
Is anyone implementing the Neo-BFHI in their units ? http://www.ilca.org/i4a/pages/index.cfm?pageid=4214 http://www.ilca.org/files/resources/NeoBFHI_Core_Document.pdf Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Koskinen K, Haiek LN. Expansion of the ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations for three guiding principles. Journal of Human Lactation 2012;28(3):289-96 Nyqvist KH, Häggkvist AP, Hansen MN, Kylberg E, Frandsen AL, Maastrup R, Ezeonodo A, Hannula L, Haiek LN. Expansion of the Baby-Friendly Hospital Initiative ten steps to successful breastfeeding into neonatal intensive care: Expert group recommendations. Journal of Human Lactation 2013; 29(3):300-9.
- Solgar priobiotic product recalled by FDA - anyone with 1-hand info?
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The worlds best NICU - what would it be like if you could design it?
Apgar10 ..those are valid points. But sadly I believe this happens everywhere . The end-users are not consulted. However everything is not lost. Good policies, some rearrangement can always make your NICU very nice !
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Base deficit and the use of bicarbonate/buffer.
Whatever side we take...the most important point to remember is that ventilation should be excellent when using Bicarbonate...if ventilation is not optimal...then the CO2 released from Bicarb in vivo goes nowhere and paradoxically leads to increased acidosis !!!
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Ankyloglossia and Frenulotomy by neos in the newborn nursery
Have a look here: http://www.ncbi.nlm.nih.gov/pubmed/23537928 Looks encouraging for breast feeding but speech benefits are still to be proved Also http://www.ncbi.nlm.nih.gov/pubmed/24937906 shows office frenotomy to be satisfying to the parents...(isn't that the new motto...CUSTOMER SATISFACTION !!!!....but is it all about the parents...how does the baby feel ????) Nice opinion: http://fn.bmj.com/content/99/3/F178.extract
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Probiotics to babies <1000 grams, do you use it?
If I am to use Probiotics in my unit...how do I counsel the parents ? DO I need a parental consent ( like for steroid use in neonates) ? If during counselling or consent process....how safe do I tell them that probiotics is ? Also are all probiotics available in the market the same?...do theyhave the same organisms ..the same strain...the same concentration?....can I generalize the findings of a study done with probiotic Brand A to probiotic Brand B ? Or should I stick to Brand A...the one that was used in the RCT ? (hey...nothing personal.....just trying to give constructive criticism... ) (In the past one year we had one surgical NEC in 95 babies with birth weight less than 1.5kg)