Flavio Martins

Hi Greice, I would do something about it when potassium levels are over 6,0. Also, It's important to rule out causes of pseudohyperkalemia, especially, artefact of collection process or acidosis. Thanks for bringing this up! Flávio Martins

Amazing results! I'd be glad to have those numbers at our NICU! Can anyone share this article? I'd like to know read it. Thanks!

looking foward for the results..

Thank you Professor Keszler! How high on PEEP would you go? 'cos, sometimes, MAP on NIPPV could be as high as 12 cmH2O, which is usually higher than the pressure people tend to fell confortable setting on the CPAP.

1 mcg/kg of fentanyl plus 0,15 mg/kg of midazolam for most babys. For older babys or babys who have been on sedatives for too longe, May need a higher dose or, ketamin 1-2 mg/kg For LISA we use a low dose or fentanyl plus atropin too

Hehe. Same here.. Talking about CPAP, how high PEEP do you use? We increase It until 8 cmH2O. No higher. Have a good Sunday! Ending night shift now 🥲

And what about Sweden, Dr? What do you do at your NICU?

About trying to get the PIP set: Usually, the problema ia about a too shot inspiratory time (you may need to use 0,4 or 0,5s, even for preemies) or air leakage (usually around the nose). We use prongs with a hydrocolloid around the nose.

For those of you who choose NIPPV: do you use synchronized NIPPV?

Hi guys! What's your first choice of ventilation suport for extreme preterm babys after delivery Room? nCPAP, NIPPV or HFNC? Most places I know uses nCPAP. But, the last Cochrane Review (2017) about this issue states that NIPPV reduces respiratory failure and need for intubation, without worsening of adverse effects. Any thoughts? The same goes for post extubation treatment..

We use inter growth charts too. I would suggest everybody watch Dr. Fenton's webinar on the UENPS website, about optimal growth.

I would do urine pcr

Done!

Thank you for your answer. I agree, it's a simple and quick procedure. I've done It, literally, dozens of times. I recall one case of secundary infeccion and one bad bleeding. But, I keep thinking: is It really necessary? And If so, are we doing It at the right time? Am I doing harm? I know It's a difficult subject for RCT, but, still, It bugs me. Thank Abdul. I work in 2 public hospitals, so It's not about money, but lt may be about some kind of confirmation bias from the speech therapists. I think, maybe, the children that go to speech therapist's clinic are those who are having problems in breastfeeding. Some of them have tongue-tie. Than, the speech therapist makes the assumption that every child with tongue-tie Will have problems in breastfeeding. There is a Clinical protocol for tongue-tie evaluation, Martinelli's (2013), that find out 23% of tongue-tie. I mean, is It even possible? By a evolucionary perspective, are 1/4 of babys not able to breastfeeding without frenulotomy?

Hi. I work in 3 NICU. One of than is only for surgical babys and we use mechanical ventilation for long times. In this unit, we use 0,5 to 4 mcg/kg/hour of Fentanyl in continuous infusion. When we use for more than 7 days, we usually tape off about 20% each 2 days. Some babys, especially term babys with prolonged intubation, need adiccional drugs. We use midazolam or dexmetomedine.

Hi guys, good afternoon! Today, at Twitter, Nick Embleton brought a discussion about tongue-tie (TT) and breastfeeding (BF). I've been thinking about it for some time now, since I'm very worried about overdiagnose of Ankyloglossia here, in Brazil. I'd like to know what's the tongue tie policie at your facilitys. 1) do you evaluate every baby for TT or just those who have dificult in BF? A: in Brazil, TT evaluation is one of the mandatory triage before discharge from the "well baby nursery" 2) who performes the evaluation? A: in my hospital, both the pediatrician and the speech therapist (ST). Usually, ST's evaluation finds higher incidence of Ankyloglossia. 3) in those babys with Ankyloglossia, at what age they undergo frenulotomy? A: before 48 hours of life. Thank you for your time!

I've read an article about Japanese management of extremely preterm infants and they use retal enemas until the meconium passes.. but, I haven't found strong evidence. Does any of you use It?

Thank you.. Although I haven't found much of a evidence for this approach, we do the same here..

Hi! I'd like to know what is your experience in enteral feeding advance in preterm with IUGR or centralization? It's well known that a faster incremention in enteral volumes provides faster achievement of full volume without worst outcomes (https://www.nejm.org/doi/full/10.1056/NEJMoa1816654). But, in preterm with IUGR it's very frequent feeding intolerance, even with MOM or DM. Do you use a diferent strategy? Thank you for your attention!

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009969.pub2/full

Hello everybody, Does anyone use lung recruitment maneuvers during CMV or CPAP to achieve optimal FRC and oxygenation? If so, do you have a procotol and/or any practical tips? I've read some articles and the Cochrane Review, but I'd to hear your opnion.. Thanks!