Audrius

Dear collegue, just my vision to your question: 1.During resuscitation in delivery room bicarb allows to save the live but not the brain, unfortunately. 2.In NICU first step would be most appropriate to try to find main cause of acidosis, after to try solve it and after - bicarb ... maybe. 3.In our practise we have very few indications for use bicarb - late shock with no responce to fluids and inotropes and some cong metabolic diseases(rare). Re AAP recomendations: if you follow them, they are in permanent process of changes( ventilation/chest compressions ratio, oxygen, prevention of MAS, etc.). I believe that bicarb will be removed from the list of delivery room drugs in the future. Audrius_LT

Dear Stefan, Thanks for your replay. The idea of the question was: if people score all the newborns "automatic" or routine, they simply forgets the real signs of Apgar score (this is my experience from many countries wich I have visited). So, my proposal would be to stop scoring healthy babies who don't require any extra help after birth. Audrius

Many thanks for replays. Another question: do you think that is reasonable to assess healthy babies by Apgar score? 1.Yes, 2.No, 3.I see no point in this question.

Of course can. But pls warrant normal environment temperature and check baby's T. Good luck from LT! Audrius

Yes

Dear coleagues, I believe that most of you were in the delivery room and more than one time in your practise. If the baby did not required resuscitation, was he/she rated by Apgar score? The question is: are healthy babies evalueted by Apgar score in your facilities? Thank you for responses, Audrius

Dear colleagues, Could you share your practise of empirical AB choice in your NICU when you suspect late onset sepsis. I will appreciate also if you add: 1.Time definitions of LOS in your NICU. 2. Rate of LOS in VLBW group in NICU. 3. No of beds in NICU. 4. No of admissions per year. I believe that LOS is one of biggest issues in many places were tiny babies are in care.Thank you in advance for your responses. ------- Audrius Kaunas Medical University Hospital, Lithuania

Dear Andrew, Would you be so kind to explain a little bit wider your phrase "it is a personal choice where to start but increase fio2 if no improvement''. I liked it very much, but I am not sure of the same meaning with your vision and mine. Thank you. Comments of other colleagues are also welcome. Audrius Kaunas Medical University Hospital, Lithuania