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Found 6 results

  1. May I ask whether anyone has experience with a prolonged hanging time of a parenteral nutrition (PN) bag (incl lipids) of up to 48h? We are probably changing our PN regimen into an all-in-one bag. Since the bag contains >400 mL, it would suffice for most premature infants for 2 days. One strategy could thus be to prolong hang time from 24h to 48h to cut PN costs by half. A recent Australian study (attached) also suggests this would be a feasible approach: https://www.ncbi.nlm.nih.gov/pubmed/23320598 Since our pharmacy will do all additions to the bag in an aseptic env
  2. Oral immune therapy (OIT) has really taken off at least in our units. The notion here is that provision of small amounts (0.2 mL intrabucally q2or 24 hours) can prime the immune system. Lymphoid tissue present in the oropharynx and intestine exposed to this liquid gold in theory will give the immune system a boost and increase levels of IgA. Such rises in IgA could help improve the mucosal defence barrier and therefore lessen the incidence of late onset sepsis. Rodriguez et al described this in their paper Oropharyngeal administration of colostrum to extremely low birth weight infants: theoret
  3. If you work in the NICU then you have seen your fair share of septic workups for late onset sepsis. Sepsis is such a common diagnosis that if I had to guess I would say that at least 50% of all discharge summaries would include this in a list of final diagnoses for any VLBW infant. If you were to look through the chart though you would find that while workups are common, the recovery of a pathogenic bacterium is not as much. This is in part due to the low threshold that many people have for doing such workups. A little bit of temperature instability, a few more apneic events than normal or
  4. Calculate risk of neonatal infection and get a recommendation for abx therapy
  5. It is one of the first things that a medical student pledges to do; that is to do no harm. We are a fearful lot, wanting to do what is best for our patients while minimizing any pain and suffering along the way. This is an admirable goal and one which I would hope all practitioners would strive to excel at. There are times however when we can inadvertently cause more harm than good when we try to avoid what we perceive is the greater harm. This is the case when it comes to collecting a sample of urine for culture as part of a full septic workup. If you ask most healthcare providers they will
  6. I read an article about 10 years ago that suggested that foul smelling amniotic fluid was NOT a strong risk factor for sepsis (I remember this well because this went against my residency teaching-either that or I am losing my faculties!). The article stated the smelliest bugs at delivery were not usually the ones that caused the most trouble in infants. Am I losing my mind or can anyone else recall this? I often teach students and I want to have my facts straight. I was able to find a few studies with small samples that listed smelly fluid as a risk factor. On the Cochrane database the art
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