Giving lungs the DELUX treatment
Extubation is a regular occurrence in the NICU. We do our best to predict who will succeed and who will fail but it isn't always easy to figure out who they are in advance. We use techniques such as looking at oxygenation histograms and using thresholds for PIP, PEEP...
What is the optimal depth of chest compressions to achieve return of spontaneous circulation (ROSC)
If you work in Neonatology or in Pediatrics for that matter there is no doubt that at some point you took the neonatal resuscitation program (NRP). Ideally you should be recertified every year or two years depending on your profession. In the course you are taught...
When it comes to ventilation are all volume modes equal?
When I began my career in Neonatology we initially ventilated primarily with pressure limited time cycled modes of ventilation and only supported some of the breaths as in SIMV modes. With time and emerging research a movement to using set volumes came about and in...
Another change to the definition of BPD?
I have written a lot over the years on the topic of BPD. It isn't by chance as it is a condition that Neonatologists have put a lot of weight on. In many ways it is a benchmark that is often the go to condition when comparing one unit to another. When two...
Can we avoid pre-op intubation in some infants with congenital diaphragmatic hernia?
For as long as I can remember I was taught that there is a desperate need to intubate babies with congenital diaphragmatic hernia right after birth and place an NG to suction. The goal of this manouver was to minimize the amount of swallowed air into the GI tract and...
T-piece resuscitation by mask vs binasal prongs. The winner is?
Who doesn't love a good match up?! Supporting neonates in need of resuscitation after delivery has been the subject of many studies over the years. The movement has certainly been to non-invasive support with CPAP or NIPPV but some babies need some degree of support...
How safe are t-piece resuscitators anyway in our smallest patients?
Here in Winnipeg we don't use t-piece resuscitators for any resuscitation. I did use them in my past position in Edmonton and I came to appreciate them for their ease of use. For the majority of infants, setting a PIP and a PEEP and then using your finger to occlude...
Late administration of surfactant linked to better survival than in 1st 2 hours. Really!?
If there is a country that leads this site in terms of mentions it has to be Sweden. This isn't just because I happen to know some Neonatologists from there who are fine people but because of the fantastic research that spills forth from their national registry of...
Can a couple puffs of albuterol help preemies on mechanical ventilation?
Giving bronchodilators to preemies on a ventilator has certainly been tried before. The major issue to contend with is getting the drug to where it is supposed to be. Anyone reading who has a child with asthma knows that you should use an aerochamber when taking a...
Is foot reflexology coming to an NICU near you?
Every now and then something unconventional comes to my attention. Management of pain is something that I have written about before and have been a proponent of things such as kangaroo care and breastfeeding to help improve responses to pain from common procedures...