Hot Topics Flashcards
Mag sulphate in EPTL
?NNT to prevent CP
63
Head cooling
?Toby trial results
Follow up study 6-7y (UK) 2014: NNT to prevent death or IQ
Oxygen at birth - ?%of 02 for term and preterm?
RA for neonates, 30%for
Benefits of caffeine?
Less PDA, less surgery for PDA, decreased CP! (First drug to reduce CP in neonates)
Results of Manley trial night flow 2013
HF not inferior to CPAP when being extubated
BOOST and SUpport trial outcomes
Boost 1: >32 weeks Boost 2 (Aus, NZ, Eng) :
Probiotic trial Al Faleh 2014
Reduced inc NEC in BW
Volume Guarantee ventilation
Reduced risk CLD compared to pressure limited ventilation
EPO in neonates (Ohls at al 2014$
Neuroprotector (better neurodevelopmental outcomes)
Australasia survival of babies adm to NICU
? 23w
?At 24w
?at 25w
44% (
Inhaled NO in 25w baby?
Some immediate improvement in oxygenation but not sustained
Caffeine and preterm babies
Reduces CLD by nearly 40%
Less Surg for PDA
Repeat course of antenatal steroids 1 week after first course
2nd dose reduces RDS by 20%
Only downside was a poorer weight gain
?position renal arteries and sup mesenteric arteries
L1-2
?position of coeliac axis
T12-L1
?position of inf mesenteric arteries
L3-4
Is CPAP associated with increased pneumothorax?
Yes (COIN trial, cpap vs ventilation, spont pTx 9% versus 3%)
?appearances of CXR 25w
HMD white!
ground glass, small volume lungs, air bronchograms
Duodenal atresia
Double bubble AXR
Pyloric stenosis ? Time of presentation
3-6w
Protracted vomiting of stomach will produce
Hypochloraemic, hypokalaemic, metabolic alkalosis
?%of duodenal atresia associated with DS
30% will have Trisomy 21 (strongly associated)
Rate of increased need for some special ed at some point for a
?28-32/40 versus term control
?for 24-27w
33-36
37 (late pre termer at increased interest)
2.5x
7x increased
1.5x
1.4x
Irish study.
NEC
?AXR
Pneumatosis
Fear PORTAL GAS
?diagnostic tool for malrotation
USS may show mal position of SMV with respect to SMA
?does indomethacin increase rate of nec and bowel perf
? Probiotics and lactoferrin protective for NEC
?complete course antenatal steroids reduce risk of NEC
Slower rates of feed increase
No difference
Yes
Yes (halves rate of NEC, and repeated course improves short term outcomes)
No difference
Free air sign AXR
Silvers sign air on either side of Falciform ligament
Air on either side of bowel = riglers sign
?50th Centile for BW at 24w
~650g
?causes for neonatal chorioretinitis
Toxo, CMV, syphilis
? Inheritance of retinoblastoma
AD with incomplete penetrance
%success rate of laser therapy for ROP stage 3
50% reduced risk of detachment
Gram positive bacilli in CSF neonate
Listeria 30% Penicillin resistant Partially cooked stuff/deli meats SIADH, low serum sodium and high urinary Na Meningitis more common late onset >1w Salmon rash
Blueberry muffin
CMV or toxo
Lactoferrin ?%of iron absorption from human and formula milk?
Major whey protein present in Breast milk
Enables 50%abs iron from HM, 10%from FM
Proven use in reducing NEC
?main immune function of lactoferrin
?loss of fxn on freezing/pasterurisation
Bacteriostatic
Looses 65%of function!
