Miscellaneous. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Sur­fac­tant can be used for RDS com­pli­cat­ed by con­gen­i­tal pneu­mo­nia (C1). 2. Sur­fac­tant ther­a­py can be used to improve oxy­gena­tion fol­low­ing pul­monary hem­or­rhage (C1). 3. The use of iNO in preterm babies should be lim­it­ed to those in clin­i­cal tri­als or those with…

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Pain and Sedation. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. The rou­tine use of mor­phine infu­sions in ven­ti­lat­ed preterm infants is not rec­om­mend­ed (C2). 2. Opi­oids should be used selec­tive­ly, when indi­cat­ed by clin­i­cal judge­ment and eval­u­a­tion of pain indi­ca­tors (D1). 3. Sucrose anal­ge­sia and oth­er non-phar­ma­co­log­i­cal meth­ods may be employed to reduce…

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Managing Blood Pressure and Perfusion.The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Treat­ment of hypoten­sion is rec­om­mend­ed when it is con­firmed by evi­dence of poor tis­sue per­fu­sion such as olig­uria, aci­do­sis and poor cap­il­lary return rather than pure­ly on numer­i­cal val­ues (C2). 2. Hb con­cen­tra­tion should be main­tained with­in nor­mal lim­its. A sug­gest­ed Hb thresh­old…

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Monitoring and Supportive Care. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1.Body tem­per­a­ture should be main­tained at 36.5–37.5°C at all times (C1). 2.Most babies should be start­ed on intra­venous flu­ids of 70–80 ml/kg/day while being kept in a humid­i­fied incu­ba­tor although some very imma­ture babies may need more (B2). Flu­ids must be tai­lored indi­vid­u­al­ly accord­ing…

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Prophylactic treatment for sepsis. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Infec­tion con­trol mea­sures should be strict­ly applied  2. Antibi­otics are often start­ed in babies with RDS until sep­sis has been ruled out, but poli­cies should be in place to nar­row the spec­trum and min­i­mize unnec­es­sary expo­sure. A com­mon reg­i­men includes peni­cillin or ampi­cillin in…

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Mechanical Ventilation Strategies.The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1.After sta­bi­liza­tion, MV should be used in babies with RDS when oth­er meth­ods of res­pi­ra­to­ry sup­port have failed (A1). Dura­tion of MV should be min­i­mized (B2). 2.Targeted tidal vol­ume ven­ti­la­tion should be employed as this short­ens the dura­tion of ven­ti­la­tion and reduces BPD and…

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Non-Invasive Respiratory Support. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. CPAP should be start­ed from birth in all babies at risk of RDS, such as those <30 weeks’ ges­ta­tion who do not need intu­ba­tion for sta­bi­liza­tion (A1). 2. Any one of the sev­er­al sys­tems of deliv­er­ing CPAP can be used. How­ev­er, we rec­om­mend…

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Oxygen Supplementation beyond Stabilization. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. In preterm babies receiv­ing oxy­gen, the sat­u­ra­tion tar­get should be between 90 and 94% (B2). 2. To achieve this, sug­gest­ed alarm lim­its should be 89 and 95% (D2). 3. Fol­low­ing the admin­is­tra­tion of a sur­fac­tant, a hyper­ox­ic peak should be avoid­ed by rapid…

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SURFACTANT THERAPY. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Babies with RDS should be giv­en a nat­ur­al sur­fac­tant prepa­ra­tion (A1). 2.A pol­i­cy of ear­ly res­cue  sur­fac­tant (with­in 2 hours of birth) should be stan­dard (A1) but there are occa­sions when sur­fac­tant should be admin­is­tered in the deliv­ery suite, such as those who…

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DELIVERY ROOM STABILIZATION. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1.If pos­si­ble delay clamp­ing the umbil­i­cal cord for at least 60 sec­onds to pro­mote pla­centofe­tal trans­fu­sion (B1). 2.Oxygen for resus­ci­ta­tion should be con­trolled using a blender. An ini­tial con­cen­tra­tion of 30%-60% oxy­gen is appro­pri­ate for babies <28 weeks’ ges­ta­tion and 21–30% for those of…

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