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

NEONATAL CARE NETWORK 2017 (NCN)  Rec­om­men­da­tions 1. Moth­ers at high risk of preterm birth <34 weeks’ ges­ta­tion should be trans­ferred to peri­na­tal cen­ters with expe­ri­ence in the man­age­ment of RDS (C1) 2.Clinicians should offer a sin­gle course of pre­na­tal cor­ti­cos­teroids to all women at risk of preterm deliv­ery, from when…

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Effect of Prophylactic Indomethacin in Extremely Low Birth Weight Infants Based on the Predicted Risk of Severe Intraventricular Hemorrhage

Foglia et al, Neona­tol­ogy 2018 Abstract Back­ground: Pro­phy­lac­tic indomethacin reduces the risk of severe intra­ven­tric­u­lar hem­or­rhage (IVH) but does not reduce death or neu­rode­vel­op­men­tal impair­ment (NDI) among extreme­ly low birth weight (ELBW) infants. Some inves­ti­ga­tors have sug­gest­ed that pro­phy­lac­tic indomethacin may have a greater treat­ment effect on severe IVH among infants at high…

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Diagnosis and Management of Necrotizing Enterocolitis: An International Survey of Neonatologists and Pediatric Surgeons

Val­pa­cos et al, Neona­tol­ogy 2018 Abstract Back­ground: Necro­tiz­ing ente­ro­col­i­tis (NEC) is a seri­ous com­pli­ca­tion of pre­ma­tu­ri­ty. Cur­rent­ly, there is lim­it­ed evi­dence to guide inves­ti­ga­tion and treat­ment strate­gies.  Objec­tives: To eval­u­ate the para­me­ters used to diag­nose or exclude NEC, and to iden­ti­fy dif­fer­ences between neona­tol­o­gists and pedi­atric sur­geons.  Con­clu­sion: Results indi­cate a wide vari­a­tion in…

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