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Tuesday, March 5, 2013

Common Acronyms

Apologies this is not in alphabetical order yet

  • VLBW: Very Low Birth Weight ( < 1500g)
  • ELBW: Extremely Low Birth Weight (<1000g)
  • HDU: High Dependency Unit
  • Neonate: First 28 days of life
  • NICU: Neonatal Intensive Care
  • Post-term: ≥ 42 weeks.
  • Preterm:  < 37 weeks.
  • SCBU: Special Care Baby Unit
  • Term:  37- 41 weeks.
  • Transitional Care:  Baby is admitted under the neonatal unit but considered stable enough to stay with mother on post-natal ward
  • DAT: Direct Antiglobulin Test (Direct Coombs Test)
  • SBR: Serum Bilirubin
  • Partial Septic Screen: FBC, CRP and blood culture
  • Respiratory Distress: A collection of respiratory signs which can include tachyonoea, nasal flaring, chest retractions, grunting and cyanosis.  Common causes are TTN and RDS.  It could be sepsis though..
  • TTN (Transient Tachypnoea of the Newborn)  Respiratory distress caused by a delay in resporption of lung fluid.  More common after caesarean section.  Most common cause of respiratory distress in neonates.
  • RDS (Respiratory Distress Syndrome/Hyaline Membrane Disease).  Alveolar Collapse and Inadequate gas exchange caused by deficiency in surfactant.  Incidence increases with extent of prematurity.
  • CLD/BPD (Chronic Lung Disease/Bronchopulmonary dysplasia). Neonates requiring oxygen support past 28 days of age
  • NEC (Necrotising Enterocolitis).  A mixed inflammatory/ischemic/infective condition affecting the bowel wall.  Occurs mainly in preterm infants in the early weeks of life.  Extremely low birth weight and hypoxia are some risk factors.  Can present with bile stained vomiting or fresh PR bleeding.
  • TPN (Total Parenteral Nutrition):  Intravenous Feeding bypassing the digestive tract.  Typically used in neonates with NEC or at risk of NEC
  • HIE Hypoxic Ischaemic Encephalopathy
  • PDA: Patent Ductus Arteriosus
  • GBS: Group B Streptococci.  An important cause of early onset neonatal sepsis
  • Terms relating to invasive/non invasive ventilation
    • CPAP: Continuous Positive Airway Pressure – most common form of non invasive ventilation. 
    • BiPAP: Bi Level Positive Airways Pressure – a step up from CPAP, often used as an attempt to avoid intubation and ventilation
    • PIP: Positive Inspiratory Pressure.
    • PEEP: Positive End Expiratory Pressure
    • MAP: Mean Airway Pressure
    • SIMV: Synchronised Intermittent Mandatory Ventilation.  A mode of ventilation in the intubated patient.
  • ROP: Retinopathy of prematurity
  • TOBY: Refers to a clinical trial and subsequent national protocol use to assess babies for neonatal hypoxic ischaemic encephalopathy and help make decisions as to whether they are candidates for brain cooling.
  • EBM: Expressed breast milk
  • DBM: Donor breast milk

Thursday, December 6, 2012

Neonates book

http://books.google.co.uk/books?id=Q5EfiEAodmEC&printsec=frontcover#v=onepage&q&f=false

Sunday, September 23, 2012

Sodium Bicarbonate

Sodium Bicarbonate
Resus dose
1-2mmol/kg
1-2 ml/kg 8.4% (1mmol/ml)
Or 2-4ml/kg 4.2% (0.5mmol/ml)
Half correction:
mmols needed = 0.4 x weight x base deficit.  
give 1/2 amount over 1/2 hour and reassess

Links list

Friday, September 21, 2012

Drug Infusions - calculating hourly rates

Being asked to write up your first morphine or dopamine infusion in neonatal intensive care looks like a challenge.  Actually it is not so bad.  You just have to work out the hourly rate.  Look at these equations below and remember you need to work in the same units in your calculations, so for example don't forget to convert your milligrams to micrograms or your minutes to hours!

1a) Micrograms per kilograms per minute to ml/hr

ml/hr =  dose required in mcg/kg/min x weight (kg) x 60
                  concentration of solution in mcg/ml

Example:
Baby A weighs 1.490 kg and has been prescribed an infusion of dopamine to be run at 1 micrograms/kg/min.  The solution prescribed is 40mg dopamine in 50mls.  What rate should the pump be set to run at

1 x 1.49 x 60   =   89.4 = 0.11mls/hr
40000/50              800


1b) To check the rate in micrograms/kg/min of an infusion already running:


Infusion rate (ml/hr) x concentration of solution (mcg/ml) = mcg/kg/min
                  weight x 60


2a) Micrograms per kg per hour to ml/hr

ml/hr =  dose required in mcg/kg/hr x weight (kg)
                  concentration of solution in mcg/ml 

2b) To check the rate in micrograms/kg/hour of an infusion already running:


Infusion rate (ml/hr) x concentration of solution (mcg/ml) = mcg/kg/hour
                                 weight