Recent discussions
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Natália Silva
In our service we use CPAP in term and preterm patients when necessary. This apparently reduces the time of observation of the newborn in the delivery room and the need for admissions to the NICU, considering that there is often a lack of available intensive care places. Complications attributed to the use of CPAP rarely occur. However, they are very valid questions for study. -
alessa mantovan
I agree with your comments. A combined intervention that should be tested in RCT before being implemented and of course this is just possible in places with continuous education in healthcare workers otherwise we should have problems. -
alessa mantovan
I agree with the Cpap in delivery room for both cases pre term and term specially in hospitals where we don’t have enough space in NICU. Of course we need to prepare our team to avoid the risks but in my reality earlier Cpap helps a lot! -
Anasuya Nagaraj
I agree that the RFM may not alter the outcome ,needs training of personnel . also it may take away the concentration of the resuscitator where time is of utmost importance especially in smaller places/centers -
Carmen Elias
Although clinically it is an intervention that we do intuitively, tactile stimulation should not delay the onset of ventilation or cause neurological damage to the NB. We have already performed tactile stimulation before, with good results. -
Carmen Elias
The practice of using CPAP in the delivery room should be more widespread, we know its benefits. In my opinion, what is lacking is the dissemination of good results, especially in premature babies. -
Carmen Elias
I have no experience with a supraglottic airway. -
Sudhakar Ezhuthachan
Suctioning of clear amniotic fluid is provided when there appears to be excessive fluid pouring out from the mouth and or nose and interfering with satisfactory respiration. -
Jose Perez
Guess the question is : can CPAP in the delivery room be harmful? In the preterm population at risk of inadequate spontaneous FRC and RDS, feel the risk/benefit ratio is low. I have read recent publications CPAP was very effective for TTNB so C/S delivery without labor, CPAP support also seems a reasonable approach. Unfortunately, TTNB is diagnosis of exclusion. In term infants with only mild distress or suboptimal target spo2, it seems reasonable to start with NC and take to transitional area. The risk CPAP may be harmful seems higher for these infants. -
Steve Gwiazdowski
I think this is a VERY sagacious opinion. The time constants driving pulonary pathology in preterm infants (many having RDS) should never have been extrapolated to term infants. The law of LaPlace governing oreterm infants with atelectasis often does call for CPAP for recruitment however, in term infants, respiratory distress does not always equate to FRC loss. A great example being meconium aspiration. CPAP should be witheld in term infants with respiratory distress unless 100% blow by oxygen cannot raise saturations to a safe level. A CXR is the prudent way to go prior to instition of positive pressure in these infants