Recent discussions
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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 -
Marcos Silva
The use of the larynx mask in our region is not a reality, as we do not have these supplies, even in resuscitation courses we do not have it to teach the proper handling by the students. But I believe it is an effective alternative in difficult incubation. -
MARINA CARVALHO DE MORAES BARROS
Performing tactile stimulation in neonates with respiratory depression soon after birth can delay the onset of ventilation, causing hypoxia, which cannot happen. Thus, I understand that the two interventions can be used in association, that is, a professional starts ventilation and another can perform the stimulation of the soles of the feet. This is a combined intervention that should be tested in RCT before being implemented. -
MARINA CARVALHO DE MORAES BARROS
I agree with the use of CPAP in preterm infants with respiratory distress after birth, aiming at alveolar recruitment and in term neonates, since it favors the reabsorption of pulmonary fluid, a frequent cause of respiratory distress in these newborns. -
MARINA CARVALHO DE MORAES BARROS
The use of the supraglottic device can be useful in ventilation in the delivery room in newborns with difficult airways, reducing the need for tracheal intubation, but it is necessary to train professionals in its use in Brazil. -
claire theyskens
So resp distress, better starts NCPAP in term and preterm -
claire theyskens
Tactile stimulation is no longer necessary -
Marcos Silva
The use of early cpap in the delivery room has reduced the permanence of newborns in the ICU, there is still resistance on the part of professionals to use cpap in children under 1000 grams, but if this group is born vigorous and placed in cpap, maintain stable saturation levels (88-94) and heart rate above 100bpm, it is important to keep them on cpap even with moderate respiratory distress. However, further studies are needed to prove the benefit of early cpap in this group. -
Helenilce Costa
Para o RN de termo usualmente não usamos CPAP precoce durante a reanimação na sala de parto. -
Marcos Silva
Tactile stimulation does not have a single, safe parameter to use as a safe measure. Despite a reasonable indication, it can act as a factor that brings confusion in the recognition of its best application as well as delay in the application of PPV.