High Flow Nasal Cannulas in NEWBORNS/// When to use them!!

[@mekawwi]

This is AMAZING ❤

[@TalaTalksNICU]

Thank you so much!!!

[@zubairqasimrashdi6882]

I am a pediatrician from Pakistan. Always learn something valuable from ur videos. Pure Brilliance.

[@TalaTalksNICU]

Hello doctor! Thanks so much for your lovely words and for taking the time to write in!!! Is there anything in particular you would like to see?

[@siobhanvargas1106]

Dr, I heard about your channel from the NICU team at the preemie party this year and this is amazing! I don’t know if you remember Bryston… he is about to be 5! He is still vent and trach and complex BUT such a hand full! Thank you for all your doing and thank you for everything you did with B!

[@TalaTalksNICU]

Leslie!!!! HELLO!!! I’m so glad you found me! I cannot believe Bryston is 5!!!!! Is that possible??? What an amazing mama you are - I am in awe of the time and effort and love and fighting you must have done to get him here. I’d love some photos if you could send them to [e-mail] Yay!! Thank you for writing!!

[@sarahg8350]

As a nursing student, thank you so much for your videos! You explain things so well.

[@TalaTalksNICU]

So glad that you’re finding them helpful Sarah! Also impressed that you’re looking for other ways to add to your education! That’s fantastic!!! Good luck in your studies

[@alisonthomas2185]

I am new to the neonatal ward coming from adult nursing in England UK. I love your content which is really helping me become more knowledgeable. Thank you!

[@TalaTalksNICU]

Hello Alison! I’m so happy for you you’ve seen the beautiful light of the NICU! Ha! Congratulations on your new role! We’re SOOOOO happy that these videos are helping! Thanks for taking the time to write to us :))

[@riham2121]

I'm so glad that I've found this channel as a new neonatology resident, you made a lot of things so easy to understand so thank you and keep up with the great work ❤

[@TalaTalksNICU]

We’re so glad the channel is helpful! Congratulations on your new role- hope you enjoy your residency doctor!

[@mswats]

I just wanted to say thank you for all of your informative videos. I'm a mom of triplets born at 25+6 last July. My 2 girls spent 3 months in the NICU and my boy was there 4 months. I found your channel sometime during that time while they were in the hospital to try to learn about their medical conditions and now, almost a year later, I still watch to further understand their diagnoses/conditions and what all they went through. I learned so much during my 3-4 month "internship" at the hospital, but your lectures really make things clear. BTW, my babies are doing really well now considering how early they were born and being multiples. I owe it in part to the excellent care they received while in the NICU. Thank you for doing what you do!

[@TalaTalksNICU]

MW- wow! Congratulations on getting your babies home after such long NICU stays (combined 10 months!!). That they are doing so well now is much more of a testament to you than anything else. I agree- it really is an “internship” for intelligent parents- it’s crazy the understanding everyone has by the end! If you have any interest in discussing your stay or giving advice to other parents/ we’d love to have you on a video?!!

[@stuartkeller6403]

Hi , my name is Stuart and i am from San Diego, but reside north of Dallas in TX. I enjoy watching your videos, because you explain the topics in an easy to understand way! Where you from Dr. Tala?

[@jream4ever]

As a NICU RRT, you did a phenomenal job, Doc. Thank you for your explanation. Especially, the intrinsic vs extrensic flow rate.

[@TalaTalksNICU]

Oh yay! Thank you so much! What a lovely compliment by someone who deals with the device all day long!

[@peddr2022]

Thank you dr Tala , for what you are doing 🎉 Your efforts emprower our knowledge at distance of 13000 km from US. Best wishes ❤

[@TalaTalksNICU]

I love that!!! Great time to live in where we information can just be shared like this!!! Thanks so much for commenting!!

[@m.e.2286]

I appreciate the references to recent studies & research! Thank your for a much needed topic! What is your experience with Ramcannulas and CPAP and NIMV?

[@TalaTalksNICU]

Hello! Thank you for your kind words! Lots experience with all! And those lectures are coming :)

[@m.e.2286]

Ok, great! Looking forward to that! Thank you!

[@madanat1000]

Wonderful as always , i really appreciate your effort in making neonatology smooth

[@TalaTalksNICU]

Thank you so much Imad- what a lovely comment!! Thanks for being here!

[@hannaankudovich8684]

Thank you Dr Tala and the team! Extremely helpful channel for my residency journey!

[@TalaTalksNICU]

SO happy this is helpful for you!!! Thanks so much for watching, commenting and subscribing!

[@AmandaPeterson-m5t]

Great video! This was really helpful. RN and NRP instructor from Wyoming USA

[@TalaTalksNICU]

Oh so happy you liked it! Also Wyoming was a big hole on our map so thank you so much for letting us know where you’re from! Ha!

[@sarahp775]

Another GREAT Tala Talk, thank you Dr. Tala!

[@TalaTalksNICU]

Thank you so much Sarah! Really appreciate your support and positive comments!

[@mariamiguelsoaresresende7584]

Thank you for the video! I’m a pediatrics resident and I’d like to better understand the general principle behind weaning from HFNC in newborns. Typically, the process starts with reducing FiO2 before decreasing flow. However, most guidelines suggest lowering the flow once FiO2 is below 30%. Why not continue reducing FiO2 closer to 21% before adjusting the flow? Thanks

[@TalaTalksNICU]

Hi! This is a great question! And honestly it’s not a black and white thing! If the fi02 is super high then we won’t wean (so like 50-60). But sometimes we just need to push the babies and in many places we can start feeding babies at 2L. So if a baby is 36 weeks, I’d prefer the baby to be on 2L 35% then 3L 30% if the baby is breathing easily enough to eat. (And often a lot of these babies need to go home on micro flow so we’ll push them down to see if we can get them on 0.2L 100% or whatever). There’s so much trial and error in this weaning. And every baby is different- some babies just really need the 3L 21% flow and can’t stand weaning! Sorry! Very grey answer!

[@mariamiguelsoaresresende7584]

@@TalaTalksNICU thank you 🙏

[@narmin3102]

Excellent! I am a resident in NICU. Could you please record a lecture about adrenal insufficiency in premies.

[@TalaTalksNICU]

Thanks so much Dr. Narmin! Yes we really need to get that out!!! Thanks so much for watching and for your suggestion :)

[@childhealth5049]

So competent and energetic. Keep creating stuff like this. Kudos 😊

[@TalaTalksNICU]

Thank you so much for your lovely comment. Had a week where I didn’t feel very energetic so this was timely!!!!

[@ancyjoseph9714]

Hi really appreciate your excellent talks. Can you talk about transposition of great arteries. Diagnosis, X-ray reading and management etc. Thank you

[@TalaTalksNICU]

Yes! This is a great suggestion and we really need to get back to our heart series!!! Thank you for being here :)

[@Kingdomcome_podcast]

I love all your videos! I’d love to watch one on NIPPV

[@TalaTalksNICU]

Hello! Thank you so much! Would love to do one on NIPPV (we haven’t gotten around to Cpap yet though!) will be coming though!!!

[@drheshamelkordi8529]

Thank U, Dr. Tala

[@TalaTalksNICU]

Thank you for watching!

[@karimzaghloul1]

Hello dr tala,thank you for your informative videos,can you please make a video about approach to feeding increments

[@TalaTalksNICU]

Thank you so much for your lovely comment! We can definitely cover this! Actually this is a great idea for a nugget- we’ve been looking for more of those videos! Thank you for being here :)

[@moseskafwabulula7068]

😂😂 The wall The bike example was good

[@TalaTalksNICU]

Hahahaha!!! Not a great example but I tried!!!

[@beverlyreyes7675]

Can you nipple feed an infant on HFNC? Just concerned with air blowing high on your nose while struggling to nipple, is it safe to nipple feed them while on it?

[@TalaTalksNICU]

Great question. Different units have different protocols- generally where I’ve worked we use 2L as the cut off (ie can feed on 2L or less). Obviously it all depends on work of breathing etc. If they’re breathing 90 times a minute and needing 40% fio2 on 2L we still wouldn’t feed!

[@jasontan7920]

Dr. What if patients in high flow 60l/95% fio2 with spo2 in monitor 98 percent but tachypnea do I need to change to cpap? My patients is 83 years old

[@TalaTalksNICU]

This is all for neonatal education!!!! I haven’t taken care of adults for nearly 25 years! Good luck!

[@Juliana_YT-g5o]

As every time, a fruitful presentation ❤ thank you Would you like to make hypotension and it’s actual management

[@TalaTalksNICU]

Hello! Thank you for your amazing comment. We definitely need to make a video on hypotension- a way that will actually make sense- since we all do stuff so differently! Thank you!!

[@IamMeeksouLB]

Hi, Dr. TALA. Should we remove th cannula during bottle feed? Luke for example baby is on 2-4LPM. Pls explain further. Thank you.

[@TalaTalksNICU]

If a baby needs a cannula it should stay on! Different units feed babies at different levels- generally 2LPM or less is pretty common. Hope that helps?

[@MaddyAlegre]

Very use! Thank you so much!

[@TalaTalksNICU]

Thank you so much for letting us know! We'll be putting out CPAP relatively soon :)

[@pranayk5588]

Great effort doc !!!

[@TalaTalksNICU]

Thanks so much :)

[@fcpsia9902]

"From the wall" NC doesn't use humidified air? But the thingamajig (I'm sorry i don't really know what it's called) has water in it, and above is the gauge where we set the liters with the ball thing floating. So i always assumed the water was humidifying it. 4:02

[@fcpsia9902]

Ah yes, the flowmeter*

[@TalaTalksNICU]

Ha! Yes!!!! You’re right! Some “from the wall” NC can have humidification- often they don’t though!!

[@makS-tm2xo]

What are your textbooks for your specialty

[@TalaTalksNICU]

I think we should do a video on this!!!! Great question!

[@PROFKASPER]

Thanks alot Dr Tala 🌹🌹

[@TalaTalksNICU]

You’re so welcome! So glad you’re here :)

[@ethelski1]

Great information, thank you. ❤️

[@TalaTalksNICU]

So glad you liked it- thanks so much for being here :)

[@dovlab3089]

How many spells and dsats is allowed for baby to switch from cpap to high flow ? Are any spells right after switching cosidered 'normal'? How low dsats after switching are 'acceptable' ?

[@TalaTalksNICU]

Urgh- these are all great questions! And we don’t really know the answers to any of them!!!!! Sometimes babies take a short period getting used to HFNC (ie they may need higher Oxygen for a bit- or continuously!) So the answer is really what are you willing to have as an fio2 on HFNC to avoid desats. If you were on cpap 5 21% and now you’re on 4 LPM HFNC at 60% and your sats are in the high 80s then for me this would be an unacceptable rise in fi02 need. So I don’t really have an answer!!! How desperate are you to get the baby off CPAP / how old is the baby/ etc etc.

[@meg071]

Hi Tala. A baby was born 23weeks and 3 days and now 42weeks. Care team placed her on HFNC 15L FI02 21-25%. Is that safe for babies lungs for that high O2 liters? Thanks

[@TalaTalksNICU]

Hello- it's really interesting what's happening in the non-invasive vent world. A few years ago, I would have said- that's really high. Now- if the baby is comfortable and it's doing the job then I'd try it. There's still a lot more potential that I don't think we've tapped into with this support!

[@stillbreathing100]

thanks.. 🎉

[@TalaTalksNICU]

Thank you for all your support!!!

[@felipeguinancio7456]

Thanks a lot!

[@TalaTalksNICU]

Thank you Felipe!!! Love your comments!

[@laraeb2514]

Another great video.

[@TalaTalksNICU]

You’re the best! Always so motivating! Bet you’re like this at work too :)

[@laraeb2514]

@TalaTalksNICU I am mostly, our work is hard we have to hold each other up!! I am sure to sprinkle in a bit a sarcasm just to keep it spicy.

[@TalaTalksNICU]

I mean - what is a work day without some sarcasm!? Ha!!!!

[@laraeb2514]

@@TalaTalksNICU I honestly wouldn't know it is my preferred language. Lol

[@BrittleSun]

But if someone on HFNP therapy is needing 100% FiO2 surely that means they need more support?

[@TalaTalksNICU]

Absolutely! Great point. If your baby is on like 4L and needing 100% for a long time and barely hanging on then they’re probably telling you they need something else!! Cpap/ NIPPV/ intubation! But a baby may have had a bad event or a brief deterioration- the concentration can go up that much if needed. Thanks for making this point! Bu

[@HarpreetKaur-hv9ft]

How much time we can use HFNC

[@TalaTalksNICU]

Great question! The answer is as long as the baby needs it! here, we don't normally send babies home on HFNC so eventually they need to be weaned off, but generally they're pretty comfortable on HFNC so we're not in a rush to push them off it.

[@enatoizehiuwa7360]

Hello Tala.....Nice job

[@TalaTalksNICU]

Thanks so much for watching and for taking the time to comment :)