How do we PREVENT and TREAT BPD??!!- Tala Talks NICU

What is the role of STEROIDS? And CAFFEINE? Vitamin A? Nutrition? DIURETICS? Which vent should we use? What is the ideal OXYGEN SATURATION for a growing preemie? How can we get babies HOME with BPD? What is the maximum home Oxygen we use? How does BPD affect children in the future? Learn all this and a lot more in our most thorough video so far!!!
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Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded!
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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**TIMESTAMPS**
What can we do to prevent preterm births?
1:16 Prevent premature birth
1:36 Decrease injury to lungs
6:35 Decrease oxygen toxicity
8:05 Decrease inflammation
9:05 Nutrition
10:40 Vitamin A
12:27 Caffeine
13:53 Steroids
How do we treat BPD?
18:21 Provide support needed
21:54 Provide good nutrition
22:37 Inhaled steroids
23:23 Diuretics
24:50 Steroids
Long term outcomes
26:12 Pulmonary issues
29:46 Growth Failure
30:31 Developmental Outcomes
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References:
1) Oxygen Saturation and Outcomes in Preterm Infants. The BOOST II United Kingdom, Australia, and New Zealand Collaborative Groups. May 30, 2013 N Engl J Med 2013; 368:2094-2104
2) Target ranges of oxygen saturation in extremely preterm infants
SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network; pubmed.ncbi.nlm.nih.gov/20472...
3) Early CPAP versus Surfactant in Extremely Preterm Infants
SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network*
www.nejm.org/doi/full/10.1056...
4) Vitamin A supplementation to prevent mortality and short‐ and long‐term morbidity in very low birth weight infants. Brian A DarlowP J GrahamMaria Ximena Rojas‐Reyes
www.cochranelibrary.com/cdsr/...
5) Htun, Z.T., Schulz, E.V., Desai, R.K. et al. Postnatal steroid management in preterm infants with evolving bronchopulmonary dysplasia. J Perinatol 41, 1783-1796 (2021).
www.nature.com/articles/s4137...
6) Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia. Eunice Kennedy Shriver NICHD Neonatal Research Network†. March 24, 2022
N Engl J Med 2022; 386:1121-1131
www.nejm.org/doi/full/10.1056...
7) FROM THE AMERICAN ACADEMY OF PEDIATRICS| POLICY STATEMENT| MAY 30 2022
Postnatal Corticosteroids to Prevent or Treat Chronic Lung Disease Following Preterm Birth
James J. Cummings, MD, MS, FAAP; Arun K. Pramanik, MD, FAAP COMMITTEE ON FETUS AND NEWBORN
publications.aap.org/pediatri...
8) Greenberg RG, Gayam S, Savage D, Tong A, Gorham D, Sholomon A, Clark RH, Benjamin DK, Laughon M, Smith PB; Best Pharmaceuticals for Children Act-Pediatric Trials Network Steering Committee. Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants. J Pediatr. 2019 May;208:134-140.e2. doi: 10.1016/j.jpeds.2018.11.043. Epub 2018 Dec 20. PMID: 30579586; PMCID: PMC6486845.
pubmed.ncbi.nlm.nih.gov/30579...
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Music: www.bensound.com (royalty free with credit)
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

[@naitramsingh6942]

Parte 2 really does bring it home, awesome video, the presentation was excellent and so helpful as always, thanks again for all the hard work

[@TalaTalksNICU]

Oh thank you so much again!! Yes! This one took many many hours- honestly there's so much information, we just wanted to squish it all in but also make it clinically relevant! So happy you liked it- thank you as always :)

[@docsamm]

टीटी

[@salmankhanroghani2885]

Im paediatric resident it really helps me alot ..thanks for clearing basic concepts regarding bpd..keep it up we really needed such lectures

[@TalaTalksNICU]

Oh yay! So happy they help you- thanks so much for letting us know!

[@Sherrianjum]

Thank you for this concise yet informative lecture on BPD.

[@TalaTalksNICU]

Hello! So glad you found it helpful!!! Thanks for letting us know and for subscribing!

[@yankiokuducu3713]

Amazing video! Thank you!

[@TalaTalksNICU]

So glad you liked it- thanks so much for taking the time to write to us!!

[@melissagerke4702]

Love the videos. As a nicu nurse, they are fabulous! Thank you for making a difference in the nicu!!

[@TalaTalksNICU]

Thank you SO much Melissa- we really appreciate you being here. And thank you for everything you do in the NICU for the babies (I keep saying this- but if anyone is spending their free time trying to learn more, then it means they're super invested in their jobs- so THANK YOU!)

[@ED-ym1gm]

Thanks for posting

[@TalaTalksNICU]

Thank you for your patience! We spent SO much time on this video trying to decide what to include and not to- and including what we thought was the interesting history of prevention(with steroids etc). We hope it helps!

[@m.e.2286]

Yay! Been waiting patiently! Very relevant information I can immediately apply. Appreciate the recent research articles..... Thank you so much!😄

[@TalaTalksNICU]

Oh we're so happy you liked it- thank you for waiting and nudging us to get it out! Was super time consuming this one!!! Thanks again :)

[@mikdaniel1969]

Amazing lecture. It really brings out everything

[@TalaTalksNICU]

Thank you so much! Thanks for commenting!

[@melishendek6472]

You probably won't believe, but im waiting every week to hear the neo-news. I think the format: "new papers in the nicu" would be really good...thanks a lot, again!!

[@TalaTalksNICU]

We're all the same here too Melis. I really like that format too- maybe we should start doing that at the end of each year- the important papers. Love that review!

[@FatimaFatima-hi4jq]

Great information Thank you so much ❤

[@TalaTalksNICU]

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

[@elaherastkar3964]

That was prefect as always . Dr Tala please make a video about "outbreaks of infection in NICU" and please point out what should we do step by step in this crisis based on last evidences. Thanks in advance.

[@TalaTalksNICU]

Oh this is such a brilliant idea! Honestly- I think I need to out source this to someone else - but it's a great idea!!! thank you!

[@PR-py6sn]

Ohhhh ..what a great knowledgeable stuff is it. Almost watched multiple times to completely understand it

[@TalaTalksNICU]

Glad it was helpful! Thank you so much for taking the time to write to us!

[@DavideScarponi]

Wonderful job! Greetings from Italy!!

[@TalaTalksNICU]

Grazi!! So happy the video was helpful!

[@user-qm6re5sf1z]

Greatly informative thank you

[@TalaTalksNICU]

So glad it helped in any way- thanks for taking the time to comment!

[@sabiitistephen8278]

Thx Dr.Tala, this was awesome

[@TalaTalksNICU]

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

[@jessicahirschel9300]

To summarise such a complex topic is very difficult and I love how you did it! Very useful for a physician, like me, currently studying for the neonatolgy subspecialty certification. thank you for your work

[@TalaTalksNICU]

Oh wow- thanks Dr. Hirschel. We're so glad it was helpful- we wish you so much luck in your exams. :)

[@osamaalagamawy3891]

Highly specialized lecture.

[@TalaTalksNICU]

hopefully not too specialized!! Thank you!

[@user-nw8fw3ug2y]

Thank you doctor❤

[@TalaTalksNICU]

Thank you so much for being here and taking the time to write to us!

[@mohammedmaheer4740]

Excellent dr.Tala

[@TalaTalksNICU]

Thank you! Love that you are watching these :)

[@evarot9585]

Thanks again for an excellent new video!! Also, I would looove to see a video about hyperglycemia. Not long ago we had two micro-preemies on our ward both struggling with hyperglycemia who also needed insuline.. which was Kind of difficult to manage especially for the residents among us.. Best wishes from Germany ☺️

[@TalaTalksNICU]

Hi Dr. Rot- thank you so much for writing to us and for your lovely comments. Hyperglycemia is an excellent suggestion- and we need some shorter videos too-so that fits the bill perfectly! Thank you :)

[@osamaalagamawy3891]

ما شاء الله. بارك اللة فيكم.

[@TalaTalksNICU]

Thank you- we love that you have been watching all of these!!!

[@amrzaghloul3936]

Amazing video It was Concised, To the point and completely applicable. I appreciate your hard work. Thanks a lot Dr. Tala.

[@TalaTalksNICU]

Fantastic- thanks so much- that's really what we're aiming for!

[@MJ-mz7us]

Good Job. Really a very informative video.

[@TalaTalksNICU]

So glad you liked it- thanks so much MJ

[@user-qm6re5sf1z]

I am watching from Zimbabwe and I watched the video on Jaundice and the afp recommendations. Greatly appreciate if you did present any other major statements which change practice. Dr Tala you are my hero.

[@TalaTalksNICU]

Hero is a strong word! Ha! So glad you’re watching form Zimbabwe! I love the idea of going through more statements - thanks so much for being here :)

[@fabianazaninotti2176]

Thaaaaaaaank you for your videos! ❤ they are amazing 🎉🎉

[@TalaTalksNICU]

SO glad they're helping in any way!!! Thank you :)

[@dalaisand5453]

I was addicted to coffee when I was pregnant. I couldn’t stop drinking espresso coffee. My daughter was talking very clear at the age of 12 months. She sang the vowels and part of the alphabet. In the school the teachers were surprised about her development that was above the normal level for her age. They recommend me to enroll her in the access academy for talent and gifted children. Today she completed her master degree in Psychology and she is 23 years old. Thanks to the coffee 💕♥️

[@TalaTalksNICU]

Oh wow!!!! Congratulations on your daughter- she sounds amazing!!! Not sure whether we can attribute this to the caffeine- or just your genes, you raising her, and the spirit of your own child! I'm with you though- love caffeine and babies!!!

[@saraq6233]

Waiting for this video long time 🤣🤣 Thank you 💞

[@TalaTalksNICU]

Thank you for your patience- and for nudging us to get it out! Was time- consuming so we needed the extra motivation! ha!

[@afomiatemesgen3964]

it was a very helpful presentation thanks Dr. tala am from Ethiopia and am postgraduate neonatal nursing student and your videos are really helpful to catch up more information easily thanks again 🙏🙏

[@TalaTalksNICU]

Hello! So happy you're watching from Ethiopia! And so happy that you're finding the videos helpful!

[@hassanfarah9883]

very interesting topic i would like if you talk prematurity lecture

[@TalaTalksNICU]

Hello Hassan! Thanks for your comment- we are tackling the various aspects of prematurity, but you're right- we haven't done an over all lecture on general aspects. We should do this! Thanks!

[@melishendek6472]

Some of my collegues assume that if we give (for the first few minutes) a higher pressure, SF can reach all alveoli, in case that the baby is intubated. And if you see you can reduce the fio2, then you reduce the pip in the same time. What do you think about this? Thank you so much!

[@TalaTalksNICU]

URGH-this is a tough one Melis. I mean- yes- increasing pressure is the P of MR. SOPA, that when PPV not working, we increase PIP. But - loads of studies have shown that high pressures even with a few breaths in the DR can increase the risk of BPD. So I would say- increase the pressure per the algorithm, if needed.

[@leahr1107]

Hi Dr. Tala, thank you for your videos! At what point is an infant considered “cured” from bpd? Is it when they’re off oxygen? Or is it a lifelong condition?

[@TalaTalksNICU]

This is a GREAT question. Honestly- depending on how severe the BPD was- there have been follow up studies in teenagers that can still have decreased expiratory forced volume or lung capacity. Having said that - there have been many premature infants who have become professional athletes- so hopefully slightly more vulnerable lungs aren't necessarily a life sentence!

[@monjidibrahim1168]

Hahaha also I love coffee as black no cream and without sugar.

[@TalaTalksNICU]

works great too- people are more likely to bring you coffee when you have an uncomplicated order! ha!!

[@kathleenjayneramos1065]

Can you do Dart therapy please 🙏🏻 ❤

[@TalaTalksNICU]

YES! We discuss it briefly in that video i think- but we can go over again!!! Thanks for being here!

[@kathleenjayneramos1065]

@@TalaTalksNICU thank you so much.. I'm a new subscriber...

[@Snirbuncle]

Hi my son is 4 month he was on cpad and then nasal cannula and off and on but still on it

[@Snirbuncle]

what will happen he very healthy but i dont know what the next step what will happen

[@TalaTalksNICU]

Congratulations on your son! it sounds like he is continuing to get better- hopefully he'll be able to come off NC soon. Good luck!

[@simply.lordia4402]

The doctors tried steroids & caffeinated medication ( Theophylline & Plaquenil) & still the medication didn’t work for my child. The Tracheotomy was the option that was giving to my child

[@TalaTalksNICU]

I’m sorry you and your child are going through this. We know that when babies reach a certain point (soon after their “due date”) babies have better outcomes when they have a tracheostomy instead of fighting the machine/ Cpap for ages. I wish you and your family health and luck xxx

[@simply.lordia4402]

@@TalaTalksNICU Thank you. Looks like that’s what we have to do. Even tho the oxygen level has come down.