Dr. K. S. Gautham @Dr_KSGautham Twitter profile

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

NG/OG tubes can be misplaced in the trachea or cause gastric perforation. An innovative method to confirm accurate placement - LED source with optical fibers that light up the tip of the tube & visible light through the anterior abdominal wall #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Pleased to share my first ever published poem, on PDA. #neotwitter #narrativemedicine

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

The term 'withdrawal of care' is still sometimes used in the chart or verbally in end-of-life care. A reminder (sorry if it's preachy) - we never withdraw care, we withdraw intensive care, or say 'we transitioned to comfort measures only'. We always provide care. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Using an unproven treatment and thinking it worked because the patient improved…. #neotwitter #neoebm #medtwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

10 reasons why intensivists make good leaders in medicine: 1. Used to dealing with crises 2. Skilled at communicating bad news 3. Can balance grim reality of bad situation with maintaining optimism, hope 4. Used to working as a team 5. Know when to act quickly vs wait & watch

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Dr. K. S. Gautham

@Dr_KSGautham

1 month

#neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

History of neonatology: Before the role of surfactant & the pathogenesis of neonatal RDS were known, and before CPAP was developed, a method used to manage RDS was application of external traction to the sternum to counteract the deep sternal retractions in severe RDS #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Neonatologist trying to interpret results of whole exome sequencing #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Have had a chance to visit some neonatal units in India. Best part of these visits is to see the Kangaroo Mother Care wards that are attached to each NICU. Rows of beds, dormitory-style, each one with a mom-baby pair doing KMC, lying skin-to-skin for hours on end.

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

NICU care can have life-long consequences.A 48 year-old man with recurrent cerebral ischemic events was found to have an intracardiac foreign body on echo. Turned out to be a fragment of a UVC placed when he was a neonate. #neotwitter From @jaccjournals

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

In the NICU: Giving NaCl supplements along with furosemide! #neotwitter

traumadramamd

@TraumaDramaMD

2 years

fluids! lasix! fluids! lasix!

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Congratulations to all newly board-certified US neonatologists! In martial arts, a black belt is not the end, but the beginning of true learning. Similarly IMHO board certification = beginning of true learning & gradual accumulation of knowledge, experience, & ultimately, wisdom

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Once I knew a resident who, after his 1st year in surgery residency changed to psychiatry. When I asked him why he switched, he said with a smile “I wanted to go into a far more invasive specialty”. Today my daughter matched into psych @ Harbor UCLA Big day for entire family!

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Whatever happened to oxygen hoods (oxyhoods)? You so rarely see them in the NICU nowadays. (Or is this question a sign that I am becoming a neonatology dinosaur?) #neotwitter Image from:

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

A common sight at @PASMeeting is an eager & excited-looking young person standing in front of a poster, but with no one stopping to view the poster. Let’s all stop in front of such posters and ask some questions. I did this a few times & it’s gratifying, plus I learned something!

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Dr. K. S. Gautham

@Dr_KSGautham

5 months

I am honored to serve as the inaugural chair of the University of Central Florida College of Medicine - Nemours Children’s Health Department of Pediatrics. This is an additional role to my previous role as Chair of Pediatrics at Nemours Children's Hospital, Orlando.

Nemours Children's Health

@Nemours

5 months

BIG NEWS! 🎉 🩺 Nemours Children’s Health and @ourmedschool are teaming up to introduce the University of Central Florida College of Medicine - Nemours Children’s Health Department of Pediatrics. Together we’re a making difference in children's health! #NemoursxUCF

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

When Kamala Harris was asked about the evidence for when and how to treat a PDA:

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

Goldsmith’s Assisted Ventilation of the Neonate edited by Dr. Keszler & me is currently in its 7th edition. We met at PAS with the publisher to plan the next edition. Lots of updates to include, but may make the book too bulky. Publisher may make next edn soft-cover☹️ #neotwiiter

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

I don’t know if it was because of a corner location or because it was about probiotics, but my poster with Sree Viswanathan got a lot of attention today. Glad to interact with many colleagues from across the world. Glad to represent ⁦⁦ @Nemours ⁩ #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

8 months

Even after so many years in academic neonatology, it’s interesting to see how thrilled I feel to receive notice that a PAS abstract or a journal manuscript has been accepted for presentation or publication. Guess it’s a sign I still enjoy the job! Simple pleasures of academia.

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

James Bond (007) can help you calculate glucose infusion rate in mg/kg/min. Multiply: James Bond number 0.007 x total fluid intake per day (ml/kg/day) x dextrose concentration (%) of the fluid, and you get the GIR #neotwitter Described in

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

One of the best parts of @PASMeeting was today- a meetup of #neotwitter . Great to see people and talk to them IRL.

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Prophylactic vitamin A reduces BPD (high-certainty evidence). Yet only 8% of babies 22-29 weeks receive it. Why have we abandoned its use? Especially with a continued high BPD rate in many NICUs? Data from this study, with good discussion #neotwitter

Severity of Bronchopulmonary Dysplasia Among Very Preterm Infants in the United States

The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network recently proposed new, severity-based diagnostic criteria for bronchopulmonary dysplasia...

www.ncbi.nlm.nih.gov

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

People usually share the news when their manuscript is published. Today I want to share the news that a manuscript of mine was rejected. Interesting how rejection stings even after so many years in the publication game. But it’s part of the process. #MedTwitter

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Dr. K. S. Gautham

@Dr_KSGautham

1 month

The Neonatal Resuscitation Program reacts to neonatal resuscitation videos posted on social media. #neotwitter @AAPneonatal

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Should LISA become routine in US NICUs? Our review article with implementation tips (free full text) #neotwitter

Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?

Pediatric Research - Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?

www.nature.com

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

For the next 2 weeks, I will tweet exclusively about bronchopulmonary dysplasia (instead of a mixture of topics like I've been) 2 reasons - 1. Experiment to see if this is a better way for me to learn & teach (my goals of posting here) 2. Prepare for 2 upcoming talks #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 months

Based on a recent online discussion with some colleagues about balancing risks vs benefits of antibiotic therapy. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

10 months

Usually I don’t like to toot my own horn but this was interesting. Immediately after finishing my talk on diagnostic errors today at Neocon 2023, as I walked out of the hall, a framed photograph of me at the lectern was waiting for me to pick up. Very slick organizing!

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

I admit two babies when NICU census is high. NICU charge nurse: "You're killing us!" I discharge two babies when NICU census is low. Same charge nurse: "You're killing us!" 🤔🤷‍♂️ #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

I'm thrilled that our proposal for a workshop on teaching was accepted for the PAS 2023 mtg. We welcome you to attend this. Date, time, room will be known in Jan. The title is: Teach like Socrates: The Right Way to use Questions when Teaching (Kalidindi, Lavery, Holmes, Gautham)

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Dr.Miller's quote that I shared during my talk was appreciated by many. Here are some data (1 of several papers) illustrating importance of post-NICU home environment, neurodevelopmental interventions, plasticity, in changing long-term ND outcomes. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Sodium bicarbonate: we know it's not effective & it's associated with worse outcomes during CPR. Yet we continue to use it in ~ 50% of pediatric CPR events. 2 good articles in neonates: - - (Love the title of this one!) #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 months

Do you agree, #neotwitter ?

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Dexmedetomidine use in NICUs is increasing rapidly without good evidence in neonates, especially in preterms. One study found⬇️cerebral regional oxygenation & also aEEG changes. Time for a moratorium? #neoTwitter Excellent review at

Dexmedetomidine: new wonder drug or next neonatal disaster?

In many units, including my own, dexmedetomidine (DXM) has been creeping into use. Initially, we noticed in some full term babies who returned from the operating room, the medication appeared in th…

neonatalresearch.org

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Dr. K. S. Gautham

@Dr_KSGautham

6 months

What advice do parents of extremely preterm infants have for clinicians? #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Is this the future of neonatal monitoring? Wireless, non-invasive technology - monitors HR, resp rate, temp, O2 levels. Also tracks movements, body orientation, records cry & even monitors systolic BP (thru surrogate). #neotwitter

A wireless wearable patch records a fragile baby’s every cry

Nature - Supple, unobtrusive sensors can provide valuable data on a newborn’s health.

www.nature.com

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Caring for babies born as early as 22-23 wks now commonplace. These babies are not merely smaller versions of >GA preterms. Their physiology, biochemistry & clinical course is still poorly understood. Need new term for care of such babies - 'nano-neonatology'? Other? #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

You should know the number 1440 if you care for ventilated babies. My fellowship mentor emphasized this. It's the number of lung inflations per day you avoid if you decrease the vent rate by 1/min (60*24 = 1440). Even if you⬇️rate slightly, might ⬇️lung injury #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

1/7: Live conferences have an energy and spirit that you don’t find in online meetings and conferences. I don’t know what the psychological explanations are, but perhaps (pure speculation) when people meet in person there is an ‘exchange or transfer of energy’.

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Neolung: A unique online conference Registration is now open! June 22-23 (half day each). Excellent speakers discussing important respiratory topics. Free for students, trainees and health professionals in LMICs Hope to see you there!

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

We often forget that antibiotic Rx in preterm infants⬆️risk of NEC. Systematic review, 12 observational studies found prolonged empiric antibiotic Rx early (author-defined) was asso with > 2-fold⬆️risk of NEC. Similar article: PMID 28369594 #neotwitter

Frontiers | Fetal–neonatal exposure to antibiotics and NEC development: A systematic review and...

BackgroundFetal and neonatal exposure to antibiotics may contribute to the development of necrotizing enterocolitis (NEC) in preterm infants. This systematic...

www.frontiersin.org

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

AAP policy statement about neonatology's most loved and hated medication (hot off the press): Postnatal Corticosteroids to Prevent or Treat Chronic Lung Disease Following Preterm Birth

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Dr. K. S. Gautham

@Dr_KSGautham

9 months

If you study the history of neonatology it’s striking how often we’ve jumped on the bandwagon & adopted unproven therapies (with good intentions) & caused harm, waste, or both. Even today we continue to enthusiastically use therapies without high-certainty evidence . #neotwitter

PHILOSOPHY ON X

@philosophytweet

9 months

We learn from history that we do not learn from history. - Hegel

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

What exactly are risks vs benefits of routine probiotic supplementation in preterm infants? Here are some estimates from literature. Such visuals can inform decision-making, policy. Number of probiotic-sepsis deaths will have to be much higher to tilt the scales. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

3 months

Guidelines for management of congenital diaphragmatic hernia from Canada, updated. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Why is it that some neonatologists and nurse practitioners love going to deliveries and others hate it? Shouldn’t going to deliveries be an essential part of our identity? I find birth to be awe-inspiring even after so many years in neonatology. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Spend three minutes to understand the key principle of non-inferiority trials. Great explanatory video from NEJM Evidence (you'll understand it better if you like Mexican food🙂) #neotwitter #medtwitter

Is Noninferior Not Inferior?

What is a non-inferiority trial margin? To answer this, ask whether you have ever weighed a tradeoff between the best version of something and an acceptable alternative. Restated, ...

evidence.nejm.org

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

Key questions about BPD 1. How to prevent it? 2. How to manage it? 3. Why prevent it (short-term & long-term outcomes, impact)? 4. What is it (definitions, phenotypes)? Let's start w prevention: Prevention of BPD: windows of opportunity Aschner et al 2017

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Powerful essay about social, economic, cultural & political determinants of prematurity (including racism and ⬆️in maternity care deserts), how mothers blame themselves wrongly for preterm birth. #neotwitter #obgyntwitter

You Can Do Everything 'Right' and Still Have a Preterm Birth

Parent often blame themselves. I try to tell them it's not their fault

time.com

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Dr. K. S. Gautham

@Dr_KSGautham

10 months

Vineet Bhandari summarized the evidence on postnatal corticosteroid usage, ending with his personal practice. Strongly recommended the Htun 2021 article. #neotwitter .

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Dr. K. S. Gautham

@Dr_KSGautham

9 months

#neoTwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Our residents graduated recently. When they started residency 3 years ago, we had them write a letter to their future selves. Some read these letters out aloud to us. Very moving, thought-provoking. We should all write letters to our future selves #medtwitter #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

'Permissive' neonatology. We've heard about permissive hypercapnia, and permissive hypotension (HIP trial). 2 other examples of a permissive approach in NICU are Rx of polycythemia & PDA management. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

And now our favorite topic, which we “have debated for six decades” per speaker

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

The Neonatal Research Network is one of the most important sources of research (including RCTs) in neonatology. 15 centers were recently funded by NICHD (new or renewal) to participate in this network for seven years. There are 3 new centers. #neotwitter

Item of Interest: NICHD announces awards for Neonatal Research Network

The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has announced new funding for participating centers in its Neonatal Research Network (NRN). The purpose of...

www.nichd.nih.gov

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

Sharing our article on probiotics for prevention of NEC. Will inform some of the current discussions on #neotwitter after FDA alert @Chetta_Milk_Lab @BrianKingNeo @docfortots Use of Probiotics to Prevent NEC—Evidence to Clinical Practice

Use of Probiotics to Prevent Necrotizing Enterocolitis—Evidence to Clinical Practice

This Viewpoint summarizes assessment of the benefits and harms of probiotics, describes current options for clinicians, and discusses the theoretical influence of future trials on treatment effect...

jamanetwork.com

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Dr. K. S. Gautham

@Dr_KSGautham

8 months

We can't improve neonatal outcomes without ensuring NICU professionals are thriving. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

In a ventilation talk yesterday I emphasized the need for a NICU to pick a few types of ventilators, and vent strategies & use them consistently. Consistency of care is important for good outcomes. We need to study it more as an intervention in itself. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Every leader is a CEO–Chief Emotional Officer. Whether you lead a resuscitation team, lead rounds, run a division, department or health system, you have to pay attention to & manage the emotions & wellness of your people. Don't just focus on technical work #neotwitter #medtwitter

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Dr. K. S. Gautham

@Dr_KSGautham

3 months

Anyone who works in the NICU should watch this! First Day of Neonatology via @YouTube

First Day of Neonatology

The NICU is a whole different world

www.youtube.com

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Good review: ETTNO & TOP trials give us high-certainty evidence about hemoglobin range to aim for in ELBWs: 11-13 g/dl in critically ill or ventilated babies in 1st week of life 7-10g/dl for stable older babies not on significant resp support #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

10 months

Thrilled to announce that we will be conducting a workshop on leadership at the PAS 2024 meeting in Toronto. It’s titled ‘The Compass, the Mirror, and the Swiss-army Knife: Key Principles of Leadership in Pediatrics’. Please sign up when the conference schedule is released in Jan

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

Hot off the press. More evidence for⬇️ on mortality, morbidity in preterm infants with probiotics, prebiotics, lactoferrin, combns. Multiple-strain probiotics associated with⬇️ in all-cause mortality, NEC, feeding intolerance, hospitalization #neotwitter

Probiotics, Prebiotics, and Synbiotics for Prevention of Mortality and Morbidity in Preterm Infants

This systematic review and network meta-analysis examines evidence about the use of probiotics, prebiotics, lactoferrin, and their combination to gauge the comparative effectiveness of alternative...

jamanetwork.com

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

#neotwitter Rx of PDA. We need a decision aid for clinicians to explain to families what's known, unknown, options re PDA The only DA related to PDA I'm aware of is: Glad to brainstorm about this if anyone interested. Can update DA as new evidence emerges

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

22-23 weekers are not just small premies, just like children are not small adults. Dr. Winn describing the excellent Tiny Baby Care program at Winnie Palmer Hospital, Orlando, FL.

Nemours Children's Health

@Nemours

1 year

Join us for the Central Florida Neonatology Conference, where we'll tackle practical & controversial issues in neonatology through a multidisciplinary approach. Developed by neonatology teams from AdventHealth, Nemours & Orlando Health Winnie Palmer.

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

How exactly is death discussed by clinicians caring for critically ill infants & family members? This elegant study found that words such as 'die' and 'dying' were infrequently used. Instead, euphemisms (4 categories) were used. #neotwitter #PedsICU

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Dr. K. S. Gautham

@Dr_KSGautham

3 months

'Everyone Post-Call Sounds Angry' is a mnemonic proposed by Rhein to remember the stages of lung development: Embryonic, Pseudo glandular, Canalicular, Saccular, Alveolar If you don't periodically revisit lung development, it's easy to forget these stages. Babies at the highest

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

Live From Toronto! Excited to be doing a live podcast this evening from @PASMeeting from the Nemours Booth. Tune in on the @Nemours YouTube channel at 530 PM Eastern to hear about The Mirror, the Compass & the Swiss-army Knife of Leadership, Other topics.

Nemours

At Nemours Children’s Health, our mission is to go well beyond medicine to help children where they live, learn and play.We believe in supporting each child’s whole health—the social, economic,...

www.youtube.com

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

A sobering realization over the span of my career. The importance of factors outside the hospital and clinic to child health. #neotwitter #medtwitter #pediatrics #children

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Over my career I've seen neonatology evolve into a kinder, gentler specialty. This evolution is well-described in this paper titled 'Less is More: Modern Neonatology'. #neoTwitter

Less is More: Modern Neonatology

Iatrogenesis is more common in neonatal intensive care units (NICUs) because the infants are vulnerable and exposed to prolonged intensive care. Sixty percent of extremely low-birth-weight infants...

www.ncbi.nlm.nih.gov

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Excellent comprehensive and practical review on ventilator management in extremely preterm infants. Good mix of evidence and practical advice. #neotwitter

Ventilator Management in Extremely Preterm Infants

Advances in ventilation strategies for infants in the NICU have led to increased survival of extremely preterm infants. More than 75% of infants born at less than or equal to 27 weeks’ gestation...

publications.aap.org

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Dr. K. S. Gautham

@Dr_KSGautham

3 months

Neonatal endotracheal intubation is steadily becoming more high-tech, esp with use of videolaryngoscopy. It's interesting to remember the technique of digital neonatal intubation, where an endotracheal tube is inserted without use of a laryngoscope, with just one's fingers (see

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

How academic faculty should focus their time and effort over their career. #medtwitter #AcademicTwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

New recommendations from the WHO about use of antenatal steroids (supercede the 2015 recommendations) #neotwitter #obgyntwitter

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

If you are attending PAS 2023 and want to improve your teaching skills, please consider our workshop: Teach Like Socrates: The Right Way to use Questions when Teaching Sunday, April 30, 2023 11:00 AM – 12:30 PM ET Location: Convention Center: 155

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Dr. K. S. Gautham

@Dr_KSGautham

2 months

Preventing IVH in Preterm Infants Many NICUs now have in place neuroprotection bundles or neuroprotection care programs. Are these effective? A systematic review of quality improvement reports to reduce IVH found: -A variety of interventions were used (heterogenous) -IVH

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Dr. K. S. Gautham

@Dr_KSGautham

10 months

Caffeine. Not just for babies. #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Is NEC a single condition or a conglomeration of subtypes? From Patel A et al. Clin Perinatol. 2017 Sep; 44(3):683-700. doi: 10.1016/j.clp.2017.05.004

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Dr. K. S. Gautham

@Dr_KSGautham

3 months

I have to confess that during a recent stretch of clinical service I did an LP with the baby lying down sideways (not sitting up) and intubated two babies with direct laryngoscopy (not VL). These 2 techniques, both successful, were in the control (inferior) arms of recent RCTs

Alexandra Scrivens

@dralexscrivens

3 months

Great to hear from Dr Mervat Elyas that NeoCLEAR is having an ongoing impact in Leeds! #JFNS24 Time to sit up for neonatal LP success - videos available on YouTube @ccroehr @NPEU_CTU @EdJuszczak

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Dr. K. S. Gautham

@Dr_KSGautham

7 months

Neonatology debates about PDA management remind me about the history of tonsillectomy - it used to be widely done in the past, unnecessarily in most cases. Tonsils were blamed for a variety of conditions without good evidence. PDA = tonsils of neonatology?

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Dr. K. S. Gautham

@Dr_KSGautham

8 months

In my role I have to frequently interview candidates for jobs & advise trainees, faculty, about job hunting. Here is a useful framework- criteria to assess a job. In addition, the 'gut feeling' you get from visiting the organization, and meeting the people is important.

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

What an amazing visual. A picture truly is worth 1000 words. Compliments to @jennykoomd and @neosatyan (from grand rounds by @NeoAnup )

Clara Song

@songMD

11 months

Learning something new EVERY time @NeoAnup reviews cord management! Impossible not to w/ the beautiful #NeoGraphics from @jennykoomd & @neosatyan Thanks, @DrRamanathanUSC , for the invite to @KeckMedicineUSC #NeoGrandRounds

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

In neonatology, why don't we use a weight-based 'dosing' of high-flow nasal cannula flow and CPAP levels? As in: Randomized Trial of Weight-Based Versus Fixed Limit High-Flow Nasal Cannula in Bronchiolitis #neotwitter

Randomized Trial of Weight-Based Versus Fixed Limit High-Flow Nasal Cannula in Bronchiolitis

BACKGROUND. High flow nasal cannula (HFNC) is increasingly used to treat bronchiolitis. Although lower HFNC rates (≤8 L per minute) are commonly employed, higher weight-based flows more effectively...

publications.aap.org

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Dr. K. S. Gautham

@Dr_KSGautham

11 months

"It is time to limit PPI use in infants and children, especially when they are otherwise healthy." PPI use associated with⬆️risk of infections. #MedTwitter

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Dr. K. S. Gautham

@Dr_KSGautham

26 days

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Umbilical Venous Catheter Placement in Neonates Compared to radiologic assessment, US was associated with a significantly lower incidence of primary malpositioning of UVCs, reduced catheter

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

The Journal of Hospital Medicine has a series called Things We Do for No Reason™, based on the Choosing Wisely campaign. It's promotes rational & prudent use of diag tests, treatments. We need a similar series for neonatology. Any takers? #neotwitter

Things We Do for No Reason™: Computed tomography of the head before lumbar puncture in low‐risk...

Click on the article title to read more.

shmpublications.onlinelibrary.wiley.com

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Inhaled nitric oxide. Do you know the 20-20-20 rule? Do you know when to say ‘no’ to NO? Watch this engaging Tala Talks video. Dr. Tala has the gift of explaining complex topics in a simple, comprehensible way.

Doctor explains: when to use Nitric Oxide in Pulmonary Hypertension

We've all seen the MAGIC of Inhaled Nitric Oxide at bedside, but how does it work? And how did anyone figure it out? We go over its mechanism of action (and ...

www.youtube.com

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Dr. K. S. Gautham

@Dr_KSGautham

5 months

I am concerned about how advocates for NIRS in neonatal care (believers) are pushing its use, in spite of recent evidence that does not support its use. I hope some authoritative body issues a statement to promote evidence-based NIRS use (non-use) to counter-balance these forces.

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Replenishing the microbiome on my last day in India! I believe probiotics are good for neonatologists as well as neonates.

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Dr. K. S. Gautham

@Dr_KSGautham

6 months

Should we extubate a preterm infant to CPAP or NIPPV? NIPPV is preferred if we use a multi-component primary outcome (that includes reintubn) CPAP is non-inferior if outcome restricted to reintubn. (be prepared to handle double-negatives!) #neotwitter

CPAP Versus NIPPV Postextubation in Preterm Neonates: A Comparative-Effectiveness Study

10.1542/6345002987112Video AbstractPEDS-VA_2023-0640456345002987112BACKGROUND AND OBJECTIVES. Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continu...

publications.aap.org

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Dr. K. S. Gautham

@Dr_KSGautham

4 months

Best part of @PASMeeting is meeting old friends, making new ones, talking to mentees & mentors One of my mentors yesterday explained how you know you have passion “When you feel guilty that you’re being paid for work that you would have done for free because you enjoy it so much”

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

There was a time in my career, before EBM, when the words of teachers, and textbooks were the ultimate source of truth & authority. A memorable text book in med school was 'Bailey and Love'. Crisply written, appealing layout, beautiful hand-drawn illustrations. Pleasure to read.

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Remember the Second Arrow. When you Rx a patient and he/she improves, don't pat yourself on the back that it was your treatment (the arrow over the graph) that caused the improvement. Remember there is a second arrow - time! Sometimes patients get better just with time.

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Dr. K. S. Gautham

@Dr_KSGautham

2 months

Does this happen in your unit? #medtwitter #neotwitter #academictwitter

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Dr. K. S. Gautham

@Dr_KSGautham

9 months

Had a wonderful time at the annual NNF India conference. Thanks to organizers for inviting me. This poster was outside the venue. A constructive 🙏🏽 suggestion: I know this yr many women leaders were involved, contributed. Next year hope to see more women displayed on such posters

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

Data visualization. Which graphics are best to report harms in RCTs? An excellent review and consensus recommendations. Read all about the violin plot. #neotwitter #AcademicTwitter #epitwitter

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Dr. K. S. Gautham

@Dr_KSGautham

2 years

We are never formally taught decision-making, even though it is the most commonest thing we do as clinicians. We should teach it during training. Our team discussion in rounds today emphasized 2 key points: #medtwitter #neotwitter

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Dr. K. S. Gautham

@Dr_KSGautham

8 months

State-of-the-art review on multiple aspects of respiratory management in the preterm infant. Congratulations to the authors! #neotwitter

Respiratory management in the premature neonate

Advances in neonatal care have made possible the increased survival of extremely preterm infants. Even though there is widespread recognition of the harmful effects of mechanical ventilation on the...

www.tandfonline.com

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Dr. K. S. Gautham

@Dr_KSGautham

1 year

Thank God for long flights. They are the only distraction-free time that help me write nowadays. Otherwise my days are filled with constant distractions, interruptions. I flew to India a couple of days ago. On the long flight was able to complete a manuscript revision & submit.

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