Michael Narvey 🇨🇦 @NICU_Musings Twitter profile

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

#breastfeeding in an #mri ‼️ Ever wondered what this might look like? #neoTwitter #medTwitter Credit: MRIology

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Marcus-Gunn Jaw-Winking syndrome from congenital neurosyphilis Sucking elicits blinking. Once you see it you won't forget. #neoTwitter #medTwitter @grepmeded

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

This picture is too beautiful for words. Whatever method of feeding you choose or are forced to use the important point is that you are caring for your infant! #noshame #feedingisbest

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Eyelash trichomegaly To qualify length must be > 12 mm This one qualifies #medTwitter #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

A 500g #preemie just had a 5 mL pee. It was massive 😳 #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

A 1 kg baby gets ventilated with a teaspoon of air with each breath. Don’t know if a better use for a teaspoon of anything has ever existed in the world. Aren’t preemies incredible? RT if you agree! #MedEd #neotwitter #preemiestrong

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Parents remember your words. Not your intubation, line placement or bed management skills. Choose them wisely #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Simply WOW‼️ 20 year follow-up of RCT shows larger volumes of total grey matter, basal nuclei and cerebellum in those who had received kangaroo mother care vs routine incubator care. #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Words to live by 👇 #caffeine #nicu

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Tracheal agenesis with bronchoesophageal fistula Impossible to ventilate but image is incredible #neotwitter #PedsICU

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

I love that in Neonatology after so many years of exploring high tech & roles of medications the biggest push in the last 5 years has turned to skin to skin care & maximizing mother's own milk for preemies. The "KISS" principal in action! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Exposure to maternal voice twice a day for 20 min prior to feeding attempt increases oral intake in #preemies by 7.1% #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Repeat after me‼️ There are no difficult parents. There are however parents who are: Scared Worried Misinformed Alone Depressed Our job is to identify , help & encourage their right for advocacy. #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Light emitting diode on the end of an NG tube. How genius is that? Never put food accidentally into a lung again #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Ectopia cordis from @TexasChildrens #surgeons are indeed wizards truly “heal with steel” #pedsICU #neoTwitter #medTwitter @grepmeded #CardioTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

8 months

Survival rate of single unit in Japan at 22 weeks gestation = 82.8% No patient required a tracheostomy or ventriculoperitoneal shunt If we believe that could be our future too #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Quincke’s sign in a 21 month old Not at a nail bed but at the site of an insect bite Not just from aortic regurgitation! Local diastolic dysfunction most likely here. #MedTwitter @grepmeded #Dermtwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Much like ibuprofen, it appears paracetamol may have higher efficacy at closing a PDA when used as 1st line treatment when given by the oral (70%) vs IV (40%) route regardless of GA #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

If someone finds a way to prevent preterm birth I would be happy to tender my notice of retirement. Until then thanks to everyone the world over who take care of babies in the NICU! Hoping 2021 brings us a little closer to the goal How about a RT?! #neotwitter #MedEd

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Why is it if we bring a baby into the NICU & they don't reach a set feeding volume they are gavaged yet when they are exclusively breastfed on the ward & getting drops of colostrum all is great?! Not all babies need to be medicalized! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Congratulations 👏 to the ⁦ @ClevelandClinic ⁩ for this remarkable achievement as shown on ⁦ @CNN ⁩ How did they remove a fetal cardiac teratoma?! #medtwitter #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Newborn jitteriness A relief that it’s not a seizure when it stops with gentle holding of the extremity. Source: YouTube Ercan Kirimi #neoTwitter #Medtwitter #neurotwitter @grepmeded

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Remarkable achievement in single centre in Japan for infants born at 22 weeks N=29 Survival 82.8% PDA ligation 14.7% MEC 10.3% ROP 51.7% No tracheostomies No VP shunts

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

No #baby or #preemie should need a bomb shelter‼️ #nicu #neonatal #ukraine #russia #newborn #neoTwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Systematic review +/- pacifier use in term infants finds equal breastfeeding rates at 2, 3, 4, and 6 months. In preemies , the use of a pacifier ⬇️hospitalization by 7 days and the time from gavage to total oral feeding by more than 3 days! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

When you frame #breastmilk as medicine for #preemies you'd be surprised how many mothers who weren't going to #breastfeed ask how quickly they can start to pump. #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Have you ever?!? #neotwitter

Dr. Tanmay Motiwala

@Least_ordinary

3 years

Recieved this on whatsapp and can't get over it 😍😍😍 Will stop putting NG for feeds. #Pediatrics #Neonatology #Some4pediasurg #medtwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Babies are quite happy to be extubated overnight rather than “leave till morning” A few of them just asked me to pass on the message as they wanted to let you know they weren’t doing anything overnight anyway. #MedTwitter #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Apparently my communication could use some tweaking.😐 Obtained consent for donor breast milk from a new mom in #NICU Two hours later Mom: Did the woman come to breastfeed my baby yet? 😮 Me: Um... #breastfeeding #MedEd

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

The importance of giving antenatal steroids to mothers prior to preterm birth can't be stressed enough. Study finds persistent benefits to cognition and motor skills 12 years later! #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Is there a better medicine in #neonatology than #breastmilk ? #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

60 mothers with #COVID19 or recovered. No viral RNA detected in breastmilk but antibodies present n 83%. More evidence supporting no need for disruption of #breastfeeding in the pandemic! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Parents are not visitors in NICU they are essential caregivers. @Cdn_Prem_Babies #neotwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Once you see this, you will never think of pneumatosis intestinalis the same way #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

A mother’s kiss You just saw bonding happening inside the brain Credit: Rebecca Saxe neurologist #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

You’re not officially a #Neonatologist until both you and your patient take your morning doses of caffeine in solidarity. #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Not sure who needs to hear this but if a mom has E. Coli sepsis 🦠🦠🦠🦠and you get this call about her 6 hour old baby... "should I be worried about two newborn temps of 38.2 & 38.5?" Is a hard, absolute, definite YES, YES, YES #MedTwitter #IDtwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Systematic review confirms stability of oxygenation during kangaroo care (KC) care whether receiving respiratory support or not. No basis for preventing KC over concerns that #preemie is on non-invasive support or a ventilator! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Best antenatal consult ever Me: I want to talk to you about what to expect at 26 weeks Mom: I’m not worried Me: good to hear. Why’s that? Mom: I was born 30 years ago at 26 weeks & am an academic Can you hear the 🎤 drop #MedTwitter #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

The surest way to cancel a discharge in NICU is to let the baby hear that if there is no apnea/bradycardia by the following morning they can go home. #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Complex Umbilical-Cord Knot I couldn't tie this if I tried yet a fetus did that all on their own?! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Never underestimate the power of a phone call 📞 to calm the nerves of parents in #NICU . Easy to get wrapped up in intensive care & miss the chance for intensive caring. #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

9 months

If any #preemies are listening out there, it really isn't funny when you have an apnea +/- bradycardia in the last hour before we are ready to turn off the monitors. #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

Getting married in one week today to this beautiful woman. Best data I have ever shared on Twitter. #notfakenews

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

I love it 💕when a extreme #preemie reaches full feeds and is described as "full" That's 1 tablespoon of "liquid gold" milk in the belly Yep, that small... #MedTwitter #breastmilk #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Swallowing amniotic fluid captured. Is it just me or is this really cool? Credit: best beginnings #neotwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Breastmilk non-inferior to 24% sucrose as an analgesic during heel lance associated pain. Is there anything breastmilk can't do?😀 #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

NICU SURVIVAL TIP Listen to the bedside nurse Don't think the MD itself after your name is superior to the knowledge gained after spending 8-12 hours at the bedside with a patient. When they say there is something wrong, LISTEN #medtwitter #TipsForNewDocs #Nursing

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Michael Narvey 🇨🇦

@NICU_Musings

11 months

Cool 😎neonatal invention! Pilot study using fiberoptic light at tip of NG leaves little doubt about proper placement! #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

After 15 minutes of Kangaroo Care NIRS detects cortical activation in #preemies Main effect is in the right cortex which interestingly is where attachment is thought to develop! #neoTwitter #medTwitter #kangaroocare

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

RCT of infants born 28+0 to 32+6 weeks of gestation finds that skin to skin care for 1st 6 hours of age vs incubator care leads to better composite score of: ✅Heart & respiratory rate ✅Respiratory support ✅FiO2 ✅O2 sat #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

It’s that time of year again #kangaroocare

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

En Caul #birth from the @ClevelandClinic Still waiting for my first 1:80000 births of 1 every 5 years where I’m from #neotwitter #obgyntwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

Outside of an emergency, if you are going to intubate a baby please consider full premedication. Your chances of getting the tube in & not having adverse events are better. Don't the babies deserve that? #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

This is what we are talking about in monochorionic/monamniotic twin pregnancies & the risk of cord knots! 😮 32 week twins happily were fine! #neotwitter #obgyntwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Preemies understand when they are being read to by their parents. RCT demonstrates those read to at 36 weeks have ⬆️ conversational turns‼️ Keep it up parents! #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Advocating for your child does not make you a difficult parent. #MedTwitter #PedsICU

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Michael Narvey 🇨🇦

@NICU_Musings

9 months

Not going to lie. One reason to choose #neonatology as a career is that babies & by extension NICUs smell much better than any adult ward They are also much cuter but that is a close second #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Newborn with a cough H-Type Tracheoesophageal fistula on esophagram Once you see it you can't unsee the bronchial tree! #MedTwitter #neoTwitter #PedsICU #pediatricsurgery @grepmeded @AvrahamCooperMD

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Normalize celebrating mothers for the amount of #breastmilk they have produced rather than demoralizing them for the amount they haven’t. #neotwitter #MedTwitter #PedsICU

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

#Toronto study finds intranasal #breastmilk safe, paving way to prospective study to determine if stem cells introduced via this route may reduce severity of IVH #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Normalize not doing "routine" neonatal exams when babies are sleeping, educating others as to the reasons why & not getting frustrated for not being allowed to do it. #neotwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

I don't care how much fancy equipment you have. Without nurses to care for the patient at best that equipment can be something you drape your coat over while waiting for a bed to open. Let a #nurse know you appreciate them. They are the backbone of our hospitals. #MedTwitter .

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Telling parents that their baby will get home faster if they bottle feed is not only incorrect but undermines support for #breastfeeding and the health & immunological benefits for these infants. Need to stop this. Help ‼️ #breastmilk #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Don’t be an RCT snob. If it wasn’t for the observations of #nurse Jean Ward who noted the impact on jaundice of babies exposed to sunlight. you wouldn’t be using phototherapy today. #MedTwitter #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

I was asked yesterday if I am ok working in the hospital with #COVID19 . I responded "What choice do I have? There are #babies in need and we are the front line" Thanks to all the health care professionals for joining me. We are a team & need each other for the best care.

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Parking should be free for families coming to the NICU Promoting breastfeeding. In #NICU and increasing the volume of mother’s own milk consumed will reduce BPD ROP LOS TPN NEC I am guessing that’s worth a little more than 10 bucks a day Anyone listening? #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

I never made a baby better without a #nurse by my side #InternationalNursesDay2022 #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 months

Phase 1 study of intranasal human milk (37 infants, 2x per day for 28 days) to deliver stem cells near the brain. Variability in live cells & stem cell amounts vary! Will #breastmilk in the nose one day prevent or help heal IVH? #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

Is there a better job than saving the lives of babies? Not everyone can do it but boy does it sure feel amazing to those who can. To all the preterm babies and their families I have cared for let me wish you a happy #WorldPrematurityDay2020

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Next time an OG/NG tube is needed in a #preemie you may want to insert while #kangaroocare is provided. KMC ⬇️the pain score by 39%, 32% and 30% during and at 3- and 15-min after procedure respectively as compared to control (P < 0.01) #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

One of the most important words that is so often forgotten when a baby is admitted to NICU CONGRATULATIONS Shocking how often this one word which has the power to lift parent's spirits is forgotten.

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Harlequin colour change in an infant on Prostaglandin #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Why is it that we would be put off if a friend forgot the name of our baby yet we often refer to babies in the NICU as "baby X" or "the baby in bed 5"? Takes a few minutes & would mean a lot to parents! #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

I have never in my career worried about whether a family can afford their stay in the #NICU . No co-pay No finance person asking "How will you be paying for this?" No "Do you have insurance?" Thank you 🇨🇦

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Neonatal Lupus: Periorbital rash in a newborn. Day 0 (Figure 1A) Day 3 (Figure 1B) Resolution by 5 months of age (Figure 1 C) Source: J Peds #neoTwitter #PedsICU

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Discharging a #preemie on #Xmas & seeing the parents' joy may be one of the most satisfying things one can experience in this field.🎄🎅 #ChristmasMiracle #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Some math to think about for #neoTwitter NICUs all over the world at signout... "Let's wait to extubate in the AM" 16 hours later 60 assist control breaths a minute = 57600 positive pressure breaths ❗️

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Someone decided today based on a post about #covid19 antibodies in breast milk to get vaccinated. The hundreds of hours this platform has sucked from my life has just become completely worth it! 🙏 #medtwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Normalize not openly criticizing decisions by people on call overnight You weren’t there #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

1 year

In my own backyard world's smallest surviving twins (22+0 weeks, 330g & 420g) reach one year of age. Wonder why Adrial looks ecstatic and Adiah looks totally unimpressed? #neoTwitter

‘0% chance of survival’: World’s most premature twins defy doctors

www.guinnessworldrecords.com

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Michael Narvey 🇨🇦

@NICU_Musings

4 months

Neonates always seem so stable up until they're not. The cliff is steep & the fall a rapid one #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Congenital Langerhans-Cell Histiocytosis. Guess I'll have to add this one to my differential diagnosis of a "blueberry muffin rash" 🫐 #neotwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

I love it when 22-24 #preemies ignore all the pessimists who said they were too small, too young, too sick and too hopeless, return after a year for a visit. Even better when like the bosses they are they strut in on their own two feet. 😊 #neotwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Benign neonatal sleep myoclonus One of the best examples I have seen. Source:YouTube (Ash) @grepmeded #neoTwitter #MedTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Why do we feel the need to stuff the newbron after birth? Colostrum is plenty given the stomach capacities below on day 1 and 2! Wonder why they throw up so much with large volumes of formula? #neotwitter #MedTwitter #breastfeeding

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Pulse oximetry overestimates O2 saturation by 2.4-fold greater for Black infants and resulted in greater occult hypoxemia (SpO2 > 90% when SaO2 < 85%; 9.2% vs. 7.7% of samples) Do darker skinned infants need different targets? #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

4 years

Think preemies are fragile? Born just over the size of a coke can Month on a ventilator Hypotension needing 1,2 or 3 vasopressors A surgery or 2 Sepsis a couple times Come back for a visit a year later with their parents Let's see an adult do that #preemiestrong #preemiepower

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Four vessel umbilical cord owing to persistence of the right umbilical vein. One theory of gastroschisis almost always being to the right of the cord is from weakness in the abdominal wall after regression of this vein 🤔 #neotwitter #pediatricsurgery @ManualOMedicine

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Nearly 20 years into my career and I still don't know. Is it really NEC⁉️ Should I treat the PDA, when & with what⁉️ If I will ever actually place an LMA❗️ What don't you still know⁉️ #neoTwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Best call to a patients room ever. Paging: Dr. Narvey to room # Me to Pt: “what’s wrong sir?” Pt: “I knew your great grandfather. Sit with me so I can tell you about him” 😊😊😊

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Cranial osteopathy not found to be beneficial for #breastfeeding in this RCT. Quote from an Osteopathic website "babies will often cry during the 1st treatment" Can we stop this now and RETWEET this message please? #MedTwitter #Pediatrics #neoEBM

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Michael Narvey 🇨🇦

@NICU_Musings

2 years

Should we start some golden rules of #neoTwitter Let's share some pearls of wisdom from the #NICU community I'll go first & feel free to agree or disagree...

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Neonatal Lupus Erythematosus presenting as annular plaques #neotwitter

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Michael Narvey 🇨🇦

@NICU_Musings

3 years

Not sure how many people know this but up to 6% of O2 & CO2 exchange in the newborn is through the skin! The more preterm you are the greater the exchange as > stratum corneum ⬇️ effect. Babies are 🆒 #MedTwitter #neotwitter

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