Intraventricular hemorrhage

You might get a hint of that in CT, but you'll really only see it or diagnose it conclusively on MRI, and that can be useful because it can give you some clues about how to treat it, but also obviously gives you a diagnosis.

And that's something which can be congenital or can be acquired commonly, for example, after IVH or of prematurity or after meningitis.

So another good example of a type of hydrocephalus that does not fit nicely into any particular classification mechanism.

It seems that's the running theme.

It's just supportive measures.

IVH has gotten better over time because we've learned different ways to help prevent it.

Even normal thermia, being too hot or too cold also could be very bad for the baby.

So there's so many things, different positioning of the baby, having the bed elevated a little bit.

In terms of primary outcome, The primary outcome of the study was non-invasive ventilation failure within 72 hours after birth, defined as requiring intubation with invasive mechanical ventilation.

They had a boatload of secondary outcomes, pulmonary hemorrhage, pneumothorax, etc., etc., BPD, IVH, neck, everything else.

So, The trial had 312 infants that were randomized.

153 infants were randomized to CPAP with surfactant, 159 to NIPPV with surfactant.

So no statistically significance, just like a little bit of a signal.

But still, even then, I was like, oh man, that's not the direction I was expecting this to go.

Other outcomes, including pneumothorax, pulmonary hemorrhage, BPD, IVH, PDL, late-onset sepsis, in-hospital mortality, no significant difference between the two groups, while immediate duration of non-invasive ventilation, Supplemental oxygen and corrected gestational age at discharge were comparable between the groups.

The nasal CPAP group had longer invasive mechanical ventilation duration and extended hospital stays.

In terms of primary outcome, The primary outcome of the study was non-invasive ventilation failure within 72 hours after birth, defined as the requiring intubation with invasive mechanical ventilation.

They had a boatload of secondary outcomes, pulmonary hemorrhage, pneumothorax, etc., etc., BPD, IVH, neck, everything else.

So, The trial had 312 infants that were randomized.

153 infants were randomized to CPAP with surfactant, 159 to NIPPV with surfactant.

So no statistically significance, just like a little bit of a signal.

But still, even then, I was like, oh man, that's not the direction I was expecting this to go.

Other outcomes, including pneumothorax, pulmonary hemorrhage, BPD, IVH, PVL, late-onset sepsis, in-hospital mortality, no significant difference between the two groups, while immediate duration of non-invasive ventilation, Supplemental oxygen and corrected gestational age at discharge were comparable between the groups.

The nasal CPAP group had longer invasive mechanical ventilation duration and extended hospital stays.

We're gonna kick off this episode talking about our thoughts about shunts, programmable versus non-programmable, anti-siphon versus non-anti-siphon, flow versus pressure.

To start off this discussion, I think we're gonna start at the beginning of the age spectrum with preemie IVH.

So let's say you have a baby who already has either a reservoir or a subgaleal shunt, and they are ready to shunt.

How big do you want them to be before you put a shunt in, and where are you gonna put the shunt in, frontal versus occipital? And what kind of a shunt valve are you gonna use?

I, I think I could go either way.

Uh, obviously, we know the data that there's no difference between the two.

But every once in a while, when I have a preemie IVH with a large choroid plexus in the occipital horn, I do sorta feel like I'd rather have it in the frontal.

And e- even though there's good data to indicate that perhaps that's not really an issue, but I do think about that.