NPMF 2017

WELCOME
by Chairman

Prof. Arunas Liubsys, MD, PhD

Director of Neonatal Center of Vilnius University Head of NICU, Vilnius University Children's Hospital
Vilnius, Lithuania

Perinatal Care in Lithuania: Successes and Challenges

09:00-09:15

LECTURE

Prof. Virgilio P. Carnielli, MD, PhD

Director of Neonatal Medicine G. Salesi Hospital, Polytechnic University of Marche
Ancona, Italy

Neonatal Respiratory Diseases in the Newborn Infant:
Novel Insights from Stable Isotope Tracer Studies

Respiratory distress syndrome of the preterm infant is characterized by
surfactant insufficiency, excessive lung water and a variable degree of lung
hypoplasia. Our studies with stable isotopes tried over the years to disentangle
the role of surfactant. We will discuss data on surfactant synthesis and on
exogenous surfactant catabolism. The role of surfactant lipids and of surfactant
proteins will also be discussed. Further we will talk about the prenatal and
neonatal features of different groups of preterm infants at a variable risk of
developing bronchopulmonary dysplasia.

10:10-11:40

WORKSHOP

Maria Stammler-Safar, MD, MA

Senior Specialist Obstetrics and Gynaecology Department of Feto-Maternal Medicine University Clinic of Vienna
Vienna, Austria

Prof. Virgilio P. Carnielli, MD, PhD

Director of Neonatal Medicine G. Salesi Hospital, Polytechnic University of Marche
Ancona, Italy

Pros and Cons of Delayed Cord Clamping

We are going to discuss the practice of delayed cord clamping on the basis of
clinical case presentations. The advantages and the disadvantages will be
reviewed both from the speakers perspective as well as from the most recent
literature and meta-analysis on the topic.

10:10-11:40

WORKSHOP

Kathy Mellor, MBE, BSc, RN

Advanced Neonatal Nurse Practitioner Founder & Director – BirthLink NGO
London, United Kingdom

The Role of the Neonatal Nurse to Improve Outcomes

The session will focus on essential nursing care of the sick and premature baby,
and include infection control to minimise the risk of cross-infection in the
nursery.

10:10-11:40

WORKSHOP

Prof. Rangasamy Ramanathan, MD

Division Chief, Division of Neonatal Medicine, LAC+USC Medical Center Director, NPM Fellowship Program Keck School of Medicine of USC
Los Angeles, California, USA

Oxygen and Hypoxic Respiratory Failure:
Is Oxygen Too Much of a Good Thing?

Newborns with Hypoxic Respiratory Failure (HRF) are often treated with
supplemental oxygen. It is well known that hypoxia causes pulmonary
vasoconstriction and normoxia causes pulmonary vasodilation. However,
paradoxically, hyperoxia causes pulmonary vasoconstriction, rather than further
pulmonary vasodilation. Hyperoxia blunts the response to both endogenous and
exogenous nitric oxide, a potent pulmonary vasodilator. This effect is mediated
by free radicals generated during oxygen therapy, resulting in decreased
expression of endothelium derived nitric oxide synthase (eNOS) activity and
increased activity of phosphodiesterase-5 (PDE-5), an enzyme responsible for
metabolism of nitric oxide. Clinicians should be extremely careful to avoid
hyperoxia in patients with HRF. Suggested target range for pre-ductal oxygen
saturation range is between 93 % and 97 %.

10:10-11:40

WORKSHOP

Prof. Arunas Liubsys, MD, PhD

Director of Neonatal Center of Vilnius University Head of NICU, Vilnius University Children's Hospital
Vilnius, Lithuania

Antibiotic Use and Misuse in Neonatology

Antibiotics are the most commonly prescribed medications in neonatal intensive care units. Although over 95 % of infants admitted to NICU receive empirical antibiotics in the first postnatal days, only 1–5 % have positive initial blood cultures. Many preterm infants who do not have infection receive antimicrobial agents during hospital stay and antibiotic treatment in the setting of negative cultures can have serious adverse effects, especially in case of a long term expose to broad spectrum antibiotics.

Current and future efforts focused on antimicrobial stewardship in the NICU, as well as ongoing research in the area of the preterm infant microbiome, are likely to further enhance best practices associated with antibiotic administration and, in turn, optimize microbial health of the preterm infant.

10:10-11:40

WORKSHOP

Dr. Mark Prutkin, MD

Chief of NICU, Regional Children Hospital #1 Ekaterinburg Director International Center for Medical Information Consultation and Training Medical Professionals MedICOS Ltd.
Ekaterinburg, Russia

NEC - A Sound Clinical Judgement

I am going to talk about several aspects of diagnosis and treatment of NEC. We
will discuss whether we talk about one disease or a group of diseases when we
make a diagnosis of NEC. We will also talk about possible ways of treatment and
preventive measures. Do we have enough evidence to use them and why we
don’t widely use probiotics to prevent NEC.

12:00-13:30

WORKSHOP

Dr. Merran Thomson, MB ChB, FRCPCH, MRCP

Honorary Consultant Neonatologist, The Hillingdon Hospital
London, United Kingdom

Dr. Oleg Ionov, MD

Head of NICU, "Research Center for Obstetrics, Gynecology and Perinatology named by V.I. Kulakov" Ministry of Health
Moscow, Russia

Neonatal Practices - Changes That Improve Outcome: Challenges & Solutions

Every invention or change in practice has its consequence. Implementing improvements often brings challenges, success depends on the ability to anticipate and resolve problems. This workshop will identify ways to improve care using real examples of successful practice improvements, the problems encountered, consequences and solutions.

12:00-13:30

WORKSHOP

Prof. Zbynek Stranak, MD, PhD

Head of the Department of Neonatology Institute for the Care of Mother and Child
Prague, Czech Republic

Golden Hours in Very Low Birth Weight Infants after Admission to NICU

The workshop will have main focus on:
• Thermomanagement of VLBW infants after admission
• First steps after admisson – invasive monitoring, arterial and venous access,
parenteral nutrition, prevention of apnoe
• Ventilatory support – indications for non-invasive ventilation and arteficial
ventilation: European Consensus Guidelines on the Managementof Neonatal
Respiratory Distress Syndrome in Preterm Infants
• Surfactant replacement therapy – methods of administration (INSURE, LISA)
• Initiation of enteral feeding
• Circulatory disturbances within first hours – monitoring and management:
Targeted Neonatal Echocardiography

12:00-13:30

WORKSHOP

Prof. Aleksei Mostovoi, MD, PhD

Head of the Neonatal Intensive Care Unit, Regional Perinatal Center Kaluga Associate Professor of Institute of Postgraduate Education of Yaroslavl State Medical University Chief Neonatologist, Ministry of Health in the North Caucasian Federal District
Kaluga, Russia

Controversial Respiratory Strategies Used at NICU Today

Existing guidance of treatment of the respiratory distress syndrome offers the use of different strategies for respiratory therapy. Sometimes respiratory strategies do not have strong evidence of effectiveness. The analysis of a number of treatments: sustained inflation of lungs in the delivery room, delayed cord clamping or milking (when, why, under what circumstances), surfactant administration via the endotracheal tube or small catheter (what type of catheter is best, why, if there is evidence, how to use a LISA catheter). What type of respiratory support is better after the administration of surfactant: CPAP or non-invasive ventilation? Overview of new articles, our thoughts, our experience, our researches.

12:00-13:30

WORKSHOP

Prof. Dmytro Dobryanskyy, MD, PhD

Professor of Pediatrics Department of Pediatrics Danylo Halytsky Lviv National Medical University
Lviv, Ukraine

Prof. Boris W. Kramer, MD, PhD

Neonatologist, Professor of Experimental Perinatology Director of Pediatric Research Maastricht University Medical Center
Maastricht, Netherlands

Surfactant and CPAP Failure

In this workshop we will discuss methods for identifying babies at risk of CPAP failure and basic principles of surfactant therapy

14:30-16:00

WORKSHOP

Prof. Daniele De Luca, MD, PhD

Director, Division of Pediatrics and Neonatal Critical Care South Paris University Hospitals, Medical Center “A.Beclere”, Paris, France & Dept of Anesthesia and Critical Care, Catholic University of the Sacred Heart,
Rome, Italy

Optimal Use of Surfactant:
From the Physiology to the Clinical Side

Surfactant is a cornerstone of neonatal critical care but its use need a deep knowledge of surfactant physiology and physiopathology which are quite complex. We will explain the best use of surfactant in terms of dose and administration, based on physiology and available pharmacokinetic data.

14:30-16:00

WORKSHOP

Assoc. Prof. Katrin Klebermass-Schrehof, MD, PhD

Senior Neonatologist, Department of Neonatology, Pediatric Intensive Care and Neuropediatrics Medical University Vienna
Vienna, Austria

Update on Neonatal Seizures

This workshop includes new diagnostic approaches (e.g. continuous simplified monitoring tools) for neonatal seizures especially during neonatal intensive care therapy, presents new classification system and main causes/etiology of neonatal seizures; also differences in term and preterm infants should be outlined. Most common and also new therapies will be discussed. So this workshop aims for neonatologists, electrophysiologists, neuro- pediatricians and neonatal and pediatric nursing staff.

14:30-16:00

WORKSHOP

Liis Toome, MD, PhD

Head of the Department of Neonatal and Infant Medicine Tallinn Children's Hospital Vice-president of the Estonian Paediatric Association
Tallinn, Estonia

Heili Varendi, MD, PhD

Associate Professor in Pediatrics, University of Tartu Head of Neonatal Department Children´s Clinic, Tartu University Hospital
Tartu, Estonia

Improving the Outcome of Very Preterm Infants:
Estonian Experience During the Socio-Economic Transition Period

This workshop will have following topics:
• Changes in care and short-term outcome for VPI in Estonia
• Importance of nation-wide guidelines for very preterm deliveries and infants
and the importance of data collection
• Importance of family-centered care for improving the outcome
• 2-years and 5-years follow-up and the importance of national follow-up
guidelines
• Effectiveness and costs of very preterm birth in Estonia

14:30-16:00

SESSION

Prof. Rangasamy Ramanathan, MD

Division Chief, Division of Neonatal Medicine, LAC+USC Medical Center Director, NPM Fellowship Program Keck School of Medicine of USC
Los Angeles, California, USA

Present Your Own Case! - Focus Sepsis

This session offers the opportunity to present prepared clinical cases on the selected topic sepsis. Cases will be described by the authors followed by interactive discussion of opportunities to improve outcome by using a different approach.

Aurelija Juskeviciene, Kaunas, LT
Luminita Paduraru, Iasi, RO
Ieva Paulaviciene, Vilnius, LT
Ausrine Pliauckiene, Vlnius, LT

16:30-18:00

Bulgaria, Burgas, community Nesebar, VSG Siyana south, Svety Vlas st. 8256

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