NeoFast | Neonatal prescription

Neonatal Shock: Pathophysiology and Management Neonatal shock: pathophysiology, phenotyping and bedside management. - Warm vs cold septic shock: vasopressor (norepinephrine) vs inotrope/inodilator (epinephrine, dobutamine, milrinone) - Vasoactive doses: dobutamine 5-20, epinephrine 0.05-1, norepinephrine 0.05-1, milrinone 0.25-0.75 mcg/kg/min - Fluid bolus: 10 mL/kg NS over 15-30 min (term) or 30-60 min (preterm) - Hydrocortisone 1 mg/kg q6-8h for refractory shock - SAFE-R POCUS protocol and TnECHO parameters for phenotyping Read the full guide on NeoFast

Newborn IV Fluids, Prescribed in Seconds: The NeoFast Venous Hydration Calculator Neonatal IV fluid calculator covering glucose, electrolytes, amino acids and access checks. - GIR targets: 5-7 mg/kg/min (5-8 in hypoglycemia, max 12 mg/kg/min) - Day 1 fluids: 60-80 mL/kg/day for FTNB, titrating to 120-160 mL/kg/day - Na 2-3, K 1-2, Ca 2 mEq/kg/day from day 2 of life - Access cutoffs: glucose >12.5% central, K 40-200 mEq/L central, K >200 red alert Read the full guide on NeoFast

Cool or Not? The AAP Criteria for Therapeutic Hypothermia in HIE on One Screen Interactive AAP 2026 algorithm for therapeutic hypothermia eligibility in HIE, verdict updates live with every tap. - Block A: only 1 of 4 criteria needed (pH ≤7.00, base deficit ≥16 mmol/L, Apgar ≤5 at 10 min, or ventilation ≥10 min) - Block B: ≥3 of 6 Sarnat categories moderate/severe, or seizures alone - Cooling target: 33.5°C for 72 h, start within 6 h, rewarm at 0.5°C/h - NICHD route and aEEG pattern table (CNV, DNV, burst suppression, low voltage, flat trace) included Read the full guide on NeoFast

Neonatal Laboratory Values: NeoFast App Reference Ranges by Sex, Gestational Age, and Day of Life Neonatal reference ranges by sex, gestational age and day of life, 132 parameters across 11 groups. - Thyroid: Total T4 6.29 vs 12.67 mcg/dL at 28-30 wk vs >37 wk, day 7 - Coagulation: 25 parameters, Andrew 1987/1988, aPTT 50.5 s preterm vs 42.60 s term, day 5 - Blood count: 8 parameters using the 4-7 d band, with Rodwell score shortcut - Flags when no published range exists for the age entered, instead of guessing Read the full guide on NeoFast

High-Frequency Jet Ventilation: Lower the Rate, Not the PEEP High-frequency jet ventilation settings and troubleshooting, referenced to Mammel ch. 41. - Start: rate 420 cycles/min (7 Hz), Ti 0.02 s, usual range 300-450 (Goldsmith 240-660) - Lower rates for long time constants: MAS 240-320, severe PIE 300-340, 2 mm tube 240-280 - Initial PEEP by FiO2: <0.30 give 6-7, 0.30-0.50 give 7-8, >0.50 give 9-12 cmH2O - Bedside rule: overexpansion or rising CO2, lower the rate, not the PEEP Read the full guide on NeoFast

Neonatal Mechanical Ventilation: Disease-Specific Strategies in NeoFast Disease-specific ventilation strategies for RDS, MAS, CDH, BPD and PPHN, with conventional and high-frequency settings by weight and phenotype. - RDS: VT 4-6 mL/kg, PEEP 5-8, HFOV 8-12 Hz, Paw by weight - MAS: rate <30/min, long Ti, treat air trapping vs low volume vs PPHN phenotype - CDH: gentle ventilation, VT 4-5 mL/kg, PaCO2 tolerated <65 mmHg - BPD: VT 6-12 mL/kg, PEEP 8-12, extubation thresholds by weight Read the full guide on NeoFast

Neonatal Hyperbilirubinemia ≥35 Weeks: AAP 2022 On-Call Guide AAP 2022 on-call guide for neonatal hyperbilirubinemia at 35+ weeks, with Figures 1-7 redrawn for bedside use. - Phototherapy and exchange transfusion thresholds by GA week (35 to ≥40 wk), hour-specific from 0-336 h - Escalation of care algorithm: starts 2 mg/dL below exchange threshold - Bilirubin/albumin ratio cutoffs (6.8-8.0) and IVIG dose 0.5-1 g/kg - Home phototherapy criteria and Fig 7 discharge follow-up table Read the full guide on NeoFast

Fluid & Electrolyte Management in the Newborn Bedside fluid and electrolyte management for newborns, with NeoFast calculator logic. - Term fluids day 1 60-80 mL/kg/day advancing 10-20 mL/kg/day to 120-160 mL/kg/day - Sodium 2-3 mEq/kg/day from day 2; preterm 3-5 (AAP) to 3-8 (ESPGHAN) mEq/kg/day after week 1 - Isotonic vs hypotonic fluids: 1.2% vs 7.9% hyponatremia in term infants - GIR 5-7 mg/kg/min, potassium 1-2 mEq/kg/day from day 2 once diuresis established Read the full guide on NeoFast

Neonatal Resuscitation: Essential Steps from the First Minute to Epinephrine Neonatal resuscitation algorithm from first minute to epinephrine. - PPV trigger: apnea, gasping, or HR < 100 bpm at 1 min - Target pre-ductal SpO2: 65-70% at 2 min up to 85-95% at 10 min - MR SOPA corrective steps and 3:1 compression ratio (90:30/min) at HR < 60 - Epinephrine IV/IO 0.02 mg/kg (0.2 mL/kg), ET 0.1 mg/kg, repeat q3-5min Read the full guide on NeoFast

The Finnegan Score in 2026: Assessment and Management of Neonatal Abstinence Syndrome Neonatal abstinence syndrome: Finnegan scoring, treatment thresholds, drug dosing, and the shift to Eat-Sleep-Console. - Finnegan: 21 signs across 3 domains; treat if score is ≥8 x3 or ≥12 x2 consecutive scores - Oral morphine 0.05 mg/kg/dose q4h; IV conversion ratio 3 PO:1 IV - Phenobarbital loading 20 mg/kg, maintenance 3 mg/kg/day q12h - ESC-NOW trial: 8.2 vs 14.9 days to discharge, 19.5% vs 52.0% opioid-treated Read the full guide on NeoFast

Neonatal Blood Gas: Read It Right, Step by Step Step-by-step bedside guide to reading a neonatal blood gas, from sample quality to oxygenation indices. - Winters' formula: expected pCO2 = 1.5 × HCO3− + 8 (±2) mmHg - Neonatal anion gap normal range 4–12 mEq/L; AG >16 suggests lactic acidosis - Respiratory acidosis compensation: +1 mEq/L HCO3− per 10 mmHg acute, +4 (3.5–5) chronic - OI/OSI cutoffs (>15 severe, >25 consider ECMO, ≥40 ECMO criterion) plus CaO2 and AaDO2 formulas Read the full guide on NeoFast

Preterm Growth Tracking: Corrected Age, Fenton & WHO Curves Preterm growth tracking with corrected age, Fenton curves, and WHO standards - Corrected age formula: chronological age minus (40 weeks minus gestational age at birth) - Use corrected age for growth tracking (2-5 years) and neurodevelopment (3 years), chronological age only for vaccinations - Fenton curves <33 to 50 weeks gestational age; transition to WHO Growth Standards after 50 weeks - Growth target for infants <2000g: 15-20 g/kg/day Read the full guide on NeoFast

Disposable T-piece Resuscitator: Setup, Parts, and PIP/PEEP Adjustment Guide Disposable T-piece resuscitator setup and adjustment guide. - Standard PEEP 5 cmH₂O, PIP 20 cmH₂O - Gas flow 5-15 LPM with variable PEEP: 2 cmH₂O at 5 LPM, 6 at 8 LPM, 9 at 10 LPM, 15 at 15 LPM - Manometer options: 0-40 cmH₂O or 0-60 cmH₂O - Maximum 40 cmH₂O per institutional protocol Read the full guide on NeoFast

Neonatal Respiratory Care and Non-Invasive Support: Technical Protocol for Neonatologists Full protocol for neonatal respiratory support, from interface selection to extubation. - nCPAP/NIPPV/HHHFNC parameters, ETT and blade sizing by weight, suction catheter sizing table - Suctioning protocols: no routine saline, shallow depth, 80-100 mmHg, 5-10s max - Surfactant dosing tables for Curosurf, Survanta, Infasurf with repeat schedules - DOPE mnemonic and extubation readiness criteria with caffeine dosing Read the full guide on NeoFast

Precision Resuscitation: Calibrating the T-Piece Device — A Clinical Guide to Neopuff™ Setup and Operation for Neonatologists T-piece device calibration and operation for neonatal resuscitation - Initial gas flow: 10 L/min (8 L/min with cylinders) - Maximum pressure relief: 50 cm H2O to prevent barotrauma - Peak inspiratory pressure: 25-30 cm H2O (term), 20-25 cm H2O (preterm <32 weeks) - Positive end expiratory pressure: 5-8 cm H2O; recheck if flow increases to 10 L/min - Effective ventilation: heart rate >100/min, chest rise, improved oxygenation Read the full guide on NeoFast

The Narrow Margin: The Invisible Physics of Neonatal Infusion Narrow margin in neonatal infusion: concentration, not dose, defines the boundary between therapy and collapse. - Dexmedetomidine: 4 mcg/mL (2 mL of 100 mcg/mL + 48 mL sodium chloride) - Alprostadil: over-dilution causes ductal closure and death; over-concentration causes refractory hypotension - Vasoactives: dobutamine (tachycardia, arrhythmias), epinephrine (hypertension, arrhythmias), norepinephrine (necrosis) - Three failure zones: syringe, pump drift, vessel toxicity Read the full guide on NeoFast

Challenging Cases in Neonatology: ALCAPA-Induced Dilated Cardiomyopathy ALCAPA coronary steal syndrome and dilated cardiomyopathy in neonates - Presentation at 5-8 weeks with inconsolable crying, EF drops to 25% - ECG confirmation: deep Q waves in Leads I, aVL, V4-V6 - Vasoactive management: Dopamine 10 mcg/kg/min, Milrinone 0.5 mcg/kg/min, Epinephrine 0.1 mcg/kg/min - Urgent surgical revascularization: excision and transposition of LCA into aorta Read the full guide on NeoFast

High-Frequency Jet Ventilation (HFJV): Focus on the 22-Week Extreme Premature Lung High-Frequency Jet Ventilation for 22-week extreme micropreemies - Initial: 420 bpm (7 Hz), I-Time 0.02 sec, PEEP 6-8 cmH₂O, sigh 3-5 bpm - ETT size 2.0-2.5 mm creates 16-fold airway resistance: auto-PEEP risk - HFJV jet + passive exhalation superior to HFOV for air leaks, PIE - Hypercapnia: increase PIP; if trapped, decrease frequency for longer exhalation Read the full guide on NeoFast

Germinal Matrix-Intraventricular Hemorrhage (GMH-IVH): A Clinical Guide GMH-IVH clinical guide covering Volpe grading, prevention bundles, imaging timelines, and PHVD management. - Volpe Grades I-IV plus PVHI with CP risk from <5% to ~50% - Antenatal steroids before 34 weeks cut IVH risk by over 50% - cUS timeline: Day 1, Day 3 (90% of cases), Day 7/14, TEA - PHVD action line: VI >97th percentile+4mm and AHW >6mm, with LP, VAD, and VP shunt algorithm and doses Read the full guide on NeoFast