GOLD Learning Speakers

Caffeine is one of the most prescribed medications within the neonatal intensive care unit (NICU). This presentation will summarize the current understanding of caffeine therapy in neonates including the various indications. Caffeine is the medication of choice for apnea of prematurity (AOP) however it has been shown to be beneficial in several other disease states and conditions. Despite the widespread use of caffeine, there is not consensus on optimal dosing regimen or timing. We will review the supporting literature for the nuances of caffeine dosing regimens and schedules. While caffeine is generally considered a safe medication, we will also discuss potential side effects for monitoring. After this presentation, the audience will have a full picture of the pros and cons of this ubiquitous medication in our NICU population.

At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock.

Many premature infants spend months within neonatal intensive care units (NICUs). During their NICU admission, typical preventive care ideally should also be addressed. The Centers for Disease Control and Prevention (CDC) recommends that infants and children be vaccinated at the recommended schedule regardless of premature birth. In this presentation, we will review the different immunizations given in the first six months of life that are most relevant to patients in the NICU. Additionally, we will compare distinctive immunogenic and tolerability aspects for the term and preterm population. There is also tremendous growth in new vaccines and viral prophylaxis options coming to market soon. This presentation will also address these new agents and how they are pertinent to the NICU population. So don’t miss your shot to further your immunization knowledge.