Scoring System for Starting Antibiotic NICU IV Fluid Protocol

No Criteria Score < 1 kg 1 - 1.5 kg > 1.5 kg 38th ANNUAL

1 Intrapartum Vaginal Examination > 3 6 Day 1 100 ml/kg/day 80 ml/kg/day 60 ml/kg/day
2 Clinical Chorioamnionitis 6
500ml 10% Dextrose + 10ml* Calcium Gluconate
CONVENTION
3 PROM > 12 Hours 6
4 Maternal Fever / Sepsis - Last 7 days 3
Day 2 110 ml/kg/day 90 ml/kg/day 70 ml/kg/day OF
500ml 10% Dextrose + 10ml* Calcium Gluconate
5 Home Delivery 3
Day 3 120 ml/kg/day 100 ml/kg/day 80 ml/kg/day NATIONAL NEONATOLOGY FORUM
6 Preterm / Premature onset of Labour 3
7 Outside NICU Stay > 24 hours 3 500ml 0.45 DNS + 5ml MVI (NEOCON 2018 & ANNUAL UP STATE NEOCON 2018)
8 Male Gender 3 Dextrose Conc. To be changed according to RBS monitoring Organised by: NNF UP State & NNF Varanasi
9 Birth Weight < 1.2 kg 2 * Add 20ml Calcium to 500ml in c/o Birth Asphyxia, IDM, IUGR, LGA Date : 13-16 December, 2018, Venue : Hotel Taj Ganges, Varanasi
10 Gestation < 30 weeks 2
NICU Blood Investigation Protocol - Routine Conference Theme: Pre-Term Birth
Total Score: 0 - 10 Total Score ³ 10
No Antibiotics Sent CBC, CRP
Time < 1 kg 1 - 1.5 kg > 1.5 kg National Neonatology Forum (NNF), India
CBC, CRP CBC, CRP CBC, CRP
CBC, CRP at Admission & 48 Hr Send Blood Culture
Monitor Clinically Start First Line Antibiotic 0 Hr
Blood Group
G6PD (in Male)
Blood Group
G6PD (in Male)
Blood Group
G6PD (in Male)
NICU READY RECKNER
ABG (Resp Case) ABG (Resp Case) ABG (Resp Case)
Prophylactic Criteria
Admission NNF Office Bearers :
Blood Culture in High Risk Group
Antifungal in Neonates BW < 1.2 kg, GA < 32 weeks (See Antibiotic Scoring System) Dr. B.D. Bhatia Dr. Alok Bhandari
Dose: 6 mg/kg/dose TPN > 7 Days 24 Hr Na, K, iCa, Na, K, iCa, President, NNF Hony. Secretary, NNF
Frequency: Twice a week Invasive Lines > 7 Days SOS Creat, S.Bil Creat, S.Bil --------
Route: IV / Oral Mechanical Ventilation > 7 Days CBC, CRP CBC, CRP CBC, CRP Dr. V.P Goswami Dr. Lalan Kr. Bharti
48 Hr Na, K, iCa, Na, K, iCa, Na, K, iCa, President Elect, NNF Jt.Sec. cum Treasurer, NNF
Till 4 weeks or risk factor + Broad Spectrum Antibiotics > 7 Days
Creat, S.Bil Creat Creat NNF Governing Body Members :
@ Full CBC CBC CBC
Caloric Calculation
Feeds Na, K Na, K Na, K
Dr. Utpal Kant Singh Dr. Himanshu Kelkar
EBM - Term 0.68 kcal/ml 10% D 0.34 kcal/ml
@4 iCa, PO4 iCa, PO4
Dr. Anurag Singh Dr. Mohit Sahni Dr. Vishnu Bhat
EBM-Preterm 0.67 kcal/ml 5% D 0.17 kcal/ml Weeks Alk Phosphatase Alk Phosphatase -------- NNF UP State :
Pre Nan 0.79 kcal/ml Aminoven 10% 0.4 kcal/ml Further Ix guided by previous reports and clinical condition Dr. Ashok Rai Dr. Alok C Bhardwaj
Nan 1 0.67 kcal/ml Lipid 20% 2 kcal/ml
President, NNF UP State Secretary, NNF UP State
Latogen 0.67 kcal/ml HMF 7.5kcal/Sachet Arterial Blood Gas Values - Normogram
Lactodex LBW 0.88 kcal/ml MCT Oil 0.39 kcal/drop ABG < 30 wk 30 - 36 wk Term BPD Prof. Dr. S. Manazir Ali Dr. D M Gupta
pH >7.25 >7.25 7.35-7.45 7.50-7.60 Past President, Jt. Secretary Cum Treasurer,
Protocols for < 1 kg 1 - 1.5 kg > 1.5 kg
PCO2 40-50 40-60 35-45 45-65 NNF UP State NNF UP State
USG Brain < 30 week 30 - 34 week > 34 week
Day 0 - 3
PO2 45-65 50-70 80-100 60-80 Journal of Neonatology, India : Editorial team :
Day 3 - 5 High Risk Pt Suggested Actions following ABG Report
Editor: Mohit Sahni
Day 7 - 10 If Sick High Risk Pt ABG Result Possible Reason Suggested Changes Advisory Board :
Day 28 High Risk Pt PCO2 - OK/Low Atelectasis with B Vishnu Bhat, Baldev Bhatia, Praveen Kumar, Rangasamy
Repeat USG Brain to be planned as per the findings of the 1st Scan PEEP
PO2 - Low V/A Mismatch Ramanathan, Prakesh Shah, Gautham Kanekal Suresh
High Risk RDS,Sepsis,Asphyxia,HIE,Pneumothorax,Base Deficit>10,
PCO2 - OK/Low PIP Editorial Board :
Patient Shock requiring Inotropes, , Maternal Pre-Eclampsia Over Ventilated
PO2 - OK/High PIP & PEEP Deepak Chawla, KK Diwakar Malankara, Nandkishor Kabra, Sheila
Guidelines for ROP Screening / Eye Check Rate Mathai, Ashish Mehta, Kiran More, Srinivas Murki, Karthik Nagesh,
< 28 week At Corrected 31 weeks PCO2 - OK/High Atelectasis with PIP Somashekhar Nimbalkar, M Jeeva Sankar, Pradeep Suryawanshi.
³ 28 week At Postnatal 4 weeks PO2 - Low Resultant Low TV PIP & PEEP Authors :
Term If Risk Factor - At Postnatal 2 weeks/Before Discharge PCO2 - OK/High Inadequate minute PEEP
Dr. Manan Parikh, Vadodara, Email: [email protected]
High Risk Ventilation > 72 Hr, Prolonged O2 need, RDS,Sepsis,CHD, PO2 - High ventilation with at least Rate Dr. Mohit Sahni, Surat, Email: [email protected]
Shock requiring Inotrope, Blood Transfusion,ExchangeTransfusion adequate FRC PIP Disclaimer : These are just guidelines complied from different sources. Protocols
may very from unit to unit. In case of any discrepancy please discuss with authors or
All contents copyright C NNF, India. Written permission required to reproduce any part of this material. editorial team.
 Infusion in 20 ml Syringe Silverman-Anderson Score Important Calculations
____ ml ____ Kappa Feature Score 0 Score 1 Score 2 Line Insertion Depth Tip Position
Medication Dose @ 1ml/hr Chest Respiratory Seesaw UAC (3 x Wt in Kg) + 9 cm T6 - T9
in 20 ml in 20 ml
Movement Equal Lag Respiration UVC High: (1.5 x Wt in Kg) + 5.5 cm 1 cm above Diaphragm
Dopamine 10 mcg/kg/min 0.3 x Wt 30 x Wt Intercostal None Minimal Marked UVC Low: Wt in Kg + 3 cm L3 - L4
40 mg/ml 20 mcg/kg/min 0.6 x Wt 60 x Wt Retraction NG Distance(cm) Xiphoid process to ear lobe to tip of nose
Dobutamine 10 mcg/kg/min 0.24 x Wt 24 x Wt Xiphoid None Minimal Marked IV Protien 1 gm/kg/day to 4 gm/kg/day
50 mg/ml 20 mcg/kg/min 0.48 x Wt 48 x Wt Retraction Aminoven 10% (10 x __ gm/kg/day x Wt in Kg) ÷ 24 = ___ ml/hr
Adrenaline 0.05 mcg/kg/min 0.06 x Wt 6 x Wt Nasal None Minimal Marked IV Lipid 1 gm/kg/day to 3 gm/kg/day
Flaring Intralipid 20% (5 x __ gm/kg/day x Wt in Kg) ÷ 24 = ___ ml/hr
1 mg/ml 0.1 mcg/kg/min 0.12 x Wt 12 x Wt
Expiratory None Audible with Audible w/o GIR %Dextrose x 10 x IV Rate in ml/hr
0.5 mcg/kg/min 0.6 x Wt 60 x wt
Grunt stethoscope stethoscope mg/kg/min 60 x Wt in Kg
Norad 0.05 mcg/kg/min 0.06 x Wt 6 x Wt Total Score of 4-6 Total Score of 7-10 Oxygenation MAP x FiO2 OI > 15 Need for HFOV
1 mg/ml 0.1 mcg/kg/min 0.12 x Wt 12 x Wt Moderate Distress - CPAP sos Severe Distress - Ventilation Index ( OI ) PaO2 OI > 20 Need for iNO
Milrinone Load - 0.05 mg/kg 0.05 x Wt 5 x Wt AaDO2 [(FiO2 x 713) - PaCO2] - PaO2, FiO2 in Decimal
Endotracheal Intubation ET Size Selection
1 mg/ml 0.33 mcg/kg/min 0.4 x Wt 40 x Wt AaDO2 < 200 = Normal, > 400 = ALI, > 600 = ARDS
Pre Medication Wt Gest ET Fix
Sildenfil Load - 0.4 mg/kg 0.5 x Wt 50 x Wt a/A PaO2 0.6 - 0.9 = Normal
For Planned Intubation in Kg Weeks Size @ Lip
0.8 mg/ml 0.067 mg/kg/hr 1.7 x Wt ------ Ratio (FiO2 x 713) - PaCO2 < 0.4 =ALI, < 0.2=ARDS
Atropine 0.1 mg <1 < 28 2.5 6-7
Lasix 0.06 mg/kg/hr 0.12 x Wt 12 x Wt 16 kappa Blood Transfusion Guidelines
10 mg/ml 0.125 mg/kg/hr 0.25 x Wt 25 x Wt Midazolam 0.1 mg/kg 1-2 28 - 34 3 7-8 Hb < 12 gm/dl Severe Respiratory Distress
(10 x Wt) Kappa PCV < 35 Requiring High Ventilatory Pressures
Fentanyl 1 mcg/kg/hr 0.4 x Wt 40 x Wt
Fentanyl 1 mcg/kg 2-3 34 - 38 3.5 8-9 Hb < 10 gm/dl Ventilatory Requirement
50 mcg/ml 2 mcg/kg/hr 0.8 x Wt 80 x wt
1ml+9ml, (20 x Wt) Kappa PCV < 30 Hypovolemic Shock
Morphine 1 ml Morphine + 9 ml NS = 1 mg/ml Rocuronium 1 mg/kg >3 > 38 3.5 9 - 10 Symptomatic PDA
10 mg/ml 10 mcg/kg/hr 0.2 x Wt 20 x Wt (10 x Wt) Kappa BPD with FiO2 > 30%
Pre Surgery
Infusion in 50 ml Syringe Surfactant Hb < 8.5 gm/dl Preterm < 2 week old
____ ml ____ Kappa Product Type Dose Phospholipid Vial PCV < 25 Poor Feeding
Medication Dose @ 1ml/hr
in 50 ml in 50 ml Neosurf Bovine 5 ml/kg 27 mg/ml 3 ml / 5 ml Poor Weight Gain: < 10 gm/kg/day for > 3 days
PGE1 50 ng/kg/min 0.3 x Wt 30 x Wt Survanta Bovine 4 ml/kg 25 mg/ml 4 ml / 8 ml Significant Apnea >8 in 24 Hr / >2 req Bag & Mask
Curosurf Porcine 2.5 ml/kg 80 mg/ml 1.5 ml / 3 ml Persistent Tachycardia: HR > 170 bpm
500 mcg/ml 100 ng/kg/min 0.6 x Wt 60 x Wt
Infasurf Calf Lung 3 ml/kg 35 mg/ml 3 ml Persistent Tachypnea: RR > 70 / min
Vasopressin 0.0005 U/kg/min 0.075 x Wt 7.5 x Wt Hb < 7 gm/dl Transfuse regardless
Exosurf Synthetic 4 ml/kg 25 mg/ml 4 ml / 8 ml
20 U/ml Start @ 0.6 ml/hr = 0.0003 U/kg/min PCV < 20
INSURE Criteria PCV Transfusion: 15 ml/kg/dose over 4 - 5 Hours
IV Anticonvulsant Preterm ³ 30 weeks Mid-transfusion Inj Lasix 1 mg/kg (Decide Clinically)
Midazolam 0.1 mg/kg/dose 10 kappa/kg/dose Birth Wt. ³ 1.2 kg Keep NBM - 2 hours before and 6 hours after Transfusion
1 mg/ml Spontaneous Respiration Present
Platelet Transfusion Guidelines
Lorazepam 0.1 mg/kg/dose 5 kappa/kg/dose Moderate to Severe HMD on CXR
Plt < 20000 Transfuse regardless
2 mg/ml FiO2 ³ 40% / CPAP (PEEP - 6 , Fi02 ³ 30%) with Sp02 <90 %
Plt < 40000 Active Bleeding 24 Hr Pre surgery
Good Perfusion, CRT < 3 Sec, No Inotrope Requirement
Phenobarbitone Load - 20 mg/kg Load - 10 kappa/kg Hypotension 3 Days Post Surgery
Intubate Give Surfactant Extubate to CPAP
200 mg/ml For Maintenance: 1 ml Phenobarb + 9 ml NS Inotrope Need Seizure last 72 Hr
2.5 mg/kg/dose 13 kappa/kg/dose Switch from CPAP to Intubation, Consider 2nd Surfactant DIC Culture Positive Sepsis
Continuing Retractions / Grunt on CPAP for > 6 Hours Rising CRP / TC On Indomethacin / Brufen
Fosphenytoin Load - 15 mg/kg Load - 30 kappa/kg
Recurrent Apneas on CPAP Platelet showing Downward Trend
50 mg PE/ml 2.5 mg/kg/dose 5 kappa/kg/dose
RR ³ 80/min or increasing Wt < 1.2 kg / GA < 32 wks with Probable Sepsis
Oral Anticonvulsant Clinical deterioration last 48 Hr - Suspected Sepsis
CPAP > 7 cm H2O
Gardenal 2.5 mg/kg/dose 0.6 ml/kg/dose Platelet Transfusion: 15 ml/kg, Over 20-30 min, No Lasix/No NBM
FiO2 requirement >60%
20mg/5ml 3 mg/kg/dose 0.75 ml/kg/dose PaCO2 > 55, Poor respiratory efforts
Eptoin 2.5 mg/kg/dose 0.4 ml/kg/dose SpO2 < 85% / PaO2 < 50 on CPAP > 6 cm H2O & FiO2 > 50% FFP 15 ml/kg over 1 hr, No NBM
For DIC, Coagulation Defects, Severe Sepsis
30mg/5ml 3 mg/kg/dose 0.5 ml/kg/dose

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 ANTIBIOTICS Metronidazole Load: 15 mg/kg/dose IV over 1 Hr
Amikacin IV 24 Hrly 0-7D 8 - 28 D > 28 D After 24 Hrs, 7.5 mg/kg/dose IV 38th ANNUAL
£ 29 wk 7.5 mg/kg 10 mg/kg 15 mg/kg £ 29 wk 0 - 28 D 24 Hrly
30 - 33 wk 10 mg/kg 15 mg/kg 15 mg/kg > 28 D 12 Hrly CONVENTION
³ 34 wk 15 mg/kg 15 mg/kg 15 mg/kg 30 - 36 wk 0 - 14 D 24 Hrly
Ampicillin 50 mg/kg/dose IV > 14 D 12 Hrly OF
£ 29 wk 0 - 28 D 12 Hrly ³ 37 wk 0-7D 24 Hrly
> 28 D 8 Hrly >7D 12 Hrly NATIONAL NEONATOLOGY FORUM
30 - 36 wk 0 - 14 D 12 Hrly Netilmicin 5 mg/kg/dose IV 24 Hrly
> 14 D 8 Hrly Piperacillin 100 mg/kg/dose IV, over 1 Hr (NEOCON 2018 & ANNUAL UP STATE NEOCON 2018)
³ 37 wk 0-7D 12 Hrly Tazobactum £ 29 wk 0 - 28 D 12 Hrly Organised by: NNF UP State & NNF Varanasi
>7D 8 Hrly > 28 D 8 Hrly
Date : 13-16 December, 2018, Venue : Hotel Taj Ganges, Varanasi
Azithromycin 10 mg/kg/dose IV/PO 24 Hrly 30 - 36 wk 0 - 14 D 12 Hrly
Cefotaxime 50 mg/kg/dose IV > 14 D 8 Hrly Conference Theme: Pre-Term Birth
£ 29 wk 0 - 28 D 12 Hrly ³ 37 wk 0-7D 12 Hrly
>7D 8 Hrly
National Neonatology Forum (NNF), India
> 28 D 8 Hrly

NICU MEDICARD
C
30 - 36 wk 0 - 14 D 12 Hrly Polymyxin B 10000 - 20000 IU/kg/dose IV 12 Hrly
> 14 D 8 Hrly Tiecoplanin Load: 16 mg/kg/dose IV over 1 Hr
³ 37 wk 0-7D 12 Hrly After 24 Hrs, 8 mg/kg/dose IV 12 Hrly
NNF Office Bearers :
>7D 8 Hrly Tigecycline Load: 2 mg/kg/dose IV over 1 Hr
Ceftriaxone 50 mg/kg/dose IV After 24 Hrs, 1 mg/kg/dose IV 12 Hrly Dr. B.D. Bhatia Dr. Alok Bhandari
Sepsis - 12 Hrly, Meningitis - 8 Hrly Vancomycin Sepsis: 10 mg/kg/dose IV President, NNF Hony. Secretary, NNF
Cefuroxime 50 mg/kg/dose IV 8 Hrly Meningitis: 15 mg/kg/dose IV
Chloramphenicol Load: 20 mg/kg/dose IV over 1 Hr < 37 wk 0 - 14 D 12 Hrly Dr. V.P Goswami Dr. Lalan Kr. Bharti
After 24 Hrs, 5 mg/kg/dose IV 6 Hrly > 14 D 8 Hrly President Elect, NNF Jt.Sec. cum Treasurer, NNF
Ciprofloxacin 10 - 15 mg/kg/dose IV 12 Hrly ³ 37 wk 0-7D 12 Hrly NNF Governing Body Members :
Clarithromycin 7.5 mg/kg/dose IV/PO 12 Hrly >7D 8 Hrly Dr. Utpal Kant Singh Dr. Himanshu Kelkar
Clindamycin 5 - 7.5 mg/kg/dose IV
Dr. Anurag Singh Dr. Mohit Sahni Dr. Vishnu Bhat
£ 29 wk 0 - 28 D 12 Hrly
ANTIFUNGAL MEDICATION
> 28 D 8 Hrly NNF UP State :
Amphotericin B 1 - 1.5 mg/kg/dose IV 24 Hrly
30 - 36 wk 0 - 14 D 12 Hrly Conventional IV Infusion over 2 - 3 Hr Dr. Ashok Rai Dr. Alok C Bhardwaj
> 14 D 8 Hrly
Amphotericin B 2.5 - 5 mg/kg/dose IV 24 Hrly
President, NNF UP State Secretary, NNF UP State
³ 37 wk 0-7D 12 Hrly Lipid Complex IV Infusion over 2 - 3 Hr
>7D 8 Hrly Amphotericin B 3 - 5 mg/kg/dose IV 24 Hrly Prof. Dr. S. Manazir Ali Dr. D M Gupta
Colistin Load: 10 mg/kg/dose IV (1 MU = 80 mg) Liposomal IV Infusion over 2 - 3 Hr Past President, Jt. Secretary Cum Treasurer,
After 24 Hrs, 5 mg/kg/dose IV 12 Hrly Caspofungin 2 mg/kg/dose IV 24 Hrly NNF UP State NNF UP State
Cotrimoxazole TMP: 4 - 6 mg/kg/dose IV/PO 12 Hrly IV Infusion over 2 Hr
Gentamycin IV 24 Hrly Over 1 Hr
Journal of Neonatology, India : Editorial team :
Fluconazole Prophylaxis: 6 mg/kg/dose IV/PO Twice a wk
£ 29 wk 0-7D 4 mg/kg Treatment: 12 mg/kg/dose IV/PO 24 Hrly Editor: Mohit Sahni
>7D 5 mg/kg Advisory Board :
30 - 34 wk 0-7D 4 mg/kg
>7D 5 mg/kg
ANTIVIRAL MEDICATION B Vishnu Bhat, Baldev Bhatia, Praveen Kumar, Rangasamy
³ 35 wk All 5 mg/kg Acyclovir Herpes Simplex Encephalitis Ramanathan, Prakesh Shah, Gautham Kanekal Suresh
> 32 Weeks, > 1.2 kg
Imipenem Non CNS Infection: 20 - 25 mg/kg/dose IV 12 Hrly 20 mg/kg/dose IV 8 Hrly
Editorial Board :
Levoflox 10 mg/kg/dose IV 12 Hrly Deepak Chawla, KK Diwakar Malankara, Nandkishor Kabra, Sheila
Gancyclovir Congenital CMV
Linezolid 10 mg/kg/dose IV/PO, 0 - 7 D: 12 Hrly, > 7 D: 8 Hrly 6 mg/kg/dose IV Over 1 Hr, 12 Hrly, for 6 weeks Mathai, Ashish Mehta, Kiran More, Srinivas Murki, Karthik Nagesh,
Meropenem Sepsis: 20 mg/kg/dose IV Somashekhar Nimbalkar, M Jeeva Sankar, Pradeep Suryawanshi.
Nevirapine Perinatal HIV
< 32 wk 0 - 14 D 12 Hrly 2 mg/kg PO, Single Dose Authors :
> 14 8 Hrly Within 72 Hrs of Birth
Dr. Manan Parikh, Vadodara, Email: [email protected]
³ 32 wk 0-7 12 Hrly Zidovudine Perinatal HIV
>7D 8 Hrly 2 mg/kg/dose PO
Dr. Mohit Sahni, Surat, Email: [email protected]
Meningitis: 40 mg/kg/dose IV 8 Hrly < 35 Wk: 8 Hrly, ³ 35 Wk: 6 Hrly
Disclaimer : These are just guidelines complied from different sources. Protocols
may very from unit to unit. In case of any discrepancy please discuss with authors or
All contents copyright C NNF, India. Written permission required to reproduce any part of this material. editorial team.
Acetaminophen 10 - 15 mg/kg/dose IV/PO 6 - 8 Hrly Glucagon Hypoglycemia: 0.02 - 0.03 mg/kg/dose IV/SC Salbutamol Nebulisation: 0.03 ml/kg + 3ml NS 6 - 8 Hrly
Acetazolamide Metabolic Alkalosis Glycerine 0.5 ml/kg/dose, 1:1 Dil, PR 12 - 24 Hrly Sildenafil Load: 0.4 mg/kg IV over 3 Hr
5 mg/kg/dose PO 24 Hrly x 3 days Glycopyrrolate 4 - 10 mcg/kg/dose IV 4 - 8 Hrly 0.067 mg/kg/Hr IV Infusion
Acetylcysteine TPN induced cholecystitis Heparin IV Patency: 0.5 - 1 U/ml of IVF Oral: 0.5 - 2 mg/kg/dose 6 - 8 Hrly
100 mg/kg/day IV Infusion Thrombosis: Load: 75U/kg over 10 min Sodium Bicarbonate 1 - 2 mEq/kg/dose IV, 1:1 Dil, Over 1 Hr
Nebulisation Mn: 28 U/kg/Hr IV Infusion Spironolactone 1 - 2 mg/kg/dose PO 12 Hrly
1 - 2 ml of 20% Sol, 1:1 Dil, 6 - 8 Hrly
Hydrochlorthiazide 1 - 2 mg/kg/dose PO 12 Hrly, with food Succinyl Choline 1 - 2 mg/kg/dose IV
Adenosine SVT: 0.05 mg/kg/dose Rapid IV Every 2
min, increment of 0.05 mg/kg, 3 doses Hydrocortisone Shock: 2 mg/kg/dose IV 6 - 8 Hourly Sucrose 24% 32 - 37 wk: 1 ml PO 2 min before procedure
Adrenaline Resuscitation: 1:10000 Solution Stress: 0.5 - 1 mg/kg/dose IV/PO 12 Hrly > 37 Wk: 2 ml PO 2 min before procedure
IV: 0.1 - 0.3 ml/kg, ET: 0.3 - 1 ml/kg Ibuprofen PDA: 10 - 5 - 5 mg/kg/dose IV/PO 24 Hrly Tropicamide 0.5% 1 Drop each eye, Every 5 min, 3 times
Nebulisation (1:1000): 0.5 ml/kg + 3ml NS Indomethacin PDA: ___ mg/kg/dose IV 12 - 24 Hrly, Over 1 Hr Ursodiol Cholestasis: 10 - 15 mg/kg/dose PO 8 Hrly
0.01 - 0.1 mcg/kg/min IV Infusion < 48 Hr 0.2 0.1 0.1 Vasopressin 0.0001 - 0.0003 U/kg/min IV Infusion
Alpostin (PGE1) 50 - 100 ng/kg/min IV Infusion 2-7D 0.2 0.2 0.2 Vecuronium 0.1 mg/kg IV
Albumin 0.5 - 1 gm/kg IV over 2 Hr >7D 0.2 0.25 0.25 Vitamin A 5000 IU, IM, 3 days a week, 12 doses
Aminophylline Load: 5 - 6 mg/kg IV IVH Prophylaxis: 0.1 mg/kg/dose IV Vitamin D3 400 - 1000 IU PO 24 Hrly
Mn: 1 - 2 mg/kg/dose IV 6 - 8 Hrly 24 Hrly x 3D Vitamin E 25 IU PO 24 Hrly
Amiodarone Load: 5 mg/kg IV over 1 Hr Insulin Bolus: 0.05 U/kg IV/SC Warfarin 0.1 - 0.2 mg/kg/dose PO 24 Hrly
Mn: 5 - 15 mcg/kg/min IV Infusion 0.05 - 0.2 U/kg/Hr IV Infusion
Ipratropium Bromide Nebulisation: 0.25 mg + 3ml NS 6 - 12 Hrly NICU RESUSCITATION DRUGS
Atropine 0.02 mg/kg/dose IV, Min 0.1 mg, Max 0.6 mg
Iron - Oral 2 - 3 mg/kg/dose PO 12 hrly, Elemental Iron Oxygen
Budesonide Nebulisation: 0.25 - 0.5 mg + 3 ml NS
Caffiene Citrate Load: 20 mg/kg IV Isoproterenol 0.05 - 2 mcg/kg/min IV Infusion Sodium Bicarbonate 1 - 2 ml/kg IV, 1:1 Dilution, Over 1 Hr
M®: 5 - 10 mg/kg IV/PO 24 Hrly IVIG 1 gm/kg/day IV over 4 - 5 Hr, 3 - 5 days Adrenaline 1:10000, 0.1 ml/kg IV, 0.3 ml/kg ET
Calcium Gluconate 20% 1 - 2 ml/kg/dose, 1:1 Dil, 6 - 8 Hrly Kayexelate (K Bind) 1 - 2 gm/kg/dose PO/PR 4 - 6 Hrly
Calcium Gluconate 1 - 2 ml/kg IV, 1:1 Dilution, Over 1 Hr
Ketamine 1 - 2 mg/kg/dose IV
Calcium - Oral 100 - 125 mg/kg/dose PO 12 Hrly Lidocaine 1 mg/kg IV, Over 1 Hr
Ketorolac (Eye Drops) 2 Drops Each Eye 6 Hrly, 3 days
Carnitine 50 mg/kg/dose IV/PO 12 Hrly
Levetiracetam 10 mg/kg/dose IV/PO 12 Hrly Atropine 0.02 mg/kg, 0.1 mg Minimum, IV
Chloral Hydrate 25 - 50 mg/kg/dose PO
Levothyroxine 10 mcg/kg/dose PO 12 Hrly Dextrose 10% 2 ml/kg IV
Dexamethasone Extubation: 0.15 mg/kg/dose IV 8 Hrly, 4 doses
Lidocaine Bolus: 1 - 2 mg/kg/dose IV over 2 min Adenosine 0.05 mg/kg Rapid IV F/by 5ml NS Flush
Dextrose 10% Hypoglycemia: 2 ml/kg IV
20 - 50 mcg/kg/min IV Infusion
Digoxin mcg/kg £ 29 wk 30-36 wk ³ 37 wk Midazolam 0.1 mg/kg IV
Lorazepam 0.05 - 0.1 mg/kg/dose IV
LOAD IV 15 20 30
Magnesium Sulfate 25 - 50 mg/kg/dose IV over 1 Hr, 4 - 6 Hrly VARIOUS INTUBATION DRUGS
PO 20 25 40
Metoclopramide 0.1 - 0.2 mg/kg/dose IV/PO 8 - 12 Hrly
Mn doses 24 Hrly Mn IV 4 5 4 Atropine 0.02 mg/kg, 0.1 mg Minimum
Metoprolol 1 - 2 mg/kg/dose IV/PO 12 Hrly
PO 6 6 5 Fentanyl 1 mcg/kg
Midazolam Bolus: 0.1 mg/kg IV
Dobutamine 5 - 20 mcg/kg/min IV Infusion Ketamine 1 mg/kg
0.2 - 1 mcg/kg/min IV Infusion
Domperidone 0.3 mg/kg/dose PO 6 - 8 Hrly
Milrinone Load: 0.05 mg/kg IV over 30 min Midazolam 0.1 mg/kg
Dopamine 5 - 20 mcg/kg/min IV Infusion
Mn: 0.33 - 0.75 mcg/kg/min Rocuronium 1 mg/kg
Dornase Alfa (Mesna) Intratracheal: 0.2 ml/kg
Morphine Bolus: 0.05 - 0.1 mg/kg IV
Nebulisation: 1.25 - 2.5 ml, 1:1 Dil, 12 - 24 Hrly Vecuronium 0.1 mg/kg
10 - 20 mcg/kg/Hr IV Infusion
Doxapram Load: 2.5 - 3 mg/kg IV over 1 Hr Succinyl Choline 1 mg/kg
Naloxone 0.1 mg/kg/dose IV, Repeat 2 - 3 min
Mn: 1 - 2.5 mg/kg/Hr IV Infusion Noradrenaline 0.01 - 0.5 mcg/kg/min IV Infusion Propofol 2 mg/kg
Enoxaparin Treatment: 1.75 mg/kg/dose SC 12 Hrly Octreotide Chylothorax: 1 - 4 mcg/kg/Hr IV Infusion Thiopentone 2 mg/kg
Prophylaxis: 0.75 mg/kg/dose SC 12 Hrly Omeprazole 0.5 - 1.5 mg/kg/dose IV 24 Hrly
Erythromycin Prokinetic: 5 mg/kg/dose 6 Hrly, 5 days Ondensatrone 0.1 mg/kg/dose IV/PO 8 - 12 Hrly DISCLAIMER
Erythropoietin 200 - 400 U/kg/dose IV/SC 3 times a week Pantoprazole 1 - 1.5 mg/kg/dose IV 24 Hrly
Doses of all the medications mentioned here are as per the
Fentanyl Bolus: 1 - 2 mcg/kg IV Phenobarbitone Load: 20 mg/kg IV
international guidelines for Neonates, as at March 2014.
1 - 2 mcg/kg/Hr IV Infusion Mn: 2.5 - 3 mg/kg/dose IV/PO 12 Hrly
Flecainide 2 - 4 mg/kg/dose PO 12 Hrly Jaundice: 2 - 3 mg/kg/dose PO 8 - 12 Hrly Doses of all Antimicrobial Medications are in consensus with
Phenytoin Load: 15 mg/kg IV Paediatric Infectious Disease Specialist, as at March 2014.
Fludrocortisone CAH: 0.05 - 0.3 mg PO 24 Hrly
Mn: 2 - 3 mg/kg/dose IV/PO 12 Hrly These are Neonatal doses, may not be translated in the similar
FosPhenytoin Load: 15 mg PE/kg
n Phytonadione (Vit K1) <2kg: 0.5 mg, > 2kg: 1 mg IV/IM manner for the Paediatric age group.
50 mg PE/ml M : 2 - 3 mg PE/kg/dose IV12 Hrly
Propranolol Arrythemia: 0.1 mg/kg/dose IV Push
Furosemide (Lasix) Bolus: 0.5 - 2 mg/kg IV/PO 8 - 12 Hrly In case of any discrepancy, Consult the Doctor
Ranitidine 1 mg/kg/dose IV 12 Hrly
0.06 - 0.25 mg/kg/Hr IV Infusion Confirm with Neonatologist, in case of doubt
Rocuronium 1 mg/kg/dose IV

All contents copyright C NNF, India. Written permission required to reproduce any part of this material.
 38th ANNUAL CONVENTION
OF NATIONAL
NEONATOLOGY FORUM
(NEOCON 2018 & ANNUAL UP STATE NEOCON 2018)
Organised by: NNF UP State & NNF Varanasi
Date : 13-16 December, 2018, Venue : Hotel Taj Ganges, Varanasi

Conference Theme: Pre-Term Birth

National Neonatology Forum (NNF), India
NICU INFUSION CHART
NNF Office Bearers :
Dr. B.D. Bhatia Dr. Alok Bhandari
President, NNF Hony. Secretary, NNF

Dr. V.P Goswami Dr. Lalan Kr. Bharti

President Elect, NNF Jt.Sec. cum Treasurer, NNF
NNF Governing Body Members :
Dr. Utpal Kant Singh Dr. Himanshu Kelkar
Dr. Anurag Singh Dr. Mohit Sahni Dr. Vishnu Bhat
NNF UP State :
Dr. Ashok Rai Dr. Alok C Bhardwaj
President, NNF UP State Secretary, NNF UP State

Prof. Dr. S. Manazir Ali Dr. D M Gupta

Past President, NNF UP State Jt. Secretary Cum Treasurer, NNF UP State
Journal of Neonatology, India : Editorial team :
Editor: Mohit Sahni
Advisory Board :
B Vishnu Bhat, Baldev Bhatia, Praveen Kumar, Rangasamy Ramanathan,
Disclaimer : Prakesh Shah, Gautham Kanekal Suresh
These are just guidelines complied from different sources. Editorial Board :
Protocols may very from unit to unit. Deepak Chawla, KK Diwakar Malankara, Nandkishor Kabra, Sheila Mathai, Ashish Mehta, Kiran More,
In case of any discrepancy please discuss with authors or editorial team. Srinivas Murki, Karthik Nagesh, Somashekhar Nimbalkar, M Jeeva Sankar, Pradeep Suryawanshi.
Authors :
All contents copyright NNF, India. Written
C
Dr. Hitesh Patel, Surat, Email: [email protected]
permission required to reproduce any part of this material. Dr. Mohit Sahni, Surat, Email: [email protected]
NICU INFUSION CHART FOR 25ML SYRINGE