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NeoRay ™

NeoRay ™. Bedside Digital Radiography for the NICU. Demonstration Experience. Location: Deaconess - Women’s Hospital, Newburgh, Indiana Level 3 NICU affiliated with Riley Children’s Hospital. Cassette Slides Under Mattress. Image At Bedside In Seconds. Timing Is Everything.

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NeoRay ™

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  1. NeoRay™ Bedside Digital Radiography for the NICU

  2. Demonstration Experience Location: Deaconess - Women’s Hospital, Newburgh, IndianaLevel 3 NICU affiliated with Riley Children’s Hospital

  3. Cassette Slides Under Mattress

  4. Image At Bedside In Seconds

  5. Timing Is Everything It can take 15 minutes (or more) to return the image to the waiting physician, for each exposure… But, if you need 5 images to get it right…? And if there is some urgency…?

  6. Beginning of Procedure

  7. First UVC Position

  8. Below Diaphragm

  9. Still Below the Diaphragm

  10. Fifth Attempt - Successful Placement

  11. Timing Is Everything • Yes, it was difficult to find the right position • And on the fifth attempt in seven minutes, the procedure was a documented success. • The five images, with repositioning, leading to success, required half the time than usually required for the first image, (to discover that the catheter was in the wrong place….?)

  12. NeoRay Advantages Reduced radiation per exposure As compared with CR technology Immediate result at bedside Important for tube position during procedure More valuable when procedure is difficult Digital format Manipulate image at bedside or in PACS

  13. UVC Risks Umbilical Venous Catheters (UVCs) improperly placed in the liver, or below the diaphragm, are associated with portal vein thrombosis with potential for serious liver injury*. Proper - placement has value

  14. J Pediatr. 2006 Jun;148(6):735-9. • Portal vein thrombosis in the neonate: • risk factors, course, and outcome. • Morag I,Epelman M, Daneman A, Moineddin R, Parvez B, Shechter T, Hellmann J. • Division of Neonatology and Diagnostic Imaging, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. dr._iris@walla.co.il • OBJECTIVE: To determine the risk factors, clinical features, and outcome of infants diagnosed with portal vein thrombosis (PVT). STUDY DESIGN: A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT. • RESULTS: PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter (UVC) was inserted in 73% of the infants and was in an appropriate position in 46% of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27% of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome. CONCLUSIONS: PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improperly placed UVC and with grade 3 thrombus.

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