Welcome to the NicuHacks (the Gregulator is dead, long live the Gregulator)
Greg's NICU calculators
UPDATE 3/1/24: Corrected and error where the ETT insertion depth on the printout >1kg was 1
This calculator gives the suggested early infant management doses and line insetion depths
Working Weight (g)
Calculate based on 50th centile at gestation:
g
Calculated depths and doses
0
0
0
0
0
0
0
0
0
Tap store to store the current time or enter it manually in a hh:mm format if needed. The current time will only be entered if the box is blank. Times between notification and the furthest time in the retrieval are used to calculate the retrieval time. Press clear to zero all the values for a new retrieval
Team notified
Team ready
Depart NeoRESQ
Transport arrive
Depart RBWH
Take off
Land destination
QAS arrived
Arrive bedside
Ready to leave
Depart referring site
Take-off base
Arrive accepting hospital
Depart Accepting Hospital
Arrive NeoRESQ
Restock and clean completed
Total Retrieval time:
00:00
This calculator will estimate the FiO2 and exterior temperature at altitude. A slightly more accurate calculation of temperature will occur if you enter your location rather than the Brisbane default however this data is sent to a third party. You may choose to enter an alternate city instead.
Altitude (ft)
Current FiO2 (%)
Location (City name)
0
0
0
0
This calculator gives the suggested VT for the desired weight adjusted DCO2. The weight adjusted DCO2 is the DCO2 divided by the infant weight squared. Generally weight adjusted DCO2 should be from 30-60 with 45 being a good starting point for most infants
Weight (g)
Target Weight adjusted DCO2
Frequency
Volume of VG
3.46
Use this calculator when changing frequency to keep the relative CO2 clearence similar. If you are changing the frequency due to poor gas exchange use a slightly higher VT than the given value. Using a lower frequency generally requires a higher VT however may require a lower deltaP to achieve the target volume
DCO2
Frequency
Volume of VG
2.58
This calculator gives the weight adjusted DCO2 which is a measure of the amount ventilation the patient is recieving in a similar fashion to minute ventilation. It is agnositc of frequency unlike VT values. It is important while improved over the raw DCO2 it has a poor association with PaCO2
Weight (g)
Delivered DCO2
Weight adjusted DCO2
0.00
Oxygenation index is important risk stratifier for paediatric patients and ECMO. Generally an OI >30 should consider ECMO referral while >40 should trigger an urgent referral.
FiO2 (%)
Mean Airway Pressure (cmH20)
PaO2 (mmHg)
Oxygenation Index
0
The equation by Finer et al has been rearranged to give an equivalent low flow for given FiO2. This equation assumes the peak flow on the blended flow exeeds the peak inspiratory flow such as with HFNC and nCPAP. It can not be used with low flow on a blender
Weight (g)
FiO2
Respiratory Rate
Tidal Volume
Low flow rate
63mL/min
p>1. Flow given by the formula:
" " Flow=Wt*((fiO2*(Vt/100)*RR)-(Vt*RR*0.21))/0.79)
2. Data adapeted from Finer NN, Bates R, Tomat P. Low flow oxygen delivery via nasal cannula to neonates. Pediatr Pulmonol. 1996 Jan 1;21(1):48–51.
The calculator estimates the FiO2 for a given low flow amount
Weight (g)
FiO2
Respiratory Rate
Tidal Volume
Equivalent FiO2: 0%
1. Flow given by the formula:
" " Flow=Wt*((flow*0.79)+(0.21*RR*Vt*Wt))*100/(RR*Vt*Wt)
2. Data adapeted from Finer NN, Bates R, Tomat P. Low flow oxygen delivery via nasal cannula to neonates. Pediatr Pulmonol. 1996 Jan 1;21(1):48–51.
This calculator uses data derived from two papers and not a single model and should be used with care. If using this calculator to set flow caution not to use a flow >3 L/min/kg. A flow of under 4 L/min does not generate a signficant amount of PEEP due to circuit resistance
Weight
Flow (L/min)
Estimated PEEP
1
The estimate PEEP is given by PEEP = 4 + (0.6*(flow - 4)) - 0.7 x weight (kg)
References
1. Liew Z, Fenton AC, Harigopal S, Gopalakaje S, Brodlie M, O'Brien CJ. Physiological effects of high-flow nasal cannula therapy in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2020;105(1):F87-93.
2. Nielsen KR, Ellington LE, Gray AJ, Stanberry LI, Smith LS, Diblasi RM. Effect of high-flow nasal cannula on expiratory pressure and ventilation in infant, pediatric, and adult models. Respir Care. 2018;63(2):147-57.
3. Sreenan C, Lemke RP, Hudson-Mason A, Osiovich H. High-flow nasal cannulae in the management of apnea of prematurity: A comparison with conventional nasal continuous positive airway pressure. Pediatrics. 2001;107(5):1081-3.
The Cumming's dexamethasone course for CNLD has been modified for a shorter course. Where the calculated doses are the same as the previous 3 days course the dose is skipped. The original starting dose has also been skipped. A typical course is 27-30 days in length. If a starting date is entered the days for each dose are also calculated
Weight (g)
Starting on
Days 1-3:
0mg
Days 4-6:
0mg
Days 7-9:
0mg
Days 10-12:
0mg
Days 12-15:
0mg
Days 16-18:
0mg
Days 19-21:
0mg
Days 22-24:
0mg
Days 25-27:
0mg
Days 28-30:
0mg
Days 31-33:
0mg
Days 34-36:
0mg
1. Doses calculated using the formula 0.15mg/kg/dose then decreased 10% each 3 days. If two consecutive doses are the same only the second set is discarded
2. Thanks to D. Bostock, AB Hoellering, MW Davies.
3. Adapted from Cummings, J. J., D'Eugenio, D. B., & Gross, S. J. (1989). A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia. The New England journal of medicine, 320(23), 1505–1510. https://doi.org/10.1056/NEJM198906083202301
The volume of a a solution added to a burette is calculated.
Weight (g)
Additive mmol/kg per day
Burette Flow Rate
Burette Additive
Additive strength (mmol/ml)
Volume of solution added to per 100ml burette
6.7ml
The volume of a a solution added to a burette is calculated.
Weight (g)
Base Excess
Dose of bicarbonate
0mls of NaHCO3 solution 8.4% (1mmol/ml)
the amount of dextrose added to a 100mL burette is calculated below. If there are other additives added to the burette, subtract these from the burette volume to calculate the volume of 50% dextrose that needs to be added. If using an 80:20 mixture the saline added is not considered an additive.
Base glucose
Infusion glucose %
Target Glucose
Infusion glucose %
Mixture volume (mL) - if using additives use the
volume of base solution prior to additives
Add 0mL of 50% dextrose
To 0% dextrose solution
The GIR across all sources are calculated. Generally a GIR >6 should be maintained where possible to prevent hypoglycaemia. Infants needing a GIR >10mcg/kgmin likely have increased glucose requirments suggesting hyperinsulinism
Weight (g)
Number of IV infusions
Number of enteral feed types
Infusion 1
Infusion Flow Rate
Infusion type
Infusion glucose %
Infusion 2
Infusion Flow Rate
Infusion type
Infusion glucose %
Infusion 3
Infusion Flow Rate
Infusion type
Infusion glucose %
Infusion 4
Infusion Flow Rate
Infusion type
Infusion glucose %
Enteral 1
Feed Frequency
Feed Type
Enteral 2
Feed Frequency
Feed Type
0
Weight (g)
Infusions
Infusion 1
Infusion
Solution type
Sodium content
Infusion Flow Rate (mL/hr)
Infusion 2
Infusion
Solution type
Sodium content
Infusion Flow Rate (mL/hr)
Infusion 3
Infusion
Solution type
Sodium content
Infusion Flow Rate (mL/hr)
Burette infusion
Burette with additive
Burette additive
Sodium content
Solution type
Volume (mL)
Base solution
Na content (exc. additive)
Solution type
Flow rate (mL/hr)
Bolus enteral sodium
Bolus Enteral
Bolus
Sodium content
Solution type
Volume (mL)
Frequency (doses/day)
Bolus medications
Bolus Medication (Enteral or IV)
Bolus
Sodium content
Solution type
Dose (mL or mg)
Frequency (doses/day)
Bolus Medication (Enteral or IV)
Bolus
Sodium content
Solution type
Dose (mL or mg)
Frequency (doses/day)
Sodium intake: 0mmol/Kg/day
Generally infants should gain 10-25g/kg/day, typically 15g/kg/day
Baby weight
Weight gain
Weight gain over (days)
0g/kg/day
Weight loss >10% generally needs a review of intake and supplementation if needed
Birth weight
Current Weight
0
The PMA is calculated using either GA at birth or EDD once selected
Calculate PMA on:
Based on
Method
Gestation at birth
0
1. ASID perinatal guidelines: useful resource for most common perinatal infections
2. Drager High Frequency Booklet: Not exactly light reading but very helpful in understanding the mechanics of HFOV
3. NeoMedQ: Statewide drug monographs used within Queensland
4. ANMF: Well written, referenced and extensive guidelines for neonatal medicines
These are a number of calculators I use in the management of critically unwell neonates. Once upon the time known as the Gregulator now NicuHacks with thanks to Sister Hosey
For a few them I have included the rationale behind the calculators where I got the idea or data from. I have tried to make sure it is error free but if not please let me know and I'll fix it however I cannot guaranty that they are. Similarly, I have created these for my own use and I would recommend you use them with a great deal of care.
I learnt how to code this website in a few weeks so if you're a developer please don't laugh. If you're not then you can make one too!
None of the data entered on this website is stored outside your device either (including the print pages), there are no ads and I definitely am not using any page analytics although if you choose to use the altitude correction tool then your location is sent to an external provider
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