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AaDO2

Back
%
mmHg
mmHg

Calculate the alveolar-arterial oxygen gradient for given fractional inspired oxygen and measured pCO2 and paO2

Body Surface Area

Back
kg
cm
m2

Validated for estimation of body surface area from extremely low birth weight infants through to children and adults

ET Tubes & Umbilical Catheters
ET Tubes

Back
kg
cm
Fr
cm ( + cord )
cm ( + cord )

Estimates optimal insertion length for endotracheal tube and for umbilical catheters (based on infant's weight)

Partial Exchange Transfusion
Partial Exchange

Back
kg
%

Estimates partial exchange transfusion volume required in the polycythaemic newborn to acheive target hematocrit.

Note that "small for gestational age" status is only required for infants 1.5 to 3.0 kg

Glucose Infusion Rate (GIR)
Glucose Delivery

Back

Intravenous Fluids

kg
Dextrose Rate
(ml/hour)
%
%

Enteral Intake

Select Milk:
(mL/hour)
(g/100 mL)

Calculator Result

Fluid Volume
(ml/kg/day) 		Sugar Load
(mg/kg/min)
IV 1
IV 2
Milk
Added Carbohydrate  
Total

Calculate the glucose infusion rate (in mg/kg/min) taking account of intravenous fluids AND enteral intake of breast milk or infant formula

Fluid & Feeds Rate Calculator
Fluid & Feeds Rates

Back
kg
mL/kg/day

Calculate the fluid rate per hour or the volume for feeds at 2-hourly through to 4-hourly intervals.

Enter infant weight and daily fluid prescription (in mL/kg/day)

Percentage Weight Loss Calculator
Weight Loss %

Back

Calculate the percentage weight loss from birth weight.

Enter birth weight and current weight in grams.

Low Flow O2
Low Flow O2 Delivery

Back
kg
per min
mL/min
%
%

Finds the approximate effective FiO2 for any given low flow oxygen rate and blender O2 setting

Risk of ECMO use (or death without ECMO use) in CDH
ECMO Risk in CDH

Back
%

Use this calculator to calculate the risk of an infant with congenital diaphragmatic hernia either requiring ECMO or of dying without ECMO use

Oxygenation Index

Back
cm H2O
%

Use to calculate the Oxygenation Index. Choose mmHg OR kPa pressure units as preferred.

Altitude Physiology Calculator
Altitude

Back
%
%

Estimate the barometric pressure, the gas expansion ratio and the equivalent FiO2 required at altitude. Choose mmHg OR kPa pressure units as preferred.

Extreme Preterm Outcomes
Preterm Outcomes

Back

Input Variables

In-Hospital Outcomes

%
%
%
%
%
%
%
%
%
%

Medium Term (3-Year) Outcomes

%
%
%
%
%
%
%

Estimate outcomes at extreme prematurity based on variables assessed at birth. Data is based on outcomes achieved in Japan for births from 2006 to 2015.

Diaphragmatic Hernia Survival Probability
CDH Survival

Back
kg

Use this calculator to estimate the long-term survival probability for diaphragmatic hernia

Long Lines

Back
cm
cm
cm

Calculates optimal insertion length for lines inserted via great saphenous at the medial malleolus

Nitric Oxide Delivery
NO Delivery

Back
L/min
ppm
L/min

Calculate optimal NO flow rate to reach target NO ppm (in ventilator set-ups with constant ventilator flow)

Dextrose Infusion Preparation
Dextrose Solutions

Back

Dextrose Solution Required

%

Preparation Instructions

Simple instructions for preparation of dextrose solutions from 5% dextrose through to 30% dextrose.

Select 50, 100, or 500 mL final volume.

Mean Airway Pressure
MAP

Back
cm H2O
cm H2O
per min
seconds

Base Excess

Back
mmol/L

INSURE Intubation Checklist
Intubation Checklist

Back
First Checks:
Team:
Equipment:
Drugs:
Team Talk:

Adrenaline for Neonatal Resuscitation
Adrenaline for Resus

Back

Estimated Weight (grams)

1:10000 via UVC or IV

micrograms
mL

1:10000 via ETT

micrograms
mL
Adrenaline (epinephrine) dosing in newborn resuscitation as per ILCOR and ANZCOR Guidelines

Corrected Gestational Age
Corrected GA

Back

When date of birth, and gestation at birth are both known:

Use to calculate the corrected gestational age as of today.

Gestational Age at Birth
Gestation at Birth

Back

When EDD is known:

Use to calculate the Gestational Age at birth and the corrected gestational age as of today.

Apgar Clock & CPR metronome
Apgar Clock Plus

Back

Time Since Birth

Saturation Target

00:00
available from 60 seconds

CPR Tempo Assistant

Adjust blender to 100% Oxygen if starting chest compressions

Bilirubin Units Converter
Bilirubin Units

Back

Convert bilirubin value from mg/dL to micromol/L

And from micromol/L to mg/dL

Glucose Units Converter
Glucose Units

Back

Convert glucose value from mg/dL to mmol/L

And from mmol/L to mg/dL

Pressure Units Converter
Pressure Units

Back

Convert pressure value from mmHg to kPa

And from kPa to mmHg

Weight Converter
Weight Converter

Back

Convert weight from pounds and ounces to grams

And from grams to pounds and ounces

loading

Information

Use this calculator to determine the A-a gradient.

Input the current FiO2 (21-100%) and the measured pCO2 and paO2

Algorithm

Calculator Algorithm:
AaDO2 = (7.13 x FiO2) - (pCO2 / 0.8) - (paO2).

References

No reference information.

Information

This calculator uses the formula of Haycock et al, which has been validated for the whole paediatric and adult population including extremely low birth weight infants.

Input the child's weight (kg) and length (cm).

Algorithm

Surface Area = W 0.5378  x L 0.3964  x 0.024265

The equation has two variables: weight in kg (W) , and length in cm (L).

References

Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: A height-weight formula validated in infants, children, and adults. J Pediatr 1978;93:62-6

Brion L, Fleischman AR, Schwartz GJ. Evaluation of four length-weight formulas for estimating body surface area in newborn infants. J Pediatr 1985;107:801-3

Information

Enter the infant's weight in kilograms

You must confirm the postion of the endotracheal tube, UAC or UVC after using this calculator

Note that estimation of nasal ETT length now uses the method of Maiwald et al BMJ 2020 which is derived from data from 116 infants

References

  1. Kempley ST, Moreiras JW, Petrone FL. Endotracheal tube length for neonatal intubation. Resuscitation, Volume 77, Issue 3, 2008, Pages 369-373

  2. Shukla H, Ferrara A. Rapid estimation of insertional length of umbilical catheters in newborns. Am J Dis Child 1986 Aug;140(8):786-8

  3. Wright IM, Owers M, Wagner M. The umbilical arterial catheter: a formula for improved positioning in the very low birth weight infant. Pediatric Critical Care Medicine. 9(5):498-501, September 2008.

  4. Maiwald CA, Neuberger P, Mueller-Hansen I, Goelz R, Michel J, Esser M, Engel C, Franz AR, Poets CF. Nasal insertion depths for neonatal intubation. Arch Dis Child Fetal Neonatal Ed. 2020 Nov;105(6):663-665

  5. Lean WL, Dawson JA, Davis PG, Theda C, Thio M. Accuracy of five formulae to determine the insertion length of umbilical venous catheters. Arch Dis Child Fetal Neonatal Ed. 2019 Mar;104(2):F165-F169
  6. Takeuchi S et al. Ideal endotracheal tube insertion depth in neonates with a birthweightless than 750 g. Pediatr Int. 2020 Aug;62(8):932-936

Algorithm

Results in this calculator are derived from the following formulae (all weights in kg):

ET Tube size
Weight < 1kg
Weight 1 - 3 kg
Weight 3 - 5 kg
Weight >5 kg 		= 2.5
= 3
= 3.5
= 4
ET Tube length at lips 1
6.632 + (1.822 * ln(Weight))
ET Tube length at nares 4
(45 + 1.15 * sqrt(Weight * 1000))/10 cm
Umbilical catheter size
Weight < 1.5 kg
Weight ≥ 1.5 kg 		3.5 Fr
5 Fr
UAC length 2,3
Weight < 1.5 kg Weight x 4 + 7
Weight ≥ 1.5 kg Weight x 2.5 + 9.7
UVC length 5
Weight x 1.5 + 5.5

Information

To estimate optimal partial exchange volume in neonatal polycythaemia.

Enter the infant's weight in kilograms.
Enter growth status - if known.
Enter the infant's current venous haematocrit.

Select the target haematocrit.

The Partial Exchange Volume will be displayed in mL.

Algorithm

The Partial Exchange Transfusion calculator is based on the standard formula:

Total Exchange Volume = Circulating Blood volume x ((Current haematocrit - Desired haematocrit) / Current haematocrit)

A number of studies have attempted to define the true circulating blood volume: we have selected the methodology which appears to have greatest validity for any given weight:

For infants < 1kg, circulating blood volume (mL) is calculated as Weight (kg) x 110

For infants 1 to 1.5 kg, and 3.0 to 5 kg, circulating blood volume is derived using the method of Rawlings et al regardless of growth status.

For infants 1.5 to 3.0 kg the calculator uses the method of Maertzdorf et al to determine the circulating blood volume according to the infant's growth status (SGA or not). Where growth status is not given we use the method of Rawlings et al.

For infants > 5kg, circulating blood volume (mL) is calculated as Weight (kg) x 64.

Information

This calculator determines how much sugar (in mg/kg/min) an infant is receiving (ie the Glucose Infusion rate)

Enter the infant's weight, then specify the various inputs:

  • dextrose percentage and flow rate for one or two infusions
  • type of milk and hourly milk volumes
  • added carbohydrate (if any) in grams per 100 ml of milk.

    • Assumptions:
    Breast milk sugar content 7.1 g / 100 ml
    Term formula sugar content 7.1 g / 100 ml
    Pre-term formula sugar content 8.5 g / 100 ml

    NOTE: Any newborn requiring a glucose load of 10 mg/kg/minute to maintain normoglycaemia should be investigated for hyperinsulinism.

    References

    No reference information

    Algorithm

    Algorithm not available for this calculator

    Information

    Input the child's weight (in kg) and the target daily mL/kg.

    Algorithm

    Rounding

    • Volumes less than 20 mL are rounded to the nearest 0.1 mL.
    • Volumes 20 mL to 50 mL are rounded to the nearest 1 mL.
    • Volumes greater than 50 mL are rounded to the nearest 5 mL.

    References

    References not applicable

    Information

    Input the infant's birth weight (in grams) and the current weight.

    Algorithm

    Rounding

    • Percentage weight loss rounded to one decimal place

    References

    References not applicable

    Information

    Calculate effective FiO2 via low flow nasal oxygen: Input weight (kg), respiratory rate, the flow rate and the percentage O2 at the blender.

    Algorithm

    FiO2 = ((F × (B - 21) / 100) + (0.21 × R × W × 5.5)) / (R × W × 0.055)

    The equation has four variables: weight in kg (W) , respiratory rate (R), gasflow (F) and percentage of oxygen in the gas (B). We have modified Neil Finer's formula to allow for the use of an O2 blender. A tidal volume of 5.5mL/kg is assumed.

    In the special cases where the gas flow (F) is greater than the infant�s minute ventilation (V), where V = R × W × 5.5, F is replaced with V in the main formula.

    References

    Finer et al. Low flow oxygen delivery via nasal cannula to neonates. Pediatr Pulmonol 1996;21(1):48-51

    Information

    Use this calculator to calculate the risk of an infant with congenital diaphragmatic hernia either requiring ECMO or of dying without ECMO use. Simply input the 1 and 5 minute Apgar scores, and the highest and lowest recorded pCO2 in the first 24 hours.

    Valid for infants greater than 32 weeks GA, birth weight greater than 1800 grams, and without other major anomalies or co-morbidities.

    Note that this calculator has not been prospectively validated and should not be used to guide individual patient care.

    References

    This formula was developed and validated by The Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg. 2018 Oct;53(10):1890-1895

    Algorithm

    ECMO Probability = (e X) /(1 + e X) where X = -2.0191 + (-0.1407*A) + (-0.1939*B) + (0.0313*C) +(0.0303*D)

    A is one minute Apgar, B is 5 minute Apgar, C is highest pCO2, D is lowest pCO2.

    Information

    Use this calculator to calculate the Oxygenation Index Simply input the mean airway pressure, the current FIO2 (as a percentage) and the post-ductal paO2.

    Oxygenation Index greater than 30 may indicate consideration of ECMO.

    References

    Hallman M, Merritt A, Jarvenpaa A-L, et al. Exogenous human surfactant for treatment of severe respiratory distress syndrome: a randomized prospective clinical trial. J Pediatr 1985; 106:963- 969

    Algorithm

    Oxygenation Index = (MAP * FiO2)/ PaO2

    The formula when PaO2 units are kPA is Oxygenation Index = (MAP * FiO2)/ (PaO2*7.5)

    Information

    Enter the cabin altitude. Enter FiO2 required by the infant at sea level (optional - default is 21).

    Barometric pressure is given in mmHg or kPa.

    Gas expansion ratio at this altitude is calculated.

    FiO2 required to maintain PaO2 at altitude (based on that required at sea-level) is calculated.

    Algorithm

    The Barometric Formula
    P(h) = 760 × e-Mgh/RT
    The barometric pressure at altitude h (in metres) is calculated from the Barometric Formula as above. Sea level pressure is estimated at 760 mmHg, and a sea level temperature of 290 Kelvin (15 oC) is assumed.

    M = the molar mass of the gas expressed in kg/mole = 0.0288
    g = the acceleration due to gravity = 9.81 m/s2
    R = the gas constant = 8.3145 J/molK
    T = temperature, Kelvin (see below)

    Boyle's Law
    P1V1 = P2V2
    The initial barometric pressure multiplied by the initial volume of gas equals the final barometric pressure multiplied by the final volume of gas.

    Oxygen Adjustment Equation
    Fa = F0 × (760-47) / (P(h) - 47)
    The FiO2 required at any altitude is calaculated from the sea-level FiO2 requirement multiplied by the sea-level barometric pressure and divided by the baraometric pressure at the given altitude. A pressure adjustment for the partial pressure of water at body temperature is included.

    Temperature at altitude
    Temperature is assumed to be 290 Kelvin (15 oC) at sea-level, and to drop by 6.6 Kelvin for every 1,000m (3,281ft) of additional altitude.

    References

    Guidelines for Air & Ground Transport of Neonatal & Pediatric Patients. AAP 1999

    Information

    Definitions:

    See reference for full details

    Input terms:

    1. Steroids: select "yes" if full OR partial
    2. Hypertension: BP > 140/90 after 20 weeks
    3. Chorioamnionitis: clinical disease only

    Outcome terms:

    1. Chronic Lung Disease: O2 at 36 weeks PMA
    2. NEC: Bell 2 or 3
    3. Short-term Composite: Death or IVH (3/4) or PVL
    4. DQ: Kyoto Scale at 36 months
    5. Long-term Composite: Death after NICU discharge or cerebral palsy or DQ <70

    Note that medium term outcomes (3-years) were calculated among NICU survivors. The probability of these outcomes is based on the assumption that an infant survives to NICU discharge.

    References

    Ushida T, Moriyama Y, Nakatochi M, Kobayashi Y, Imai K, Nakano-Kobayashi T, Nakamura N, Hayakawa M, Kajiyama H, Kotani T; Neonatal Research Network of Japan.

    Antenatal prediction models for short- and medium-term outcomes in preterm infants.

    Acta Obstet Gynecol Scand. 2021;100:1089-1096.

    Algorithm

    Based on a prospectively studied cohort of 31000 premature infants.

    See Reference for Algorithm Details

    Information

    Use this calculator to estimate the long-term survival probability for diaphragmatic hernia. Simply input the birth weight (in kg) and 5 minute Apgar score.

    Note that this calculator is more suitable for estimating survival probability across a population of at-risk infants rather than for any individual for whom risk will be modified by other readily appreciated clinical factors.

    References

    This formula was developed and validated by The Congenital Diaphragmatic Hernia Study Group J Pediatr Surg. 2001 Jan;36(1):141-5

    Algorithm

    Survival Probability = 1 - 1/(1 + e -X) where -X = -5.0240 + 0.9165 W + 0.4512 A

    W is birth weight in kg, and A is 5 minute Apgar.

    Information

    Enter the infant's length in centimetres

    Calculates optimal insertion length for lines inserted via great saphenous at the medial malleolus

    You must confirm the postion of the long line after using this calculator

    References

    1. Ohki Y, Nako Y, Morikawa A, Maruyama K, Koizumi T. Percutaneous central venous catheterization via the great saphenous vein in neonates. Acta Paedritrica Japonica 1997;39:312-316

    2. Odaibo F, Fajardo CA, Cronin C. Recovery of intralipid from lumbar puncture after migration of saphenous venous catheter. Arch Dis Child 1992;67:1201-3

    3. Nowlen TT, Rosenthal GL, Johnson GL, Tom DJ, Vargo TA. Pericardial effusion and tamponade in infants with central catheters. Pediatrics 2002;110:137-42

    Algorithm

    Results in this calculator are derived from the following formulae (all lengths in cm):

    Minimum insertion length (targetting L3) = (infant length * 0.44) - 0.3

    Maximum insertion length (targetting T9) = (infant length * 0.55) - 0.4

    Information

    This calculator is only accurate when using ventilators with a constant flow of gases.

    When using for example the Draeger Babylog 8000 in High Frequency mode, the gas flow will vary with MAP, frequency and amplitude. In that case a specialised injection system such as the Inovent (which will vary the flow of NO as the flow of ventilator gas changes) will remove the need to use this calculation.

    NO delivery via paediatric and adult ventilators also usually needs to be via specialised injection systems.

    Use of the calculator does not mean that analysers do not need to be used, as leaks in the delivery system can occur causing changes in dosage. The NO level measured by the analyser should coincide with the dose set as calculated above. Any major discrepancy must be investigated immediately and its cause rectified.

    References

    No reference information

    Algorithm

    NO Flow Rate = V x D / C

    The equation has four variables: NO Flow Rate (F) , Ventilator Flow Rate (V), Prescribed NO Dose (D) and Nitric Oxide Cylinder Concentration (C).

    Information

    Preparation instructions for a variety of dextrose solutions.

    Select the desired final dextrose concentration.

    Choose the required solution volume.

    References

    No reference information

    Algorithm

    No algorithm information

    Information

    Calculate an approximation of mean airway pressure:

    Input PIP, PEEP, rate and i-time.

    Algorithm

    MAP = ((rate × i-time / 60) × (PIP - PEEP) + PEEP)

    References

    References not available

    Information

    This calculator uses the Siggaard-Anderson equation to calculate the Base Excess (negative results represent a base deficit)

    Input the pH and HCO3 (mmol/L).

    Algorithm

    Base Excess = 0.9287*(HCO3 -24.4 + 14.83 *(pH-7.4))

    References

    Siggaard-Andersen 0. An acid-base chart for arterial blood with normal and pathophysiological reference areas. Scan J Clin Lab Invest 1971;27:239-245

    Information

    This checklist is provided as a sample of a checklist to improve safety and performance of INSURE procedure.

    INSURE: Intubation - Surfactant - Extubation in newborn requiring intubation for administration of surfactant and then extubation without a period of mechanical ventilation.

    Algorithm

    Provided as an example of a simple checklist.

    Local variations will be required to reflect team composition, equipment variations, and preferred medications.

    References

    Based on "Development & Testing of a Neonatal Intubation Checklist for an Air Medical Transport Team" Davidson et al. Air Med J 2018

    Gawande, A. (2011). The checklist manifesto. Profile Books.

    Information

    From ANZCOR 2021.

    Select the estimated newborn weight

    References

    ANZCOR Guidelines Section 13: Neonatal Guidelines.

    Australian Resuscitation Council

    Algorithm

    Adrenaline via UVC or IV: 10 - 30 micrograms/kg

    Adrenaline via ETT: 50 - 100 micrograms/kg

    Information

    When you know the Gestation at Birth but need to calculate the corrected gestaional age

    Algorithm

    Calculates days since birth, and adds this elapsed time to the gestational age at birth.

    Until 40 weeks, results are expressed as weeks and days from conception

    Beyond 40 weeks, results are expressed as Term plus months, weeks and days

    Postnatal age (days since birth) counts the birth day as zero, the following day as one day and so on.

    EDD is the calculated date at which CGA is 40 weeks

    References

    No reference information

    Information

    When the Estimated Due Date is known this tool calculates gestation at birth

    and the current gestational age

    Algorithm

    Given the EDD, calculates corrected Gestational Age

    With DOB, the gestation at birth is also calculated

    References

    No reference information

    Information

    Features

    1. Apgar Timer (mm:ss)

    2. Appropriate saturations targets as per ANZCOR Guidelines, and consistent with North American & European Guidelines

    3. Aid for maintaining appropriate rhythm and rate of chest compressions and ventilation

    Why another Apgar Clock?

    It's about reducing the cognitive load at newborn resuscitation.

    Direct and timely presentation of the appropriate target saturations.

    Chest compressions / ventilation timing and co-ordination also are a challenge - clinicians can call out the rhythm but often have to break that rhythm to talk about other resuscitation concerns

    And the recommended rate is faster than many sim participants appreciate

    References

    1. ANZCOR Guidelines Section 13: Neonatal Guidelines. Australian Resuscitation Council

    2. European Resuscitation Council Guidelines 2021 Resuscitation 161:291-326

    3. Neonatal Resuscitation 2020 AHA Guidelines Pediatrics Jan 2021

    4. Dawson JA, Kamlin CO, Vento M, Wong C, Cole TJ, Donath SM, Davis PG, Morley CJ. Defining the reference range for oxygen saturation for infants after birth. Pediatrics. 2010 Jun;125(6):e1340-7

    Algorithm

    Saturation Targets:

    See reference for full details

    Saturation Targets at age in minutes

    • 1 minute: 60-70%
    • 2 minutes: 65-85%
    • 3 minutes: 70-90%
    • 4 minute: 75-90%
    • 5 minutes: 80-90%
    • 6 - 10 minutes: 85-90%
    • Beyond 10 minutes we have specified 90-95%

    CPR Tempo:

    3 Compressions to 1 Breathe

    90 Compressions & 30 Breathes per minute

    Information

    Simply input the bilirubin value and units.

    The calculator will output the corresponding value in the alternate units.

    References

    Labcorp SI Unit Conversion Table

    Algorithm

    To convert a bilirubin value from micromol/L to mg/dL: divide value by 17.1

    The inverse operation will convert mg/dL to micromol/L

    Information

    Simply input the glucose value and units.

    The calculator will output the corresponding value in the alternate units.

    References

    Labcorp SI Unit Conversion Table

    Algorithm

    To convert a glucose value from mmol/L to mg/dL: multiply value by 18

    The inverse operation will convert mg/dL to mmol/L

    Information

    Simply input the pressure value and units.

    The calculator will output the corresponding value in the alternate units.

    References

    Wikipedia Millimetre of Mercury

    Algorithm

    To convert a pressure value from kPa to mmHg: multiply value by 7.501

    The inverse operation will convert mmHg to kPa

    Information

    Select the conversion required, and input the starting values

    The calculator will output the corresponding value in the alternate units.

    Ounces are rounded to the nearest ounce.

    References

    Wikipedia Where we learn that an ounce of gold weighs more than an ounce of butter!

    Algorithm

    To convert grams to ounces: multiply value by 0.035274

    The inverse operation will convert ounces to grams

    Nicutools

    Version 2.021

    Nicutools is a comprehensive suite of calculators and tools designed for neonatal care professionals.

    © 2024 Nicutools. All rights reserved.

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