neoSim by Nicutools

The 2.7 series brings neoSim's biggest visual upgrade yet, plus more realistic physiology. A new 3D chest • A true 3D torso replaces the flat manikin — lifelike chest rise, indrawing and colour change. • "Cold Light" transillumination now shines applied via a "wand" not your finger-tip for better visibility, with the affected side glowing red under a tension pneumothorax. Smarter thermoregulation • Plastic wrap now properly keeps preterm babies warm — and is offered for any baby under 1500 g. • Cold babies now show depressed breathing (apnoea when severe), reversing on rewarming. • Overheating now behaves realistically by gestation.

• Meet the new 3D newborn — a fully three-dimensional chest that rises, retracts and changes colour in real time, so every breath, compression and intervention feels true to life. • Cold Light transillumination now uses a handheld wand — your finger no longer blocks the glow when localising a pneumothorax, with cleaner, more realistic light. • Tension pneumothorax — the affected side now shows subtle chest movement and indrawing instead of sitting frozen, recovering as you decompress. • Refined scoring for chest-compression response. • Stability and polish.

Nasal CPAP: choose nasal CPAP for preterm RDS instead of mask PPV. Available for babies ≤32 weeks. LISA (Less Invasive Surfactant Administration): give surfactant via thin catheter without intubating. Tap Surfactant with no ETT in place to start LISA; with an ETT in, it gives the INSURE dose. Ability to bail out of LISA if infant unstable Failed intubation: pick a tube that's too large for the baby and you'll now see the attempt play through: blade in, tube enters, tube withdraws, advisory across the top. Code button: bell glyph plus a clearer red-to-green colour change when help has been called. Vagal HR drop while the laryngoscope blade is in the airway.

Sim Builder — refinements Sim Builder (the Design & Share Your Own Sims feature added in 2.5.0) lets you author and share custom resuscitation scenarios. Three fidelity issues are resolved this release. Custom sims with high airway obstruction now actually obstruct ventilation as authored — previously, even setting obstruction to 100 % silently rolled through to zero. Meconium aspirate is now clearly visible during suction: the catheter darkens to a near-black column as you suction, with intensity scaled to the obstruction level. And the PPHN checkbox now produces clinically visible PPHN behaviour at any lactate — previously it had no effect on babies authored at modest lactate. A well term baby with PPHN at lactate 2 now reads as the classic teaching presentation: SpO₂ around 88 % on room air, climbing to ~97 % on 30 % O₂ Newborn breathing patterns: Babies described as breathing regularly at birth no longer appear apnoeic on arrival at the warmer. The brainstem drive model has been retuned so that a well term baby in the transitional first-minute window — typical SpO₂ in the 50s, mild lactate — visibly breathes rather than presenting at the borderline of apnoea. Extreme preterms without asphyxia continue to present with the expected immature pattern — apnoea or minimal respiratory effort at the same saturations. Gasping, when it occurs, now reads as a depressed-but-visible pattern (6–20 /min) rather than once-every-15-seconds. Early-sim fairness floor In the first 3 minutes, a competent NRP-style resuscitation now has a soft floor on SpO₂ so the engine's feedback loops can't compound into a non-survivable state when the team is doing the right thing. The floor activates only when ventilation is effective, FiO₂ is fully escalated, and if HR is below 60) compressions are running. Fades out before the 3-minute mark so the underlying physiology asserts after the resuscitation window. Stability Several quieter fixes including a refactor that closes a class of parity bugs between iOS and the engine, an Xcode build script that self-heals on machines without node in the default path, and tighter tuning across the meconium suction animation on both iOS and the web team mode.