Author Archives: keithbarrington

About keithbarrington

I am a neonatologist and clinical researcher and chief of service at Sainte Justine University Health Center in Montréal

Treating pneumothoraces? Either a tube or leave them alone.

I never understood why it was recommended to give 100% oxygen to treat a pneumothorax. I think the idea was that the gas in the pneumothorax could be replaced by oxygen which would then be reabsorbed more quickly if we … Continue reading

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Something else that doesn’t work in sepsis; albumin

Another multi-center RCT in adults with severe sepsis or septic shock with a negative result. This time 1800 adults in 100 ICUs in Italy were randomized. Fluid boluses were either crystalloid or 20% albumin and crystalloid. Blood pressure was somewhat … Continue reading

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Bloody Placentas

No, literally. There is now quite good evidence of the advantages of delayed cord clamping in the term infant, with most particularly an improvement in iron stores in the baby that has lasting effects during the first year of life. … Continue reading

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Resuscitating preterm infants: how many O’s

Very often in neonatology (and in life) we have to make a decision based on inadequate data. For example, when resuscitating a very preterm baby you have to decide where to set the starting FiO2, even if there are no … Continue reading

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More from SUPPORT, not research governance and consent this time!

One of the difficulties in performing neonatal research is how to determine the most clinically appropriate outcomes. Bronchopulmonary dysplasia is often used as a dichotomous outcome variable, partly to facilitate the design of research, including combining it with other competing outcomes, … Continue reading

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Probiotics: what do parents want?

Some day, I might slow down with the probiotics posts, but not right now! A letter published in Archives reports the results of a parent survey. In the 3 NICUs implicated probiotics are given with parental information and an ‘opt-out’ … Continue reading

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Neonatal Updates: more nutrition

It is not surprising when I write a blog post about nutrition in the preterm neonate to find that at least one, and on this occasion two, of the articles are from the productive pen of Johannes van Goudoever. Vlaardingerbroek H, … Continue reading

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Zinc supplementation: should we be galvanized into action?

I wasn’t sure how many non native-English speakers would get that joke, and jokes are rarely improved by explaining them, so if you don’t get it, just keep on reading. Terrin G, Berni Canani R, Passariello A, Messina F, Conti … Continue reading

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Bugs and Breast Milk

Neonatology recently published a commentary asking the following question about routine probiotic supplementation, ‘what will it take to change practice?‘ This was immediately followed by another commentary, from Neena Modi, explaining why she is still reluctant. Although I have a … Continue reading

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Single baby rooms?

Terrie Inder and her colleagues have put the cat among the pigeons (as we say in England, I guess we are not keen on pigeons). Her (non-randomized) study suggests that babies who were treated in single rooms had poorer language skills … Continue reading

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