Monthly Archives: November 2017

The end of the Papile classification? (part 1)

In 1978 Lu-Ann Papile published a landmark article detailing the incidence of intraventricular hemorrhage (IVH) in 46 VLBW preterm infants using CT scanning, describing the differing extent of hemorrhage that may be seen, and developing a grading system (there are … Continue reading

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Ethical conflicts and moral distress in the NICU, are they all bad?

The term “moral distress” was coined by nursing researchers who were, generally, referring to situations in which nurses were constrained to act in opposition to their ethical beliefs, usually by having to follow medical orders that they disagreed with. More … Continue reading

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Recent publications

Even though the blog has been quiet recently, other academic output has continued… In the NICU we are often faced with babies with late- or early- onset sepsis. The worst cases develop shock, which carries a significant mortality; they may … Continue reading

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What to do with mild encephalopathy?

Therapeutic hypothermia improves the chances of babies with moderate or severe hypothermia of surviving without serious disability; referrals for evaluation for therapeutic hypothermia have exploded in our center, and many others, now that this advance is widely acknowledged. Many of … Continue reading

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The last word on delayed cord clamping in the preterm? part 3.

Lo and behold. Fogarty M, et al. Delayed Versus Early Umbilical Cord Clamping for Preterm Infants: A Systematic Review and Meta-Analysis. Am J Obstet Gynecol. 2017. Some of the authors of the APTS trial have performed an updated systematic review, … Continue reading

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The last word on delayed cord clamping in the preterm? Part 2.

I mentioned the second trial I wanted to discuss at the beginning of part 1. Duley L, et al. Randomised trial of cord clamping and initial stabilisation at very preterm birth. Archives of disease in childhood Fetal and neonatal edition. … Continue reading

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The last word on delayed cord clamping for preterms? Part 1.

The APTS (Australian placental transfusion study) trial has just appeared on line. This was a high-quality multicenter, international RCT of immediate cord clamping (less than 10 seconds) compared to delayed clamping (60 seconds) for babies born less than 32 weeks … Continue reading

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Guidelines to help parents who have lost one of twins

Many readers of this blog will recognize the name of Nick Embleton as someone who has done a great deal of nutrition research, and research into the intestinal microbiome of very preterm infants. He also has a major interest in … Continue reading

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