Monthly Archives: March 2022

Steroids to improve pulmonary outcomes in preterm infants.

Posted on 29 March 2022 by Keith Barrington

When we consider using steroids in a preterm infant, ventilator dependent, with evolving lung disease, what outcomes are we most interested in? Survival, surely, is the first outcome that we want to improve, and secondly long-term pulmonary health. The adverse … Continue reading →

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Hydrocortisone, with backup dexamethasone, to prevent Bronchopulmonary Dysplasia

Posted on 28 March 2022 by Keith Barrington

A trial that has been awaited for a while has just been published (Watterberg KL, et al. Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia. N Engl J Med. 2022;386(12):1121-31). It was a multi-centre RCT of hydrocortisone in 800 very preterm … Continue reading →

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Dexmedetomidine: new wonder drug or next neonatal disaster?

Posted on 23 March 2022 by Keith Barrington

In many units, including my own, dexmedetomidine (DXM) has been creeping into use. Initially, we noticed in some full term babies who returned from the operating room, the medication appeared in the anaesthesia record, then when infants returned occasionally with … Continue reading →

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Common interventions for common conditions; what do they have in common? A lack of evidence.

Posted on 21 March 2022 by Keith Barrington

There are a number of problems in neonatal care for which good evidence is lacking, and an evidence based approach is therefore not really possible. Two recent reviews highlight this problem. The first is a systematic review of tactile stimulation … Continue reading →

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Composite outcomes for research; this is how to do it!

Posted on 21 March 2022 by Keith Barrington

As regular readers of the blog will know, I have been very critical of some very important, otherwise excellent, trials over one vital part of their design, that is, the use of composite outcomes such as “death or BPD”, “death … Continue reading →

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Should we give up on nebulised surfactant?

Posted on 17 March 2022 by Keith Barrington

A new RCT of curosurf given by nebulisation was published shortly after a systematic review of the previous data. The RCT showed no real benefit, whereas the SR suggested efficacy. The RCT first, this international trial (Dani C, et al. … Continue reading →

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Hypoglycaemia, symptomatic or non-?

Posted on 15 March 2022 by Keith Barrington

Many algorithms for detection and treatment of hypoglycaemia make a big deal of whether the hypoglycaemia is symptomatic or not. Symptomatic hypoglycaemia is supposed to be more dangerous in the long term, and requires more aggressive treatment. But symptoms accredited … Continue reading →

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Skin to skin contact reduces pain… in mothers!

Posted on 8 March 2022 by Keith Barrington

Some neonatal interventions for pain relief don’t seem to work in older subjects, sucrose for example doesn’t seem effective out of the neonatal period, a study from our Emergency Room showed no benefit of sucrose for bladder catheterisation in infants … Continue reading →

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Should we feed insulin to preterm babies?

Posted on 8 March 2022 by Keith Barrington

This was an idea I had not heard about prior to seeing this newly published trial (Mank E, et al. Efficacy and Safety of Enteral Recombinant Human Insulin in Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr. 2022). The introduction … Continue reading →

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Does Gastro-Oesophageal Reflux matter in BronchoPulmonary Dysplasia?

Posted on 6 March 2022 by Keith Barrington

The title is deliberately a bit vague as I wanted to discuss whether GOR contributes to the pathogenesis of BPD, and also whether it is important in infants with established BPD. Does GOR contribute to the development of BPD? There … Continue reading →

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