Author Archives: keithbarrington

About keithbarrington

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

Inhaled Steroids to Prevent BPD? Think again… again!

The NEUROSIS trial that I discussed in my previous post has, among other published trials, most in common with the trial by Nakamura published in 2016. Nakamura T, et al. Early inhaled steroid use in extremely low birthweight infants: a … Continue reading

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Inhaled steroids to prevent BPD? Think again…

The NEUROSIS trial was a high quality trial of inhaled budesonide started before 12 hours in extremely preterm infants (23 to <28 weeks gestation) receiving positive pressure respiratory support. The primary outcome of the trial was survival without needing oxygen … Continue reading

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Pre-discharge MRI for the very preterm infant?

For a pre-christmas present, one of the most important recent studies in neonatology. The study is related to the following question: if I wanted to know how best to counsel my very preterm baby parents about potential long-term outcomes, when … Continue reading

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Time to abandon the Papile classification? (part 3)

What should we do now? I think we should stop using the Papile classification. We should clarify that an intraventricular hemorrhage with acute hemorrhagic dilatation of the ventricle(s) is not the same pathophysiology as a hemorrhage followed by dilatation. (stage … Continue reading

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Time to abandon the Papile classification? (part 2)

As I mentioned in the last post, the initial report of outcomes by Bassan and others showed that the infants with severity score 0, (unilateral haemorrhage without midline shift affecting one zone) had reasonably good outcomes, 7 of 8 had … Continue reading

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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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