Author Archives: keithbarrington

About keithbarrington

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

More thoughts about what to de-adopt

My post about de-adopting certain investigations or procedures in the NICU got a lot of suggestions and responses. Here are a few, either from the comments section or from Twitter. We should de-adopt the following: Dopamine. This is a suggestion … Continue reading

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Medication use in babies with bronchopulmonary dysplasia

A few recent studies have noted the marked variability between sites in the use of medications in preterm infants with BPD. Nelin TD, et al. The association between diuretic class exposures and enteral electrolyte use in infants developing grade 2 … Continue reading

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The ACOG patient information page; what should it say about 22, 23, 24 weekers?

I mentioned not so long ago that the web page of the US Obstetricians professional association has information for prospective parents of babies of less than 25 weeks gestation that is… questionable. They state, for example, the following : Medical … Continue reading

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What should we de-adopt in Neonatology?

When practices become ingrained in practice it can be very difficult to change them, even when new evidence becomes available, or a review of existing evidence points out that the practice is worthless. An editorial towards the end of last … Continue reading

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Long term outcomes; the 2 year Bayley tells us very little

The Bayley Scales of Infants Development were created to screen babies for developmental delay, and can be used as one way of identifying children with potential problems, and then determining whether they might benefit from intervention. Unfortunately they have become … Continue reading

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Coagulopathy and intraventricular haemorrhage

Intraventricular haemorrhages continue to be a source of concern to families of very preterm babies, and to all of us; severe hemorrhages are associated with poorer outcomes, especially bilateral extensive periventricular haemorrhagic infarction. This is one of my occasional series … Continue reading

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Back to blogging

I have been unable for various reasons to blog for a while, but getting back in the saddle is a good feeling, and I plan to try and blog at least once a week. There have been a few blog … Continue reading

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The HIP trial, treating hypotension in the extremely preterm infant.

I guess the HIP trial should be about screening for congenital dislocation, but in reality, it stands for Hypotension In Preterm infants. The long road to the unsatisfactory conclusion of the trial started more than 10 years ago, in discussions … Continue reading

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More about Prebiotics

I don’t know if there is an “official” definition of prebiotics, but I think of them as molecules present in the diet that promote the growth of probiotic organisms. I believe that originally the term was applied only to molecules … Continue reading

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When should we transfuse preterm babies, and why? Redux.

The TOP trial has just been published in the FPNEJM (Kirpalani H, et al. Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants. N Engl J Med. 2020;383(27):2639-51). It was a multicenter, non-masked RCT among 1800 babies of less than … Continue reading

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