Author Archives: keithbarrington

About keithbarrington

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

Treating seizures in the newborn: phenobarbitone unexpectedly not so bad!

Or perhaps “probably better than the current fashionable alternative” might be a better title. Phenobarbitone (or phenobarbital, I will call it PHE) is one of the oldest anticonvulsants out there, and because of little good data, remains the drug of … Continue reading

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Antenatal steroids : good, bad, or both?

Antenatal steroids prior to very preterm birth save lives. Antenatal steroids prior to planned late preterm delivery reduce respiratory distress and increase hypoglycaemia. Might there be other long-term effects on brain structure? There are now some animal models which suggest … Continue reading

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Do estimates of survival change decisions made?

Kidszun A, et al. Effect of Neonatal Outcome Estimates on Decision-Making Preferences of Mothers Facing Preterm Birth: A Randomized Clinical Trial. JAMA Pediatr. 2020. This is a short report of an interesting idea, published as a research letter. The authors … Continue reading

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Glucose screening and treatment in the newborn; what now?

This is a field that stagnated in darkness for a while, “But, soft! what light through yonder window breaks? It is the east, and science is the sun” (with apologies to Romeo). Recent research has shown that 1. In healthy … Continue reading

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Let it GLOW… Normal blood sugar profiles in newborn infants.

To stay with this recent “hot topic” of this blog; what low blood sugar threshold should be used for intervention in the neonatal period? The usual risk factors (SGA, LGA, IDM, late preterm, maternal beta-blockers) select a group of babies … Continue reading

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Not COVID-19. Who is at risk for hypoglycaemia?

In my previous post about hypoglycaemia, I made certain estimates about the proportion of well-appearing term and late preterm babies who would be considered at-risk. Karen Puopolo and her group at the Pennsylvania hospital have just published a study covering … Continue reading

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Linezolid seems safe for preterms, probably

A few years ago we started having difficulty clearing Coagulase-Negative Staphylococcal (CoNS) sepsis from the blood cultures of some babies in our NICU, children with CoNS also seemed to be sicker, and to more often have thrombocytopenia. It was at … Continue reading

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What to do about early postnatal steroids?

Steroid metabolism in the very immature infant is… immature. Adrenal function is still developing in the fetus between 20 and 26 weeks, and a source of precursors from the placenta is important, but obviously disappears at delivery. Very preterm babies … Continue reading

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We are all treaty peoples

We are all treaty peoples if we live in North America! We, at least the “we” who are concerned about such things, have a tendency to think that the treaty people are only the aboriginal descendants of those who had … Continue reading

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They really are CRAP! C-ReActive Protein: “Hazardous Waste”.

I have railed against the use of C-Reactive Protein, CRP, on this blog previously, it was my analysis that the CRP is sensitive, but with very poor specificity, both for early-onset sepsis, and for late-onset sepsis. A new systematic review … Continue reading

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