Author Archives: Keith Barrington

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About Keith Barrington

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

Hypotension and cerebral oxygenation

Posted on 18 July 2012 by Keith Barrington

Two recent observational studies have examined how cerebral oxygenation is affected by therapies designed to increase blood pressure. The first, by Hilde Bonestroo and co-workers, studied 71 infants less than 32 weeks gestation who had a mean arterial blood pressure … Continue reading →

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Trying to improve outcomes of preterm infants

Posted on 17 July 2012 by Keith Barrington

Two recent RCTs in high risk newborns of things I would never have thought of. The first is a trial of Estradiol and Progesterone supplementation (Trotter A, Steinmacher J, Kron M, Pohlandt F. Neurodevelopmental Follow-Up at Five Years Corrected Age … Continue reading →

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More on Probiotics

Posted on 16 July 2012 by Keith Barrington

All of the accumulated evidence regarding probiotics in preterm infants to prevent necrotising enterocolitis (NEC) clearly shows that probiotic bacteria (specifically bifidobacteria and lactobacilli) are effective in reducing the incidence of NEC by more than 50%, they, as a result, reduce mortality in eligible infants. … Continue reading →

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Predicting outcomes: Adults vs Babies

Posted on 11 July 2012 by Keith Barrington

An interesting article in Archives of Internal Medicine (Chan PS, Spertus JA, Krumholz HM, Berg RA, Li Y, Sasson C, Nallamothu BK, Investigators. GWTG-RR: A validated prediction tool for initial survivors of in-hospital cardiac arrest. Arch Intern Med 2012, 172(12):1-7. http://archinte.jamanetwork.com/article.aspx?articleid=1162169); … Continue reading →

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How to Improve Ventilation of Babies during Resuscitation

Posted on 9 July 2012 by Keith Barrington

So how do we improve resuscitation of newborn babies, and specifically of the preterm? Although I am a “true believer (TM)”  in evidence based practice it is obvious that every individual change in neonatal practice will not (and cannot) be … Continue reading →

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A toxic placebo

Posted on 8 July 2012 by Keith Barrington

One very frequently used agent in the NICU is metoclopramide, prescribed almost exclusively for gastro-esophgeal reflux, (occasionally in an attempt to improve feeding tolerance). Let us assume for a moment that a baby does have clinical signs which are due to reflux, that … Continue reading →

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Reducing transfusions in the NICU

Posted on 6 July 2012 by Keith Barrington

I don’t know why I didn’t think of this, but it is sort of obvious, it just takes someone to think about it and then do it. We need to reduce blood draws in preterm infants, the blood we take … Continue reading →

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Outcomes of GBS meningitis; as good as 24 week premies.

Posted on 4 July 2012 by Keith Barrington

As several of you may know, I am co-author, with Annie Janvier, of a series of articles examining how our prejudices about the worth of individuals affect decision making in the critically ill. In some of those articles we compare … Continue reading →

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Does the way we feed babies affect Necrotizing Enterocolitis?

Posted on 2 July 2012 by Keith Barrington

There is a widespread feeling that the method of introduction and advancement of feeds affects the frequency of necrotizing enterocolitis (known as NEC). Multiple observational studies have been published that seem to support this fear. However when we search for randomized controlled trials comparing feeding practices … Continue reading →

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What do babies die of in resource poor countries?

Posted on 28 June 2012 by Keith Barrington

Two very recent publications about neonatal mortality in resource poor countries. The first is from 6 different low resource countries and one medium resource country (Argentina) the authors presented the birth weight, gestational age and age at death of babies … Continue reading →

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