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

Survival and outcomes for the extremely preterm. The NICHD network results continue to improve: Can we do even better?

Posted on 20 January 2022 by Keith Barrington

A new publication from the NRN describes short term outcomes and care practices of babies from 22 to 28 weeks gestation born in recent years (2013 to 2018) and for those born in 2013-2016 results of evaluations of those followed … Continue reading →

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Probiotics in preterms; what’s new? Part 2

Posted on 19 January 2022 by Keith Barrington

Rao S, et al. Probiotic supplementation in neonates with congenital gastrointestinal surgical conditions: a pilot randomised controlled trial. Pediatr Res. 2022. When we started using probiotics there had been a couple of case reports of probiotic associated sepsis in infants … Continue reading →

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Probiotics in preterms; what’s new? Part 1

Posted on 18 January 2022 by Keith Barrington

I haven’t, surprisingly, posted about probiotics recently, but there are some new findings in the literature that warrant discussion. Granger C, et al. Necrotising enterocolitis, late-onset sepsis and mortality after routine probiotic introduction in the UK. Arch Dis Child Fetal … Continue reading →

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Cardiovascular support in the preterm, how to determine adequate perfusion?

Posted on 17 January 2022 by Keith Barrington

As many of you will know, I have advocated for many years for evaluation and management of very preterm babies based on their tissue perfusion rather than the blood pressure. There is little or no correlation between BP and perfusion, … Continue reading →

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STOP-BPD follow up study

Posted on 13 January 2022 by Keith Barrington

Does routine hydrocortisone, started at 7 to 14 days of age among infants <30 weeks GA and/or <1250g birth weight who were ventilator dependent and at increased risk for BPD, affect their long term developmental progress? (Halbmeijer NM, et al. … Continue reading →

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Antenatal treatment of Diaphragmatic Hernia, indications for intervention.

Posted on 12 January 2022 by Keith Barrington

My previous post about the FETO trials noted that the published trials reported a clear benefit of antenatal treatment of the highest risk group, but the moderate risk group had an improved outcome which didn’t meet classic definitions of statistical … Continue reading →

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Ethically acceptable pain research

Posted on 12 January 2022 by Keith Barrington

Just imagine for a moment that you are the parent of Jo, who is 4 years old, Jo has a sudden onset of breathlessness and the investigations in the Emergency Room show a spontaneous pneumothorax, that needs a drain. You … Continue reading →

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Unethical pain research in the newborn. A list of shame.

Posted on 11 January 2022 by Keith Barrington

Unethical pain studies are still being published, in journals which include several from mainstream publishing houses. In these studies published recently and appearing on-line in recent weeks, newborn infants were assigned by the researchers to experience pain. The reviewers of … Continue reading →

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How do we make decisions for the most immature babies, with their families?

Posted on 10 January 2022 by Keith Barrington

Although babies under 25 weeks account for a tiny proportion of births, and a small proportion of NICU admissions, the importance of the question asked in the title can be seen by the ongoing number of publications, below are just … Continue reading →

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Should we treat electrographic seizures?

Posted on 6 January 2022 by Keith Barrington

In order to answer the question posed in the title you would need to take babies at risk of seizures, but not yet having clinically diagnosed convulsions, randomize them to have routine continuous EEG monitoring or not and then treat … Continue reading →

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