Author Archives: keithbarrington

About keithbarrington

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

RCTs prevail: Antibiotic impregnation of central lines doesn’t reduce sepsis.

In older children and adults who need central venous access, using catheters impregnated with stuff that kills bugs decreases invasive sepsis rates. A multicentre trial in English PICUs showed a reduction in sepsis from 4% to 1% when antibiotic impregnated … Continue reading

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Putting steroids in the lungs? Still unclear if it is safe or effective.

Systematic reviews, and meta-analyses should help us make a clinical decision, by accumulating all the evidence, determining its quality, and synthesizing impacts, we can then decide which therapeutic option to pursue. This latest review answers the following question “should I … Continue reading

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Insulin like growth factor: does it prevent BPD, or does it increase RoP and mortality?

In the March print edition of the Journal of Pediatrics, the report of the Insulin-like growth factor 1/IGF binding protein 3 trial, as a preventive for retinopathy. Ley D, et al. rhIGF-1/rhIGFBP-3 in Preterm Infants: A Phase 2 Randomized Controlled … Continue reading

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Measure gastric residuals? Safe to stop?

A new RCT published in JAMA pediatrics compared growth and other clinical outcomes between infants <33 weeks gestation and <1250g who were managed with routine gastric residual measurements or without. (Parker LA, et al. Effect of Gastric Residual Evaluation on … Continue reading

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Do transfusions trigger NEC? or does anemia?

I am still unconvinced that transfusion associated NEC is a real thing, I think it is possibly a real phenomenon, but I am not sure how to know for sure. Some of the best evidence I think comes from the … Continue reading

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Platelet transfusions don’t close the PDA, but they may increase IVH

I would never have actually thought to ask the question whether platelet transfusion might close the PDA, although early thrombocytopenia is associated with persistent PDA, and platelet plugs seem to be part of the mechanism of closure. A group in … Continue reading

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Sail Away, Sail Away…

You could probably guess that a post about the SAIL trial (Kirpalani H, et al. Effect of Sustained Inflations vs Intermittent Positive Pressure Ventilation on Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants: The SAIL Randomized Clinical Trial. JAMA. 2019;321(12):1165-75.) … Continue reading

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