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

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

Posted on 14 April 2021 by Keith Barrington

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 →

Posted in Neonatal Research | Leave a comment

Coagulopathy and intraventricular haemorrhage

Posted on 13 April 2021 by Keith Barrington

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 →

Posted in Neonatal Research | 7 Comments

Back to blogging

Posted on 12 April 2021 by Keith Barrington

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 →

Posted in Neonatal Research | 5 Comments

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

Posted on 12 April 2021 by Keith Barrington

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 →

Posted in Neonatal Research | 5 Comments

More about Prebiotics

Posted on 6 January 2021 by Keith Barrington

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.

Posted on 5 January 2021 by Keith Barrington

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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Should all asphyxiated babies have MR spectroscopy?

Posted on 21 December 2020 by Keith Barrington

MRI post-asphyxia, and post-rewarming, seems to be more predictive of long term outcomes than MRI at term for preterm infants. Imaging and analysis of the Apparent Diffusion Coefficient in the PLIC (posterior Limb of the Internal Capsule), for example, has … Continue reading →

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Diuretics as Anticonvulsants?

Posted on 16 December 2020 by Keith Barrington

In recent years there has been a lot of interest in neonatal seizures and how to treat them. Older studies confirmed that phenobarbitone (or phenobarbital, I never know these days) appears effective, but with limits; many babies have a partial … Continue reading →

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Do Sub-Ependymal Haemorrhages cause cerebral palsy?

Posted on 15 December 2020 by Keith Barrington

The germinal matrix is a region in the immature brain where a large proportion of cortical neurones are formed before they migrate out to form the neo-cortex. It is intensely metabolically active as it is producing hundreds of thousands of … Continue reading →

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Does intravitreal bevacizumab adversely affect long term development? Two simultaneous systematic reviews say yes, or no.

Posted on 14 December 2020 by Keith Barrington

A reliable answer to the above question would require a large multicentre RCT comparing intravitreal bevacizumab (IVB) to laser, powered for long term outcomes. Such a trial does not currently exist. As a result, 2 groups have just published systematic … Continue reading →

Posted in Neonatal Research | Tagged , , | 4 Comments