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

Intestinal perforation in the very preterm, what causes it, and what to do about it.

Posted on 24 September 2021 by Keith Barrington

There are 2 main causes of intestinal perforation in the very preterm, Necrotising Enterocolitis and Spontaneous Perforation. NEC, as I have previously discussed, may be a convenient name for a few different conditions which present in a similar fashion. In … Continue reading →

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Extreme preterm survival and outcomes

Posted on 16 September 2021 by Keith Barrington

There are frequently publications about the outcomes of extreme preterm infants; as a community I think we should be proud of our investment in outcome research. Indeed, neonatologists invented the entire field of outcomes research (Barrington KJ, Saigal S. Long-term … Continue reading →

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Opioid infusions for ventilated preterm babies

Posted on 13 September 2021 by Keith Barrington

Many practices in neonatology are variable between NICUs, and many vary from year to year; without any good scientific data practices become fashionable or routine or ingrained without necessarily having an evidence base to support them. One such practice is … Continue reading →

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Drug use and abuse in the NICU

Posted on 2 September 2021 by Keith Barrington

The title does not refer to”drugs of abuse” but rather to how we use and choose medications for use in newborns, particularly the very immature. A new publication has just appeared on-line which focuses of medication use in the NICU, … Continue reading →

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Pain studies with untreated control groups in babies are unethical.

Posted on 19 August 2021 by Keith Barrington

If you are performing a study of pain control in the newborn and you assign babies to untreated controls, you are creating unnecessary avoidable pain in the control patients. That is true for any patient who is incompetent, obviously including … Continue reading →

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Plug the Lung Until it Grows: the FETO RCTs of antenatal diaphragmatic hernia intervention.

Posted on 18 August 2021 by Keith Barrington

What was at one time called PLUG, and, with the change from open to endoscopic intervention, is now called FETO (fetal endoscopic tracheal occlusion) is a way to harness the normal physiology of the lung in congential diaphragmatic hernia (CDH) … Continue reading →

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What is critical in a “critical sample”?

Posted on 17 August 2021 by Keith Barrington

It is common practice in the evaluation of neonatal hypoglycaemic episodes, especially if unusual or prolonged, to perform a “critical sample”. This is performed to rule out underlying metabolic or endocrine disorders. But what should the critical sample consist of? … Continue reading →

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Two amazing trials, at the opposite ends of the spectrum. What a weird world.

Posted on 27 May 2021 by Keith Barrington

In the most recent NEJM two trials impacting newborn/paediatric care. One including 3,211 preterm infants, which shows that a very simple intervention could save, I estimate, tens of thousands of lives each year at almost no cost; the other with … Continue reading →

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What do you think are meaningful long term outcomes for preterm infants? Give your opinion!

Posted on 13 May 2021 by Keith Barrington

Annie Janvier is part of a group of collaborators who are trying to get multiple opinions about meaningful outcomes in preterm babies. It is part of a project being run by the Canadian Follow-up Network CNFUN, which is called Parent-EPIQ. … Continue reading →

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Which is worse; death or a low Bayley score? Comparing composite outcomes between groups, taking into account clinical priorities.

Posted on 13 May 2021 by Keith Barrington

I keep harping on about this issue as I think we make a mistake in the design of our research studies when we include death and a much less important outcome in composite outcomes. For example in the STOP-BPD trial, … Continue reading →

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