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Meta
Author Archives: Keith Barrington
Does LISA protect your brain?
A few years ago now a multicenter RCT among infants of 23 to 26 weeks gestation showed that LISA was possible in even these most immature infants., NINSAPP. Kribs A, et al. Nonintubated Surfactant Application vs Conventional Therapy in Extremely … Continue reading
Posted in Neonatal Research
Tagged long term outcomes, Randomized Controlled Trials, surfactant treatment
1 Comment
Delayed cord clamping in the very preterm
I haven’t written about this issue in a while, the APTS trial, and the systematic review which was published at about the same time appeared to show definitively that there was a reduction in mortality with delayed clamping compared to … Continue reading
Diagnosing seizures in the newborn: a small step forward
The use of continuous EEG has become much more frequent in the NICU in recent years. It has become clear that clinical recognition of seizures, both those with and without clinical convulsions (which I will call electrographic seizures for all … Continue reading
Dexamethasone ENT doses
Although we have a great group of ENT surgeons at my hospital, we do have one bone of contention; at least, there is just one bone left since they have agreed that you cannot diagnose reflux by performing a laryngoscopy! … Continue reading
Posted in Neonatal Research
Tagged Randomized Controlled Trials, respiratory support, steroids, Systematic Reviews
1 Comment
Probiotics: are they cost effective?
Like almost any intervention in the NICU (even maternal breast milk requires pumps and equipment, and kangaroo care requires chairs) there is some cost associated with routine probiotic administration. A new publication attempts to calculate the cost-effectiveness relationship. (Craighead AF, … Continue reading
Posted in Neonatal Research
Tagged Cost effectiveness, Necrotising Enterocolitis, Probiotics
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Probiotics, can’t get enough…
All probiotics are not equal. I think it is clear, for example, that the probiotic fungi (Saccharomyces) studied in 2 small trials had no impact on NEC. In addition one of the largest and best trials (PiPS) from the UK … Continue reading
Posted in Neonatal Research
Tagged microbiome, Necrotising Enterocolitis, Probiotics
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Probiotics save the lives of preterm infants. Find a reliable source.
The American Gastroenterological Association has recently published its guidance about probiotics for various conditions. They found little evidence of benefit for most indications with the probable exception of preventing antibiotic-associated diarrhoea. The 8th indication that they reviewed was the prevention … Continue reading
Posted in Neonatal Research
Tagged Necrotising Enterocolitis, Probiotics, Systematic Reviews
6 Comments
Lactoferrin: Does it decrease late-onset sepsis?
The first multicentre trial of bovine lactoferrin supplementation in preterm infants showed a dramatic reduction in late-onset sepsis of about 70%. I was very excited when I first saw Paolo Manzoni’s trial and rushed to set up a pilot in … Continue reading
Posted in Neonatal Research
Tagged Lactoferrin, Randomized Controlled Trials, Sepsis, Systematic Reviews
1 Comment
When should we start Parenteral Nutrition?
Following on from the previous post: This all brings me to a larger and very thorny issue, which is whether we should even be routinely starting parenteral nutrition (PN) immediately after birth at all! I hate to discuss this, as … Continue reading
Posted in Neonatal Research
Tagged enteral feeding, nutrition, Parenteral Nutrition, Randomized Controlled Trials
4 Comments
How much Intravenous lipid should we start with?
Since I started neonatology (just a little over 5 years ago…) we have given intravenous lipid emulsions starting at low doses and progressively increasing. As a reminder to everyone, when intralipid (as I will call it to refer to all … Continue reading
Posted in Neonatal Research
Tagged growth, Parenteral Nutrition, Randomized Controlled Trials
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Neonatal Research 