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

International variations in outcomes of extreme preterm infants

Posted on 9 December 2019 by Keith Barrington

A publication from an international collaboration of neonatal databases has just appeared, (Lui K, et al. Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries. J Pediatr. 2019). It makes very interesting … Continue reading →

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Platelet transfusion threshholds: 25,000 even for the highest risk infants?

Posted on 6 December 2019 by Keith Barrington

The Planet-2 trial that I posted about when it first came out showed no benefit among preterm infants, <34 weeks gestation when they received platelet transfusions at a threshold of 50,00 compared to waiting until they dropped to 25,000. I … Continue reading →

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Diazoxide for hyperinsulinism? Not so fast

Posted on 5 December 2019 by Keith Barrington

Infants with congential persistent hyperinsulinism have been treated for years with diazoxide, well before many of the genetic mutations underlying the condition were known (there are now at least 14 of them!). Diazoxide seems to be relatively well tolerated in … Continue reading →

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Donor human milk for congenital heart disease?

Posted on 26 November 2019 by Keith Barrington

Newborns with serious Congenital Heart Disease are at risk of intestinal injury which may present in a similar fashion to Necrotising Enterocolitis (NEC). Our local guidelines for eligibility for donor milk from our provincial milk bank include infants with significant … Continue reading →

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Where does sepsis come from?

Posted on 25 November 2019 by Keith Barrington

One of the findings of the recent SIFT trial was that although the babies in the fast feeding group had shorter duration of parenteral nutrition, TPN, (and presumably of central lines), they did not have less late-onset sepsis, LOS. Why … Continue reading →

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Progesterone doesn’t prevent prematurity?

Posted on 25 November 2019 by Keith Barrington

Progesterone analogues, including 17-OH progesterone caproate have been investigated over the last several years for prevention of prematurity. In the pivotal trial from 2003 17OHPC intramuscularly once per week was shown to reduce prematurity at less than 37 weeks, less … Continue reading →

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Eye exams for fewer babies

Posted on 17 October 2019 by Keith Barrington

In Canada, the current Canadian Pediatric Society recommendations, dating from 2016 are to screen infants for retinopathy of prematurity with Gestational Age <31 weeks or Birth weight <1,251 g. These recommendations are already somewhat more restrictive than other countries, in … Continue reading →

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Not futile any more; survival and long term outcomes at 22 weeks.

Posted on 15 October 2019 by Keith Barrington

Imagine, if you will, that you work at a breast cancer center with moderately good results, but you have decided, as a group, to not offer therapy to women with stage 4- triple negative lesions. Survival is so low, you … Continue reading →

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How fast to feed?

Posted on 14 October 2019 by Keith Barrington

One of the recurring themes in this blog is that good, large enough, prospective RCTs do not necessarily reproduce the results of prior smaller trials, and often do not reproduce the findings of observational studies. Specifically, I have mentioned previously … Continue reading →

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Should we try?

Posted on 11 October 2019 by Keith Barrington

Arnolds M, et al. Worth a Try? Describing the Experiences of Families during the Course of Care in the Neonatal Intensive Care Unit When the Prognosis is Poor. The Journal of pediatrics. 2018;196:116-22 e3. A few times a year many … Continue reading →

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