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

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 →

Posted in Neonatal Research | Tagged , , | 11 Comments

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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Why is MOM best? part 2

Posted on 10 October 2019 by Keith Barrington

MOM is best, because it leads to the lowest incidence of NEC; but why? (if you didn’t read part 1, MOM is Mother’s Own Milk) The impacts of milk processing which create the differences in milk composition, detailed in my … Continue reading →

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Why is MOM best?

Posted on 10 October 2019 by Keith Barrington

Mother’s Own Milk (MOM) seems to be the best base for enteral nutrition of the preterm infant, in terms of the risk of infection, the risk of Enterocolitis (NEC) and, probably, long term neurodevelopment. Reasonably good data show that replacing … Continue reading →

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Dr William Meadow 1948-2019

Posted on 20 September 2019 by Keith Barrington

A sad way to fire up the blog after a long summer break. My good friend and colleague, Bill Meadow, died a few days ago. I first got to know Bill when I was junior faculty in Edmonton. At that … Continue reading →

Posted in Neonatal Research | 3 Comments

Are these data relevant to my practice?

Posted on 21 June 2019 by Keith Barrington

A couple of recent published trials have made me wonder about that question, and how to assess if an impact suggested by the results of a trial might be relevant to how I practice, and would likely be reproduced if … Continue reading →

Posted in Neonatal Research | 1 Comment

Pulse Oximetry screening; a bizarre decision in the UK.

Posted on 20 June 2019 by Keith Barrington

Universal pulse oximetry screening for critical congenital heart disease is a simple cheap addition to universal hearing and metabolic screening with undeniable benefits. Infants with undiagnosed life threatening congenital heart disease can be detected prior to closure of the ductus … Continue reading →

Posted in Neonatal Research | Tagged , | 1 Comment