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

Probiotics might save lives in low-resource countries

Posted on 5 February 2018 by Keith Barrington

After several years of preliminary investigations,  a huge RCT has been published from India (Panigrahi P, et al. A randomized synbiotic trial to prevent sepsis among infants in rural India. Nature. 2017;548:407.) which enrolled babies over 2 kg birth weight … Continue reading →

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Endotracheal intubation, making it safer for babies

Posted on 5 February 2018 by Keith Barrington

Many of our patients need invasive ventilatory support, for which endotracheal intubation is required, but we intubate many fewer babies than in the past. We also very rarely intubate babies for endotracheal suction to remove meconium any longer. Which means … Continue reading →

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Does tactile stimulation in the delivery room actually do anything?

Posted on 2 February 2018 by Keith Barrington

One of the things that is done in neonatal resuscitation that isn’t part of resuscitating older patients is tactile stimulation. Babies who are apneic and/or floppy often receive stimulation in the form of rubbing the back, patting or flicking the … Continue reading →

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New Published Letter, a response to the ‘number needed to suffer’.

Posted on 2 February 2018 by Keith Barrington

The new issue of Acta Paediatrica (Februray 2018) includes a letter I wrote in response to a commentary written by a paediatric anaesthetist, Dr Lönnqvist. If you receive an email with a description of the contents of each issue, as … Continue reading →

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Curing genetic diseases

Posted on 18 January 2018 by Keith Barrington

One of the most difficult things that we have to deal with, as neonatologists and pediatricians, is to announce the diagnosis of a lethal, or a lifelong life-changing, genetic diagnosis. Spinal Muscular Atrophy (Werdnig-Hoffman disease), and Haemophilia A are 2 … Continue reading →

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Inhaled Steroids to Prevent BPD? Think again… again!

Posted on 16 January 2018 by Keith Barrington

The NEUROSIS trial that I discussed in my previous post has, among other published trials, most in common with the trial by Nakamura published in 2016. Nakamura T, et al. Early inhaled steroid use in extremely low birthweight infants: a … Continue reading →

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Inhaled steroids to prevent BPD? Think again…

Posted on 15 January 2018 by Keith Barrington

The NEUROSIS trial was a high quality trial of inhaled budesonide started before 12 hours in extremely preterm infants (23 to <28 weeks gestation) receiving positive pressure respiratory support. The primary outcome of the trial was survival without needing oxygen … Continue reading →

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Pre-discharge MRI for the very preterm infant?

Posted on 18 December 2017 by Keith Barrington

For a pre-christmas present, one of the most important recent studies in neonatology. The study is related to the following question: if I wanted to know how best to counsel my very preterm baby parents about potential long-term outcomes, when … Continue reading →

Posted in Neonatal Research | 4 Comments

Time to abandon the Papile classification? (part 3)

Posted on 7 December 2017 by Keith Barrington

What should we do now? I think we should stop using the Papile classification. We should clarify that an intraventricular hemorrhage with acute hemorrhagic dilatation of the ventricle(s) is not the same pathophysiology as a hemorrhage followed by dilatation. (stage … Continue reading →

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Time to abandon the Papile classification? (part 2)

Posted on 7 December 2017 by Keith Barrington

As I mentioned in the last post, the initial report of outcomes by Bassan and others showed that the infants with severity score 0, (unilateral haemorrhage without midline shift affecting one zone) had reasonably good outcomes, 7 of 8 had … Continue reading →

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