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

It’s not enough to be good

Posted on 16 November 2014 by Keith Barrington

You have to keep practicing as well. The way our health systems are organized has impacts on outcomes. Multiple small centers doing complex surgery and looking after fragile patients only infrequently will likely have poorer outcomes overall. Large centers which … Continue reading →

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Neonatal Updates

Posted on 14 November 2014 by Keith Barrington

I haven’t done one of these for a while, getting too verbose I  guess, but here is a selection of interesting recent articles with just a few sentences about them. Mola-Schenzle E, Staffler A, Klemme M, Pellegrini F, Molinaro G, … Continue reading →

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Comparing Currently Used Treatments

Posted on 14 November 2014 by Keith Barrington

The idea that we should actively and scientifically compare treatments that are in widespread use, but currently with haphazard variations based on poor or no evidence, is a vital part of improving medicine. In my own field, the care of … Continue reading →

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Feeding and NEC

Posted on 14 November 2014 by Keith Barrington

Necrotizing Enterocolitis remains a devastating disease. One of the major causes of mortality in Very Low Birth Weight Infants, it often strikes when babies are starting to do well. Because it is relatively unpredictable, observational studies are potentially useful, but can … Continue reading →

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Frozen poop sounds much more palatable

Posted on 7 November 2014 by Keith Barrington

Fecal transplants are effective in treatment of persistent clostridium difficile infections. The publication showing that, in the small RCT published in the PNEJM, was remarkable in the pre-screened donors who were ready and available to produce a “donation” on demand. … Continue reading →

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Magnesium for brain protection and longer term outcomes.

Posted on 6 November 2014 by Keith Barrington

Two new articles describing the longer term follow up (to school age) of antenatal magnesium, when used for brain protection. 1. Doyle LW, Anderson PJ, Haslam R, Lee KJ, Crowther C, Australasian Collaborative Trial of Magnesium Sulphate Study G. School-age … Continue reading →

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Murky Guidance

Posted on 5 November 2014 by Keith Barrington

After the OHRP meetings and their evaluation of the SUPPORT controversy, the OHRP have now released what they call “Draft Guidance on Disclosing Reasonably Foreseeable Risks in Research Evaluating Standards of Care” The conclusion of the draft guidance starts with … Continue reading →

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What do parents of twins (and the twins) think about randomizing multiples

Posted on 31 October 2014 by Keith Barrington

There has been some controversy recently about how we should randomize twins (and triplets or more) in neonatal trials. The question being whether randomizing the babies independently or randomizing them as a group is preferable. Those who wish to randomize … Continue reading →

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Reassuring Prophylactic Indomethacin Data

Posted on 28 October 2014 by Keith Barrington

One of Annie Janvier’s first research projects was a case control study of the influence of prophylactic indomethacin on intestinal perforations. Under my supervision she analyzed cases of spontaneous intestinal perforation (SIP), and we analyzed the influence of prophylactic indomethacin, … Continue reading →

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Effects of (not very) NICE guidelines

Posted on 27 October 2014 by Keith Barrington

Call me prescient, OK, you won’t, but I will. Two recent observational studies suggest that the recent NICE guidelines have had adverse effects on infants evaluated for potential early neonatal sepsis. ‘NICE’ of course is not an adjective for how good … Continue reading →

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