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

22 to 23 weeks gestation, what is so special?

Posted on 27 March 2024 by Keith Barrington

I was confused by this new article published in the Journal of Pediatrics. I really don’t understand what the point of it is, except to try and discourage intensive care for one particular group of high risk babies (Guillen U, … Continue reading →

Posted in Neonatal Research | 6 Comments

Oxygen is toxic in older kids too!

Posted on 22 February 2024 by Keith Barrington

A new large RCT from PICUs in the UK randomly compared 2 saturation target ranges, 88-92 and >94%. (Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial. … Continue reading →

Posted in Neonatal Research | Tagged , , | 4 Comments

Donor human milk, not toxic after all!

Posted on 31 January 2024 by Keith Barrington

It was fairly recently that I deconstructed a truly terrible database analysis which claimed that neonatal mortality was dramatically increased among very preterm infants who received mother’s own milk (MoM) and donor human milk (DHM), without any formula or fortifier, … Continue reading →

Posted in Neonatal Research | Tagged , , , | 1 Comment

Is there any indication to close the PDA?

Posted on 26 January 2024 by Keith Barrington

Yet another trial of PDA treatment and attempted closure with a null result. Baby-OSCAR was a UK multi-center masked RCT of ibuprofen treatment of 23 to <29 week infants who were screened with echocardiogram within the first 72 hours of … Continue reading →

Posted in Neonatal Research | Tagged , , | 2 Comments

Time to open the DOOR

Posted on 17 January 2024 by Keith Barrington

I have written many times about the problems with classical composite outcomes in neonatal research. “Death or BPD”, “death or NDI”, or sometimes “death or NEC or Sepsis or BPD or severe IVH” have been used as a way of … Continue reading →

Posted in Neonatal Research | Tagged , , | 1 Comment

To bolus or not to bolus? Not really a question…

Posted on 19 December 2023 by Keith Barrington

Many preterm babies receive boluses of normal saline, often during the first 24 hours when their blood pressure is lower than desired. I have 3 serious questions about this. The rationale for giving a fluid bolus is that the infant … Continue reading →

Posted in Neonatal Research | Tagged , | 3 Comments

Early routine surfactant, method and outcomes

Posted on 13 December 2023 by Keith Barrington

Two important new studies of the use of very early routine surfactant, compared to later selective surfactant if necessary. The first I will discuss is the one that didn’t seem to improve any important clinical outcomes (Murphy MC, et al. … Continue reading →

Posted in Neonatal Research | 1 Comment

Umbilical cord management at birth for preterm infants

Posted on 24 November 2023 by Keith Barrington

The Lancet just published back-to-back articles from the iCOMP collaborative reporting the results of the Individual Patient Data Meta-analysis of trials of differing cord management techniques in preterm infants. There were 48 trials with a total of 7000 patients in … Continue reading →

Posted in Neonatal Research | Tagged , , , , | 1 Comment

Which Probiotic is Preferable?

Posted on 21 November 2023 by Keith Barrington

The word “probiotic” is defined rather vaguely as a micro-organism which has beneficial health impacts. I think it is obvious that there is a huge difference between fungi that are found in the intestinal microbiome of adults, and the lactic … Continue reading →

Posted in Neonatal Research | Tagged , , , , | 2 Comments

Do probiotics only work in bigger babies? What is the risk-benefit of routine probiotics in the extremely preterm?

Posted on 13 November 2023 by Keith Barrington

The recent statement from the AAP and a recent review article both state that probiotics only appear to be effective in babies over 1000g birthweight. This would be remarkable if it were true. I am trying to think of another … Continue reading →

Posted in Neonatal Research | Tagged , , , , , | 1 Comment