Category Archives: Neonatal Research

Evidence-based neonatology, or science based neonatology?

Posted on 14 April 2022 by Keith Barrington

To many followers of this blog, the title may seem a little strange; is there any difference? Surely science underlies all of our field, and testing treatments in adequately designed trials leads to progressive improvements through the application of evidence-based … Continue reading →

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Antenatal steroids prior to late preterm delivery; still many questions, but a major shift in practice.

Posted on 7 April 2022 by Keith Barrington

It can sometimes take years for major advances in medicine, based on clear evidence of improved outcomes, to lead to shifts in practice. One example is the initial demonstration by Liggins and Howie that antenatal steroids (ANS) improved survival of … Continue reading →

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Preterm babies, PLEASE don’t smoke!

Posted on 5 April 2022 by Keith Barrington

One of the most addictive and harmful drugs of all is perfectly legal. Tobacco, and the nicotine it contains, are subject to prohibition for adults nowhere in the world, despite millions of deaths, prolonged severe disability, and being probably as … Continue reading →

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We need to rethink neonatal hypoglycaemia

Posted on 4 April 2022 by Keith Barrington

A great deal of time and effort is expended to detect and treat low blood sugars in the newborn. Studies to determine risk factors, monitoring schedules, and treatment strategies have taken a great deal of effort, and implementing the recommended … Continue reading →

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Steroids to improve pulmonary outcomes in preterm infants.

Posted on 29 March 2022 by Keith Barrington

When we consider using steroids in a preterm infant, ventilator dependent, with evolving lung disease, what outcomes are we most interested in? Survival, surely, is the first outcome that we want to improve, and secondly long-term pulmonary health. The adverse … Continue reading →

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Hydrocortisone, with backup dexamethasone, to prevent Bronchopulmonary Dysplasia

Posted on 28 March 2022 by Keith Barrington

A trial that has been awaited for a while has just been published (Watterberg KL, et al. Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia. N Engl J Med. 2022;386(12):1121-31). It was a multi-centre RCT of hydrocortisone in 800 very preterm … Continue reading →

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Dexmedetomidine: new wonder drug or next neonatal disaster?

Posted on 23 March 2022 by Keith Barrington

In many units, including my own, dexmedetomidine (DXM) has been creeping into use. Initially, we noticed in some full term babies who returned from the operating room, the medication appeared in the anaesthesia record, then when infants returned occasionally with … Continue reading →

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Common interventions for common conditions; what do they have in common? A lack of evidence.

Posted on 21 March 2022 by Keith Barrington

There are a number of problems in neonatal care for which good evidence is lacking, and an evidence based approach is therefore not really possible. Two recent reviews highlight this problem. The first is a systematic review of tactile stimulation … Continue reading →

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Composite outcomes for research; this is how to do it!

Posted on 21 March 2022 by Keith Barrington

As regular readers of the blog will know, I have been very critical of some very important, otherwise excellent, trials over one vital part of their design, that is, the use of composite outcomes such as “death or BPD”, “death … Continue reading →

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Should we give up on nebulised surfactant?

Posted on 17 March 2022 by Keith Barrington

A new RCT of curosurf given by nebulisation was published shortly after a systematic review of the previous data. The RCT showed no real benefit, whereas the SR suggested efficacy. The RCT first, this international trial (Dani C, et al. … Continue reading →

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