Tag Archives: long term outcomes

Intestinal perforation in the very preterm, what causes it, and what to do about it.

There are 2 main causes of intestinal perforation in the very preterm, Necrotising Enterocolitis and Spontaneous Perforation. NEC, as I have previously discussed, may be a convenient name for a few different conditions which present in a similar fashion. In … Continue reading

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Extreme preterm survival and outcomes

There are frequently publications about the outcomes of extreme preterm infants; as a community I think we should be proud of our investment in outcome research. Indeed, neonatologists invented the entire field of outcomes research (Barrington KJ, Saigal S. Long-term … Continue reading

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Opioid infusions for ventilated preterm babies

Many practices in neonatology are variable between NICUs, and many vary from year to year; without any good scientific data practices become fashionable or routine or ingrained without necessarily having an evidence base to support them. One such practice is … Continue reading

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Longer-term outcomes: what should we measure? part 2

I have made my concerns about developmental screening tests including the Bayley clear over the years, including in the previous post, which might make what I am going to say now seem odd: I do not think we should stop … Continue reading

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Longer term outcomes; what should we measure? part 1.

Many important trials include follow-up to about 2 years in order to ascertain longer-term effects. Such as this one: Adams-Chapman I, et al. Neurodevelopmental outcome of preterm infants enrolled in myo-inositol randomized controlled trial. J Perinatol. 2021. Ira Adams-Chapman was … Continue reading

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When should we transfuse preterm babies, and why? Redux.

The TOP trial has just been published in the FPNEJM (Kirpalani H, et al. Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants. N Engl J Med. 2020;383(27):2639-51). It was a multicenter, non-masked RCT among 1800 babies of less than … Continue reading

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Should all asphyxiated babies have MR spectroscopy?

MRI post-asphyxia, and post-rewarming, seems to be more predictive of long term outcomes than MRI at term for preterm infants. Imaging and analysis of the Apparent Diffusion Coefficient in the PLIC (posterior Limb of the Internal Capsule), for example, has … Continue reading

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Do Sub-Ependymal Haemorrhages cause cerebral palsy?

The germinal matrix is a region in the immature brain where a large proportion of cortical neurones are formed before they migrate out to form the neo-cortex. It is intensely metabolically active as it is producing hundreds of thousands of … Continue reading

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Does intravitreal bevacizumab adversely affect long term development? Two simultaneous systematic reviews say yes, or no.

A reliable answer to the above question would require a large multicentre RCT comparing intravitreal bevacizumab (IVB) to laser, powered for long term outcomes. Such a trial does not currently exist. As a result, 2 groups have just published systematic … Continue reading

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Three trials with null results, how should we respond?

These 3 articles have just been published, all show no difference in long term outcomes between the randomized groups. What does that mean for the impact on therapeutic decision-making? Natalucci G, et al. Neurodevelopmental Outcomes at Age 5 Years After … Continue reading

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