Tag Archives: Randomized Controlled Trials

Why doesn’t closing the PDA help preterm infants?

Posted on 12 December 2025 by Keith Barrington

I have been continuing to think about this issue, so will subject you all to some of my thoughts. The large RCTs of medication for closure of the PDA show no benefit, and some evidence of harms, but we all … Continue reading →

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Should we ever close the PDA?

Posted on 10 December 2025 by Keith Barrington

The latest large multicentre RCT has just been published. Laughon MM, et al. Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants. JAMA. 2025. In this trial, infants of 22 to 28 weeks GA were randomized at between … Continue reading →

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Is this article trustworthy?

Posted on 21 November 2025 by Keith Barrington

There are many ways that an article in the medical literature may not be worthy of trust, and whose results may be unreliable. I remember one of my own trials, LACUNA, which was a pilot RCT of lactoferrin supplementation to … Continue reading →

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Face masks for resuscitation?

Posted on 12 November 2025 by Keith Barrington

Blank DA, et al. Face mask versus nasal mask device use for initial resuscitation in extremely and very preterm infants (FONDUE): an open-label, single-centre, randomised, controlled trial. Lancet Child Adolesc Health. 2025;9(10):715–23. An excellent acronym for this trial. Hopefully it … Continue reading →

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Clinical examination and treatment of septic shock. Not neonatology.

Posted on 7 November 2025 by Keith Barrington

Andromeda-Shock-2 Investigators for the Andromeda Research Network SSoAR, et al. Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial. JAMA. 2025. This is a very interesting trial evaluating the usefulness of clinical assessment … Continue reading →

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Lactoferrin supplementation does not prevent late-onset sepsis in the preterm… or is it more complicated that that?

Posted on 6 November 2025 by Keith Barrington

Many of my readers will remember the impressive results of the high-quality study by Paolo Manzoni, Manzoni P, et al. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA. 2009;302(13):1421–8) which showed that … Continue reading →

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Return to the Regression to the Mean

Posted on 5 November 2025 by Keith Barrington

After my post on regression to the mean, and its importance in studies of apnoea therapy, I was thinking of other examples. Some which have been most evident to me are those which impact on areas of medicine that I … Continue reading →

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Beware of meta-analysis factories

Posted on 4 November 2025 by Keith Barrington

I mentioned in my previous post, an issue with meta-analyses; there have been several I have read recently which are very problematic. They seem to be produced by groups that have little concern for the quality of their product. This … Continue reading →

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Do blood transfusions treat apnoea of prematurity?

Posted on 3 November 2025 by Keith Barrington

There has for a long time been a thought that anemic babies with many apnoeas could benefit from a blood transfusion which would decrease their apnoeic spells. This idea has never been directly tested by an RCT. That is, a … Continue reading →

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Non-invasive high-frequency oscillation; worth the hassle?

Posted on 29 October 2025 by Keith Barrington

Non-invasive HFOV can be delivered by a variety of different equipment and interfaces. The high flows and upper airway turbulence probably have an impact on gas exchange; It appears that the effective dead space of the oro-nasopharynx is washed out … Continue reading →

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