Tag Archives: Randomized Controlled Trials

Automated oxygen control, what’s taking so long?

A long long time ago, in a galaxy… actually quite near here, the idea of servo control of inspired oxygen was already in the air. At the time I first heard about it, the idea was to control FiO2 based … Continue reading

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

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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Steroids to improve pulmonary outcomes in preterm infants.

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

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

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!

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?

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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Should we feed insulin to preterm babies?

This was an idea I had not heard about prior to seeing this newly published trial (Mank E, et al. Efficacy and Safety of Enteral Recombinant Human Insulin in Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr. 2022). The introduction … Continue reading

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Speak French to your babies (or Chinese) in the NICU

This is a fascinating study from Columbus Ohio in mildly preterm babies when they reached term. (Richard C, et al. Randomized Trial to Increase Speech Sound Differentiation in Infants Born Preterm. J Pediatr. 2021) We know that prematurity and NICU … Continue reading

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Probiotics in preterms; what’s new? Part 2

Rao S, et al. Probiotic supplementation in neonates with congenital gastrointestinal surgical conditions: a pilot randomised controlled trial. Pediatr Res. 2022. When we started using probiotics there had been a couple of case reports of probiotic associated sepsis in infants … Continue reading

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