Tag Archives: Randomized Controlled Trials

Cardiovascular support in the preterm, how to determine adequate perfusion?

Posted on 17 January 2022 by Keith Barrington

As many of you will know, I have advocated for many years for evaluation and management of very preterm babies based on their tissue perfusion rather than the blood pressure. There is little or no correlation between BP and perfusion, … Continue reading →

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STOP-BPD follow up study

Posted on 13 January 2022 by Keith Barrington

Does routine hydrocortisone, started at 7 to 14 days of age among infants <30 weeks GA and/or <1250g birth weight who were ventilator dependent and at increased risk for BPD, affect their long term developmental progress? (Halbmeijer NM, et al. … Continue reading →

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Antenatal treatment of Diaphragmatic Hernia, indications for intervention.

Posted on 12 January 2022 by Keith Barrington

My previous post about the FETO trials noted that the published trials reported a clear benefit of antenatal treatment of the highest risk group, but the moderate risk group had an improved outcome which didn’t meet classic definitions of statistical … Continue reading →

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Ethically acceptable pain research

Posted on 12 January 2022 by Keith Barrington

Just imagine for a moment that you are the parent of Jo, who is 4 years old, Jo has a sudden onset of breathlessness and the investigations in the Emergency Room show a spontaneous pneumothorax, that needs a drain. You … Continue reading →

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Unethical pain research in the newborn. A list of shame.

Posted on 11 January 2022 by Keith Barrington

Unethical pain studies are still being published, in journals which include several from mainstream publishing houses. In these studies published recently and appearing on-line in recent weeks, newborn infants were assigned by the researchers to experience pain. The reviewers of … Continue reading →

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Should we treat electrographic seizures?

Posted on 6 January 2022 by Keith Barrington

In order to answer the question posed in the title you would need to take babies at risk of seizures, but not yet having clinically diagnosed convulsions, randomize them to have routine continuous EEG monitoring or not and then treat … Continue reading →

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Was OPTIMIST too optimistic?

Posted on 5 January 2022 by Keith Barrington

One of the trials we have been waiting for has just been published Dargaville PA, et al. Effect of Minimally Invasive Surfactant Therapy vs Sham Treatment on Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome: The OPTIMIST-A … Continue reading →

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Neonatal Updates

Posted on 18 October 2021 by Keith Barrington

It’s a long time since I did one of these, but there were several publications that I thought warranted a quick comment. Abbey NV, et al. Electrocardiogram for heart rate evaluation during preterm resuscitation at birth: a randomized trial. Pediatr … Continue reading →

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Delivering better CPAP in the delivery room, can we avoid intubation in the most immature babies?

Posted on 7 October 2021 by Keith Barrington

Randomized trials have shown that trying to prevent intubation in the DR leads to less severe lung injury. The Cochrane review of prophylactic CPAP compared to immediate intubation included 3 trials (SUPPORT, COIN and DR Management study), that review found … Continue reading →

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

Posted on 24 September 2021 by Keith Barrington

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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