Tag Archives: Randomized Controlled Trials

Anti-VEGF vs laser therapy for retinopathy, not worse, but not not worse?

A newer anti-VEGF drug has been invented, and evaluated in retinopathy therapy. This new drug aflibercept works differently to the “-mab” drugs we have been using. Those others are monoclonal antibodies (hence mab) directed against VEGF, whereas this new stuff … Continue reading

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Resuscitation before clamping the cord?

Delayed cord clamping is now standard of care for all deliveries, at term or preterm. In term deliveries it leads to improved iron stores in the baby which difference persists during the first year of life. In very preterm infants … Continue reading

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Erythropoietin does not protect the brain, what next?

The latest trial to fail to find a benefit of erythropoietin (Epo) for neonatal brain protection has just been published (Wu YW, et al. Trial of Erythropoietin for Hypoxic-Ischemic Encephalopathy in Newborns. N Engl J Med. 2022;387(2):148-59). The HEAL trial, … Continue reading

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The list of shame, and the continued shame of the Journal “Pain”

Randomized controlled trials of pain control measures prior to planned painful procedures that have an untreated control group are unethical. I would have thought in 2022 that statement was about as uncontroversial as a statement about ethics could be, nevertheless … Continue reading

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Preventing desaturation during intubation. Shine on, you crazy….

Recommendations for older children and adults during endotracheal intubation frequently include the use of free flow oxygen, indeed when I was a fellow with Neil Finer we routinely provided additional free flow oxygen from a catheter placed near the nose, … Continue reading

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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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