Tag Archives: Randomized Controlled Trials

Surfactant without intubation, where are we?

Posted on 4 February 2016 by Keith Barrington

A recent trial from Germany tried to answer the question of whether giving surfactant through a thin catheter while the baby was on CPAP would reduce “death or BPD” compared to intubation for surfactant. Kribs A, et al. Nonintubated Surfactant Application … Continue reading →

Posted in Neonatal Research | Tagged , , , | 1 Comment

When to deliver after Preterm Ruptured Membranes

Posted on 2 February 2016 by Keith Barrington

I have often wondered why my obstetrical colleagues would often induce labour once a woman with ruptured membranes reached 34 weeks. I wasn’t aware of any data to support doing this, or, on the other hand, any good data to … Continue reading →

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The best outcome variable for very preterm newborns?

Posted on 27 November 2015 by Keith Barrington

Death or ‘neurodevelopmental impairment’ (NDI) as a combined outcome has become a sort of de facto standard as the primary outcome for neonatal clinical trials. Because many very preterm infants have developmental delay, intellectual and learning difficulties, and some have … Continue reading →

Posted in Clinical Practice Guidelines, Neonatal Research | Tagged , , , | 1 Comment

The last nail in the coffin of permissive hypercapnia?

Posted on 24 November 2015 by Keith Barrington

Thome UH, et al. Permissive hypercapnia in extremely low birthweight infants (PHELBI): a randomised controlled multicentre trial. Lancet Respir Med. 2015;3(7):534-43. This German multi-center trial randomized infants 400 to 1000 g birth weight to 2 different CO2 target ranges. The … Continue reading →

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Retinopathy: up or down?

Posted on 17 November 2015 by Keith Barrington

The oxygen saturation targeting trials showed more retinopathy with higher oxygen saturation targets. Will this translate into more retinopathy in actual practice? Many units have increased their saturation targets as a result of those studies. This may indeed lead to … Continue reading →

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Late Surfactant may not be effective, probably.

Posted on 29 October 2015 by Keith Barrington

A large multi-center trial (n=511) led by Roberta Ballard has just been published. (Ballard RA, et al. Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide. J Pediatr 2015.) In this trial infants had similar … Continue reading →

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Early steroids to prevent Chronic Lung Disease; give them directly into the lungs?

Posted on 16 October 2015 by Keith Barrington

Bassler D, et al. Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia. New England Journal of Medicine. 2015;373(16):1497-506. One of those ongoing trials that we have been awaiting the results of has just been published. The NEUROSIS trial was a … Continue reading →

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At least they weren’t worse off.

Posted on 14 October 2015 by Keith Barrington

Fever is a frequent response to infection. The inflammatory response to invading organisms often leads to a febrile reaction, which many have suggested is an adaptive response, that might actually have an evolutionary advantage, and improve survival from serious infections. Of course … Continue reading →

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Many unethical pain studies in newborns

Posted on 23 September 2015 by Keith Barrington

Carlo Bellieni and Celeste Johnston (Conflict of Interest flag, I have collaborated with both of them) have just reviewed a couple of recent years research of analgesic interventions in the newborn. Of 46 randomized studies of painful procedures, 70% had … Continue reading →

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Lower oxygen resuscitation for preterms?

Posted on 15 September 2015 by Keith Barrington

A new publication from a group of us in the CNN, suggests that the answer to that query is ‘not so fast’. Rabi Y, Lodha A, Soraisham A, Singhal N, Barrington K, Shah PS, et al. Outcomes of preterm infants following … Continue reading →

Posted in Neonatal Research | Tagged , , , | 4 Comments