Tag Archives: Randomized Controlled Trials

Antenatal Steroids at 36 weeks?

Posted on 11 February 2016 by Keith Barrington

Most of the studies of antenatal steroids for lung maturation included mothers at less than 34 weeks. Most babies at 34 to 36 weeks do fine, although there is a growing realization of their increased long term risks. Even the … Continue reading →

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Preventing and Treating Sepsis in Preterm Babies

Posted on 10 February 2016 by Keith Barrington

These two studies are both issues that I am involved with, Theresa Ochoa’s study I was aware of, and was waiting for the full publication, the other, from Egypt, I didn’t know about but should have done, but it confirms … Continue reading →

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Enhanced Nutrition

Posted on 9 February 2016 by Keith Barrington

Strømmen K, et al. Enhanced Nutrient Supply to Very Low Birth Weight Infants is Associated with Improved White Matter Maturation and Head Growth. Neonatology. 2015;107(1):68-75. This is a report of a secondary outcome of a small RCT, there were only … Continue reading →

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The death knell for Xenon?

Posted on 4 February 2016 by Keith Barrington

Azzopardi D, et al. Moderate hypothermia within 6 h of birth plus inhaled xenon versus moderate hypothermia alone after birth asphyxia (TOBY-Xe): a proof-of-concept, open-label, randomised controlled trial. The Lancet Neurology. 2016;15(2):145-53.  Babies who undergo therapeutic hypothermia for perinatal encephalopathy … Continue reading →

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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 →

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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 →

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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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