Tag Archives: Randomized Controlled Trials

Supporting oxygen limits

The initial results of the SUPPORT trial examining the effects of different oxygen limits stopped a lot of us in our tracks. We started these trials because most of us thought that aiming for lower oxygen saturation targets would reduce … Continue reading →

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Testing treatments

Imogen Evans, Hazel Thornton, Iain Chalmers, and Paul Glasziou have written a great book about why we need to do clinical trials, with introductory chapters about how they should be done. The second edition of their book is available free … Continue reading →

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New agents for hemodynamic support; how to evaluate them?

I have only ever prescribed a vasopressin infusion once for a baby. An infant was dying of septic shock and I done everything that I thought might help, without any evident benefit. So I decided to try vasopressin, based on … Continue reading →

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Erythromycin: not another toxic placebo!

Erythromycin is an antibiotic. This much is true. It is active against mycoplasma and against ureaplasmas, but is very poor at actually eradicating them. It also stimulates motilin receptors in the bowel, that is why it increases bowel activity, and … Continue reading →

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More about reflux: anti-acid medications may also be toxic placebos

While I am still finalizing my long overdue chapter on gastro-esophageal reflux (sorry Sanjay if you are reading this, it is on its way, honestly) I have been reviewing the data on acid blockade as a potential treatment. Probably the … Continue reading →

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Premedication for Intubation

There are several studies of what premedication should be used for intubation of the newborn. An analgesic or anesthetic agent should be given in to reduce pain, which also reduces the adverse physiologic consequences of the intubation. Several studies of … Continue reading →

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Feeding patterns and NEC

I have discussed before evidence about whether the pattern of introduction or advancement of feeds affects NEC.  I noted that there is only one out of a large number of trials of feeding introduction and advancement which has shown an … Continue reading →

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Chloride is toxic

I think we have given too little attention to the nature of the crystalloid solutions we use. Not just in neonatology, but apparently in the adult ICU also,  (Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M: Association between … Continue reading →

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Glutamine supplementation, just when you thought it was solved…

Glutamine is one of the most abundant amino acids in our bodies, but there is relatively little in TPN as it is poorly soluble. During the first few days of limited enteral nutrition preterm babies receive little glutamine from any … Continue reading →

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Early Detection of Sepsis in the NICU

This came out before I started my blog, but think it is very important. I was reminded that I had never mentioned it on this blog when I met Joseph Randall Moorman at the airport on the way back from … Continue reading →

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