Tag Archives: Resuscitation

Making intubation safer for the most fragile babies

Posted on 31 October 2022 by Keith Barrington

Many, many years ago, when I was a young trainee physician, we learned almost everything “on the job”. I can’t remember the first patient I intubated, but there were no mannequins, and no simulations, the phrase “see one, do one, … Continue reading →

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Cord milking and resuscitation, an alternative?

Posted on 2 September 2022 by Keith Barrington

My recent posts about resuscitation with an intact cord were rapidly followed by a publication of another multicentre randomized controlled trial, this time a cluster randomized crossover trial, of cord milking in babies who needed intervention. (Katheria AC, et al. … Continue reading →

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Resuscitation before clamping the cord, some physiologic considerations

Posted on 30 August 2022 by Keith Barrington

Delaying cord clamping until respiration is well established is a physiologically pleasing approach, and avoids the dramatic decrease in left ventricular preload, simultaneously with an increase in afterload that occurs with early clamping. But does delaying clamping during positive pressure … Continue reading →

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Resuscitation before clamping the cord?

Posted on 29 July 2022 by Keith Barrington

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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Common interventions for common conditions; what do they have in common? A lack of evidence.

Posted on 21 March 2022 by Keith Barrington

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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Survival and outcomes for the extremely preterm. The NICHD network results continue to improve: Can we do even better?

Posted on 20 January 2022 by Keith Barrington

A new publication from the NRN describes short term outcomes and care practices of babies from 22 to 28 weeks gestation born in recent years (2013 to 2018) and for those born in 2013-2016 results of evaluations of those followed … Continue reading →

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How do we make decisions for the most immature babies, with their families?

Posted on 10 January 2022 by Keith Barrington

Although babies under 25 weeks account for a tiny proportion of births, and a small proportion of NICU admissions, the importance of the question asked in the title can be seen by the ongoing number of publications, below are just … 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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Oropharyngeal airways for resuscitation of the preterm? Throw them away!

Posted on 18 December 2019 by Keith Barrington

When I saw the title of this new study I thought immediately this has to either be by Peter Davis or one or more of his disciples… former trainees, I mean. In fact it is both: Kamlin COF, et al. … Continue reading →

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