Tag Archives: Sepsis

Early low dose hydrocortisone seems to not affect medium term development; PREMILOC outcomes at 22 months.

Posted on 18 April 2017 by Keith Barrington

The PREMILOC trial was a multi-center RCT of hydrocortisone, 0.5mg/kg twice per day for 7 days followed by 0.5 mg/kg per day for 3 days, given starting within 24 hours of age to infants of 24 to less than 28 … Continue reading →

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Reducing antibiotic use in full term babies.

Posted on 27 January 2017 by Keith Barrington

Early onset neonatal sepsis currently has an incidence in North America among term infants of about 0.5 to 1 per thousand live births. But 15% of newborn infants have risk factors and they end up receiving antibiotics if current guidelines … Continue reading →

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Neonatal Sepsis after Chorioamnionitis, what to do about healthy appearing newborns

Posted on 23 November 2016 by Keith Barrington

In 2007, when I was chair of the CPS Fetus and Newborn Committee, we published a guideline regarding the approach to term and late preterm infants with perinatal risk factors for sepsis. Obviously any infant with clinical signs consistent with … Continue reading →

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Culture negative sepsis: what is it?

Posted on 27 May 2016 by Keith Barrington

One of the things that I have wondered about over the years is whether infants who appear to be infected, but who have negative cultures, might have viral infections. A new study suggests that this is not rare. Kidszun A, et … Continue reading →

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The microbiome of plastic tubes in children

Posted on 16 May 2016 by Keith Barrington

Petersen SM, et al. Nasogastric feeding tubes from a neonatal department yield high concentrations of potentially pathogenic bacteria – even one day after insertion. Pediatr Res. 2016.  These authors cultured 94 nasogastric feeding tubes from 34 preterm infants. 1 ml … Continue reading →

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Is breast-milk really best?

Posted on 11 May 2016 by Keith Barrington

Although many people (including myself) are convinced that human breast milk is the preferable nutrition for human babies, including the preterm, some of the evidence regarding benefits is shaky. For example the evidence that breast milk feeding reduces late-onset sepsis. … Continue reading →

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TPN toxic?

Posted on 28 March 2016 by Keith Barrington

Humans, after they are born, are supposed to receive their nutrition via the gut. Before that of course, they receive a continuous infusion of nutrition via the umbilical vein. We are far from having an intravenous nutrition mixture for sick … Continue reading →

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Lacuna trial now in print

Posted on 10 March 2016 by Keith Barrington

Now available on-line the pilot trial of lactoferrin prophylaxis that I performed at Sainte Justine. (Barrington KJ, Assaad M-A, Janvier A. The Lacuna Trial: a double-blind randomized controlled pilot trial of lactoferrin supplementation in the very preterm infant. J Perinatol. … 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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NICUs are working better: still room for improvement.

Posted on 11 September 2015 by Keith Barrington

As NICUs have become more effective, any proportional incremental improvements will necessarily get smaller, so larger and larger datasets will be needed to show any trends. The NICHD has just published data about survival and major acute morbidities among extremely … Continue reading →

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