Tag Archives: Systematic Reviews

Reducing pain from retinopathy screening

Retinopathy screening is undoubtedly painful for preterm babies, formal evaluation with PIPP scores routinely exceed 10 during screening, and may exceed 14, meaning moderate to severe pain. As a planned procedure there is always opportunity for pre-emptive analgesia prior to … Continue reading

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The list of shame, and the continued shame of the Journal “Pain”

Randomized controlled trials of pain control measures prior to planned painful procedures that have an untreated control group are unethical. I would have thought in 2022 that statement was about as uncontroversial as a statement about ethics could be, nevertheless … Continue reading

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Long term impacts of antenatal steroids

To return to a concern expressed in a recent blog, there are animal models and some observational data that suggest that antenatal steroids (ANS) could have a negative effect on cerebral development, at least with the doses used currently. Among … Continue reading

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

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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Should we give up on nebulised surfactant?

A new RCT of curosurf given by nebulisation was published shortly after a systematic review of the previous data. The RCT showed no real benefit, whereas the SR suggested efficacy. The RCT first, this international trial (Dani C, et al. … Continue reading

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Neonatal Updates

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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Opioid infusions for ventilated preterm babies

Many practices in neonatology are variable between NICUs, and many vary from year to year; without any good scientific data practices become fashionable or routine or ingrained without necessarily having an evidence base to support them. One such practice is … Continue reading

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More about Prebiotics

I don’t know if there is an “official” definition of prebiotics, but I think of them as molecules present in the diet that promote the growth of probiotic organisms. I believe that originally the term was applied only to molecules … Continue reading

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Does intravitreal bevacizumab adversely affect long term development? Two simultaneous systematic reviews say yes, or no.

A reliable answer to the above question would require a large multicentre RCT comparing intravitreal bevacizumab (IVB) to laser, powered for long term outcomes. Such a trial does not currently exist. As a result, 2 groups have just published systematic … Continue reading

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Probiotics and NEC, the latest answer?

The updated Cochrane review of probiotics for prevention of NEC, sepsis and mortality has been published. Meta-analysis showed that probiotics may reduce the risk of NEC: RR 0.54, 95% CI 0.45 to 0.65 (54 trials, 10,604 infants; I2 = 17%); … Continue reading

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