Tag Archives: Systematic Reviews

Lactoferrin: Does it decrease late-onset sepsis?

Posted on 24 August 2020 by Keith Barrington

The first multicentre trial of bovine lactoferrin supplementation in preterm infants showed a dramatic reduction in late-onset sepsis of about 70%. I was very excited when I first saw Paolo Manzoni’s trial and rushed to set up a pilot in … Continue reading →

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Does erythropoietin prophylaxis prevent NEC? Unreliable data.

Posted on 14 August 2020 by Keith Barrington

Routine erythropoietin administration from early life in very preterm babies has been postulated to be neuro-protective. Unfortunately, despite some early promising results, 2 large well-performed RCTs showed no benefit, including the largest with 750 babies under 28 weeks, which showed … Continue reading →

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Outcomes of infants born at 22 weeks gestation; attitudes are the best predictor of survival

Posted on 10 August 2020 by Keith Barrington

Among the most immature infants, mortality and morbidity are common even if they receive active neonatal intensive care, a new systematic review has attempted to find out how common. Backes CH, et al. Proactive Neonatal Treatment at 22 Weeks of … Continue reading →

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Why are so many mothers hypothyroid, and what should pediatricians do about it?

Posted on 27 July 2020 by Keith Barrington

I don’t know if, like me, you are surprised by how often when admitting a baby, or doing an antenatal consult, mothers are taking thyroxine. It seems that there is an epidemic of hypothyroidism during pregnancy, and I am not … Continue reading →

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What to do about early postnatal steroids?

Posted on 3 March 2020 by Keith Barrington

Steroid metabolism in the very immature infant is… immature. Adrenal function is still developing in the fetus between 20 and 26 weeks, and a source of precursors from the placenta is important, but obviously disappears at delivery. Very preterm babies … Continue reading →

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Erythropoietin for brain protection in the very preterm? Not worth Penuts.

Posted on 17 January 2020 by Keith Barrington

That isn’t a mis-spelling, just a bad attempt to play with the acronym for a good trial; the PENUT trial, just published in the (FP)NEJM. (Juul SE, et al. A Randomized Trial of Erythropoietin for Neuroprotection in Preterm Infants. N … Continue reading →

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Progesterone doesn’t prevent prematurity?

Posted on 25 November 2019 by Keith Barrington

Progesterone analogues, including 17-OH progesterone caproate have been investigated over the last several years for prevention of prematurity. In the pivotal trial from 2003 17OHPC intramuscularly once per week was shown to reduce prematurity at less than 37 weeks, less … Continue reading →

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How fast to feed?

Posted on 14 October 2019 by Keith Barrington

One of the recurring themes in this blog is that good, large enough, prospective RCTs do not necessarily reproduce the results of prior smaller trials, and often do not reproduce the findings of observational studies. Specifically, I have mentioned previously … Continue reading →

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What respiratory outcomes are important?

Posted on 31 May 2019 by Keith Barrington

When bronchopulmonary dysplasia was first described by Northway in 1967 he didn’t try to produce a definition, his paper was a description of a small number of preterm survivors of high oxygen and positive pressure ventilation. He noted some years … Continue reading →

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Putting steroids in the lungs? Still unclear if it is safe or effective.

Posted on 7 May 2019 by Keith Barrington

Systematic reviews, and meta-analyses should help us make a clinical decision, by accumulating all the evidence, determining its quality, and synthesizing impacts, we can then decide which therapeutic option to pursue. This latest review answers the following question “should I … Continue reading →

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