Prophylactic vs therapeutic treatment with caffeine. Which one wins out?
If you work in Neonatology you talk about caffeine endlessly whether addressing your own consumption or that of your patients. Our unit like many others typically starts caffeine early in a prophylactic fashion for babies under 32 weeks. The reason for this is due to...
Not routinely intubating non-vigorous infants born through meconium might just be a good thing after all.
I recall the shock waves through the neonatal community when ILCOR changed its recommendation to stop routine intubation of non-vigorous infants born through meconium. The rationale again was that for most practitioners it would be better to give bag valve mask...
With COVID-19 the nose really does have it. Why vertical transmission & neonatal infection may be so rare after all.
As awful as COVID19 has been over the last year and a half one thing has continued to perplex myself and others. Why do babies whethe term or preterm so rarely acquire the virus? Numerous studies have been able to document placental changes and infection of these...
High CPAP vs NIPPV. Is there a winner?
A couple years back at the Canadian Pediatric Society annual meeting a discussion broke out about extubating infants to higher levels of CPAP. Conventional thinking had been to use levels between 5 - 8 cm H2O typically. I shared with the group the experience we had in...
Poll question update!
So of course it turns out that the email version of the poll doesn't actually include the poll! Please go to the post here or below and cast your vote using the poll at the bottom of the post. Really appreciate the feedback!...
A question for the readers of this blog! Your turn to help me.
Good morning everyone! In medicine we learn a lot through feedback from our learners. The same prinicple I think can apply here on this blog. When I post a new blog post there are a few ways that it is shared. If you subscribe to this blog then you get a direct email...
Glucose gel for all at risk falls short of the mark
What can I say? I have had a love affair with research on hypoglycemia. I suppose ever since my colleague and I began the quest of rewriting the Canadian Pediatric Society statement The screening and management of newborns at risk for low blood glucose it has become...
Is Heliox A Magic Bullet For Treating Meconium Aspiration Syndrome
This post is special to me. A redemption of sorts. When I was a fellow in Edmonton in the early 2000s my fellowship project was to see whether heliox (helium/oxygen) given to piglets with meconium aspiration syndrome (MAS) would improve ventilation and measures of...
A one size fits all approach to preterm ventilation may not have been right all this time.
I had the opportunity recently to give a talk on strategies to reduce BPD in our preemie population. For the talk, I used as a springboard the recommendations for reducing BPD as laid out by the Evidence Based Practice for Improving Quality (EPIQ) group. There are far...
Stop checking baseline cortisol levels for preemies with hypotension
As readers of this blog will know I am a big fan of anything that challenges my practice. It's something that I think in general is a good practice to live by. For many years now when a preterm infant in particular is hypotensive it has been our practice to draw a...