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...
Who needs ECHO to diagnose a hemodynamically significant PDAs when you have the pulsatility index?
It gives me great pleasure to write this piece as it is about research that two of my colleagues Dr. Yasser Elsayed and Dr. Shyamala Dakshinamurti authored along with colleagues in Saudi Arabia. Both colleagues have worked in the fields of hemodynamics and pulmonary...
Families in NICU deserve more than just a say
The journey from conception to the labour floor and then for some to the NICU is not a straight one. There are times of joy, interspersed with sadness, denial, anger and eventually acceptance, as initial news of being pregnant leads to complications in pregnancy...
Augmented Reality: The Evolution of Video Laryngoscopy
Cool title for a post I think. If you have children or even if you are an adult who likes to play video games you would be aware of virtual reality headsets. These headsets take games to a new level by immersing you in the experience so all you see is the game in your...
Can High-Dose Nitric Oxide Prevent Death From Pneumonia?
This post is a written as a tribute to John Minski RRT who taught me much about ventilation over the years and has been a champion for innovation in our unit. As he prepares to move on to the next phase of his life I thought it would be a nice send off to talk about...
Can transcutaneous auricular vagus nerve stimulation do the impossible and fix the baby who won’t eat?
If you work in NICU you will have seen many babies who have passed through the stages of apnea, weaned off respiratory support and have reached a sufficient weight for discharge but alas will just not feed. Different strategies have been employed to get these infants...
At 22-24 weeks does practice make perfect?
In the book Outliers by Malcolm Gladwell he talked about 10000 hours being the threshold at which if you practiced or gained that much experience with something you could become an expert. In Sweden the approach to 22 week pregnancies and above is to resuscitate all...
Should CPAP be weaned or is stopping “cold turkey” the way to go?
With American Thanksgiving coming up this weekend a post about "cold turkey" seemed apropos. You can't work in Neonatology and not be familiar with CPAP. We have learned much about this modality in the last couple decades as clinicians have moved more and more towards...
So you tested positive for COVID19. How to tell if you are infectious now that much clearer.
Testing for COVID19 has become so much the norm in society that in casual conversation you might ask someone if they have been tested. Chances are you know someone who has and even more likely that it is many people at this point. If you have been following this blog...
Can a single serum cortisol target those who should receive prophylactic steroids to reduce BPD?
Precision medicine is a growing field in which genetic factors, environment, metabolism and even lifestyle are taken into account when deciding who should receive a treatment or not. When it comes to bronchopulmonary dysplasia I believe anyone who works in Neonatal...