Dr. Michael Narvey Neonatologist MD
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nicumusings.bsky.social
Dr. Michael Narvey Neonatologist MD
@nicumusings.bsky.social
A neonatologist in Canada.🇨🇦 Love sharing knowledge

Sharing the occasional #wine or #cocktail thoughts!

TikTok, Instagram: @NICU_musings
Linkedin: https://www.linkedin.com/in/michael-narvey-06aaa562
Blog: www.allthingsneonatal.com
#NeoSky #MedSky #PedSky
Pinned
Did you ever think you would see a mother and child breast-feeding in an MRI?
#nicu #neonatal #newborn #radiology
I never met a baby I didn't like.

I didn't always appreciate how they behaved in the #NICU but with age I learned not to take it too personally.
#NeoSky
August 24, 2025 at 7:08 PM
In the NICU, time bends — minutes can feel like eternities, and eternities can change in a single breath.
#NeoSky
August 8, 2025 at 4:53 PM
Although darbepoetin for newborns 23-29 weeks increased RBCs and decreased transfusions sadly it didn’t translate into better neurodevelopmental outcome
The silver bullet remains elusive!
#NeoSky #MedSky
jamanetwork.com/journals/jam...
Darbepoetin for Neuroprotection in Preterm Infants
This randomized clinical trial investigates if darbepoetin initiated less than 36 hours after birth improves red blood cell mass and cognitive outcome at 2 years’ corrected gestational age in infants ...
jamanetwork.com
August 5, 2025 at 2:19 PM
Study finds that non-pharmacological care prior to LISA for surfactant administration may be enough without giving fentanyl. No difference between saline or fentanyl on COMFORTNeo score
#NeoSky

pubmed.ncbi.nlm.nih.gov/40753114/
August 3, 2025 at 12:27 PM
Delighted to see our statement “Applications of point-of-care ultrasonography in the NICU: A Canadian perspective” in print!
#NeoSky

cps.ca/en/documents...
Applications of point-of-care ultrasonography in the NICU: A Canadian perspective | Canadian Paediatric Society
Point-of-care ultrasonography (POCUS) is an adjunctive, portable clinical assessment tool that in the hands of trained clinicians can support differential diagnosis, clarify therapeutic options, and i...
cps.ca
July 31, 2025 at 4:22 PM
Use of postnatal betamethasone to ⬇️ hosp stay for O2.
Of the infants receiving betamethasone, those weaned from oxygen were discharged home at an earlier PMA (39.6 ± 5.0 vs. 42.0 ± 3.7 week, p < 0.001)
Risks of added steroids in long term?
#NeoSky

pubmed.ncbi.nlm.nih.gov/40671420/
July 30, 2025 at 2:40 PM
Our new statement on managing newborns at risk of neonatal abstinence/neonatal opioid withdrawal from the CPS
academic.oup.com/pch/advance-...
#NeoSky #Pedsky
Managing newborns at risk for neonatal abstinence syndrome (NAS)/neonatal opioid withdrawal syndrome (NOWS): Updates and emerging best practices
Abstract. The incidence of newborns at risk for withdrawal due to antenatal substance exposure has increased rapidly, presenting significant health and ear
academic.oup.com
July 27, 2025 at 1:41 PM
In #preemies, furosemide did not ⬆️ adverse events, hearing loss, or nephrocalcinosis, but ⬆️ incidence of electrolyte abnormalities.
Furosemide given for 28 consecutive days was not associated with a difference in mod-to-severe BPD or death at 36 weeks PMA.
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky
July 25, 2025 at 12:37 PM
Pilot study giving 100% O2 during deferred cord clamping for extreme #preemies ⬇️ risk of hypoxemia 5 min after birth compared with 30% oxygen
No ⬆️ risk of severe IVH or death
#NeoSky
www.medpagetoday.com/obgyn/pregna...
High Oxygen During Cord Clamping Helps Extremely Preterm Infants
Pilot randomized trial shows safety and reduced early hypoxemia
www.medpagetoday.com
July 22, 2025 at 8:15 PM
Is atropine really required in addition to fentanyl & succinylcholine prior to intubation to prevent severe bradycardia in neonates?

We found yes...

Severe bradycardia during the whole procedure was signif > in placebo vs atropine group; RR 6.3(95% CI 1.2 - 34.1)

t.co/TKJovw24BQ

#NeoSky #PedSky
July 18, 2025 at 1:47 PM
Distal limb ischemia in a 26 week infant treated with topical nitroglycerin.
Toes saved! Pretty amazing before and after results
pubmed.ncbi.nlm.nih.gov/40589288/
#NeoSky #DermSky
July 9, 2025 at 6:56 PM
After adjusting for preterm birth there is no association between neonatal jaundice and #autism
I repeat jaundice does not cause autism
#AutismAwareness #NeoSky
pubmed.ncbi.nlm.nih.gov/40590769/
July 7, 2025 at 4:06 PM
Pilot study finds diaphragmatic thickness worsens with intubation in infants born < 28 wks but even > when sedation is given.
Pause & consider if sedation is required on the ventilator & ask if non-pharmacological strategies are maximized?
pubmed.ncbi.nlm.nih.gov/40365938/ssss
#NeoSky #MedSky
July 3, 2025 at 2:23 PM
Concerning signal ☹️
Serial f/u of neurodevelopment up to 8-10 years following HIE treated w/ cooling.
Motor Z-scores ⬇️ nonlinearly throughout visits, & cognitive Z-scores ⬇️ linearly inchildren with mammillary body abnormalities on neonatal MRI
www.physiciansweekly.com/cognitive-an...
#NeoSky
Cognitive and Motor Decline in Children With Asphyxia
Therapeutic hypothermia for NE was linked to declining motor, cognitive, and behavioral outcomes, emphasizing the need for long-term monitoring.
www.physiciansweekly.com
June 26, 2025 at 7:16 PM
Permissive hypercapnia (60-75 mmHg & pH ≥ 7.20 vs (40-55 mmHg and pH ≥ 7.25) for 28 days from day 7-14 in #preemies may shorten the total days of ventilation but doesn't change the big outcome of survival without moderate to severe BPD
pubmed.ncbi.nlm.nih.gov/40525736/
#NeoSky
June 25, 2025 at 4:00 PM
Could a little #yoga be just what the doctor ordered to reduce stress for parents in the NICU?
Pilot study suggest there just might be some benefit
pubmed.ncbi.nlm.nih.gov/40480276/
#NeoSky #PedSky
June 16, 2025 at 4:43 PM
Delighted to announce that I have joined the board of the Canadian Paediatric Society / Société canadienne de pédiatrie as Vice President! I look forward to working with the other fantastic board members to improve the health of children nationwide!
#NeoSKy #PedSky
June 3, 2025 at 6:15 PM
Meta-analysis of eat, sleep, console approach to withdrawal vs Finnegan scoring

Is there any reason not to adopt ESC?

ESC ⬇️hospitalisation days (MD -4.11 days, p<0.0001 & the proportion treated with withdrawal medications (OR 0.36, p<0.0001
#NeoSky #PedSky
pubmed.ncbi.nlm.nih.gov/40393782/
May 30, 2025 at 8:23 PM
#conjoined twins are a rarity. How many types are there and how might ethics play into their separation?

Starting to post longer form educational videos on YouTube. If you are interested in keeping up-to-date, please consider subscribing to the channel.

youtu.be/GOxDeK63Jj4?... #NeoSky #PedSky
Conjoined #twins Many varieties but timing is everything! #pediatrics #obstetrics #pregnancy
YouTube video by Michael Narvey
youtu.be
May 26, 2025 at 1:15 PM
Even if survival is quite unlikely, I see the need of parents to at least try.
You lose 100% who aren’t resuscitated in the 500g range.
Parents may not know what lies ahead but they may be certain they don’t want to spend the rest of their lives asking “what if?”
#NeoSky
May 25, 2025 at 5:55 PM
In #pregnancy mothers often avoid excessive #caffeine & yet we give it so readily to #preemies after birth
Why is that?👇
youtu.be/OYPP_sxQ9SY
#nicu #neonatal #meded #medsky #medstudent #PedSky
Caffeine is truly a wonder drug for #preemies and yet pregnant women avoid it. Huh? #pediatrics
YouTube video by Michael Narvey
youtu.be
May 20, 2025 at 6:44 PM
Pilot study finds that fentanyl as sedation for newborns born < 28 weeks reduces diaphragmatic thickness at both end inspiration and expiration.
Does sedation impact not just drive but respiratory muscle function?
doi.org/10.1002/ppul...
#NeoSky
May 20, 2025 at 2:56 PM
It’s international #kangaroocare day again. Doing my part to represent all the kangaroo fanatics out there supporting akin to skin care for babies!
#NeoSky
May 15, 2025 at 10:45 PM
A device to measure how much breastmilk is fed to a baby would certainly take the guess work out & stop pre/post weights to estimate volumes!
medicalxpress.com/news/2025-05...
#NeoSKy #PedSky
Got data? Breastfeeding device measures babies' milk intake in real time
While breastfeeding has many benefits for a mother and her baby, it has one major drawback: It's incredibly difficult to know how much milk the baby is consuming. To take the guesswork out of breastfe...
medicalxpress.com
May 15, 2025 at 3:56 PM