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
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
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/
#NeoSky
pubmed.ncbi.nlm.nih.gov/40753114/
August 3, 2025 at 12:27 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/
#NeoSky
pubmed.ncbi.nlm.nih.gov/40753114/
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/
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
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/
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/
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
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
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
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
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
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
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
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
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
Toes saved! Pretty amazing before and after results
pubmed.ncbi.nlm.nih.gov/40589288/
#NeoSky #DermSky
July 9, 2025 at 6:56 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
Toes saved! Pretty amazing before and after results
pubmed.ncbi.nlm.nih.gov/40589288/
#NeoSky #DermSky
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/
I repeat jaundice does not cause autism
#AutismAwareness #NeoSky
pubmed.ncbi.nlm.nih.gov/40590769/
July 7, 2025 at 4:06 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/
I repeat jaundice does not cause autism
#AutismAwareness #NeoSky
pubmed.ncbi.nlm.nih.gov/40590769/
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
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
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
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
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
pubmed.ncbi.nlm.nih.gov/40525736/
#NeoSky
June 25, 2025 at 4:00 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
pubmed.ncbi.nlm.nih.gov/40525736/
#NeoSky
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
Pilot study suggest there just might be some benefit
pubmed.ncbi.nlm.nih.gov/40480276/
#NeoSky #PedSky
June 16, 2025 at 4:43 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
Pilot study suggest there just might be some benefit
pubmed.ncbi.nlm.nih.gov/40480276/
#NeoSky #PedSky
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/
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
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/
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/
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
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
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
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
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
Does sedation impact not just drive but respiratory muscle function?
doi.org/10.1002/ppul...
#NeoSky
May 20, 2025 at 2:56 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
Does sedation impact not just drive but respiratory muscle function?
doi.org/10.1002/ppul...
#NeoSky
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
#NeoSky
May 15, 2025 at 10:45 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
#NeoSky
The last decade of the war with #syphilis in Canada has not been great but is the tide starting to turn for congenital and infections?
www.sciencedirect.com/science/arti...
#NeoSky #PedSky #STBBI
www.sciencedirect.com/science/arti...
#NeoSky #PedSky #STBBI
May 13, 2025 at 1:48 PM
The last decade of the war with #syphilis in Canada has not been great but is the tide starting to turn for congenital and infections?
www.sciencedirect.com/science/arti...
#NeoSky #PedSky #STBBI
www.sciencedirect.com/science/arti...
#NeoSky #PedSky #STBBI
Pre-term babies, love skin to skin care. Take a look at that smile‼️
Don’t forget to make a mother in the NICU smile today and wish them a happy Mother’s Day !
#mothersday #NeoSky #PedSky
Don’t forget to make a mother in the NICU smile today and wish them a happy Mother’s Day !
#mothersday #NeoSky #PedSky
May 11, 2025 at 4:00 PM
Pre-term babies, love skin to skin care. Take a look at that smile‼️
Don’t forget to make a mother in the NICU smile today and wish them a happy Mother’s Day !
#mothersday #NeoSky #PedSky
Don’t forget to make a mother in the NICU smile today and wish them a happy Mother’s Day !
#mothersday #NeoSky #PedSky
After all these years we are still hoping that furosemide will help prevent BPD - spoiler alert, it doesn't😲
But 28 days of furosemide will give you a wee bit of electrolyte disturbance
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky #PedSky
But 28 days of furosemide will give you a wee bit of electrolyte disturbance
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky #PedSky
May 7, 2025 at 8:57 PM
After all these years we are still hoping that furosemide will help prevent BPD - spoiler alert, it doesn't😲
But 28 days of furosemide will give you a wee bit of electrolyte disturbance
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky #PedSky
But 28 days of furosemide will give you a wee bit of electrolyte disturbance
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky #PedSky
MoCHA trial ☕️
RCT at 33-35 weeks GA extending #caffeine treatment until 28 days after discharge for babies born at 29-33 weeks did not shorten length of hospital stay
(18.0 days [IQR, 10 to 30 days] for caffeine vs 16.5 [IQR, 10 to 27 days]
shorturl.at/DXwsF
#NeoSky #PedSky
RCT at 33-35 weeks GA extending #caffeine treatment until 28 days after discharge for babies born at 29-33 weeks did not shorten length of hospital stay
(18.0 days [IQR, 10 to 30 days] for caffeine vs 16.5 [IQR, 10 to 27 days]
shorturl.at/DXwsF
#NeoSky #PedSky
May 4, 2025 at 12:06 PM
MoCHA trial ☕️
RCT at 33-35 weeks GA extending #caffeine treatment until 28 days after discharge for babies born at 29-33 weeks did not shorten length of hospital stay
(18.0 days [IQR, 10 to 30 days] for caffeine vs 16.5 [IQR, 10 to 27 days]
shorturl.at/DXwsF
#NeoSky #PedSky
RCT at 33-35 weeks GA extending #caffeine treatment until 28 days after discharge for babies born at 29-33 weeks did not shorten length of hospital stay
(18.0 days [IQR, 10 to 30 days] for caffeine vs 16.5 [IQR, 10 to 27 days]
shorturl.at/DXwsF
#NeoSky #PedSky
Turns out for culture proven sepsis 7 days of treatment not different than 14 days
Exclusions: S. Aureus, fungus & infections requiring long term abx
Also what effect on the #microbiome might that have?
pubmed.ncbi.nlm.nih.gov/40280737/
#IDSky #NeoSky
Exclusions: S. Aureus, fungus & infections requiring long term abx
Also what effect on the #microbiome might that have?
pubmed.ncbi.nlm.nih.gov/40280737/
#IDSky #NeoSky
April 29, 2025 at 1:37 PM
Turns out for culture proven sepsis 7 days of treatment not different than 14 days
Exclusions: S. Aureus, fungus & infections requiring long term abx
Also what effect on the #microbiome might that have?
pubmed.ncbi.nlm.nih.gov/40280737/
#IDSky #NeoSky
Exclusions: S. Aureus, fungus & infections requiring long term abx
Also what effect on the #microbiome might that have?
pubmed.ncbi.nlm.nih.gov/40280737/
#IDSky #NeoSky
Contrary to recent thought in #NeoSky circles dopamine vs norepinephrine RCT for empiric treatment of shock not much different
Neonates with shock reversal at 30 minutes was 32% vs 46% in NE and DA groups, (RR 0.69, 95% CI 0.39 to 1.20, p=0.19)
pubmed.ncbi.nlm.nih.gov/40252959/
Neonates with shock reversal at 30 minutes was 32% vs 46% in NE and DA groups, (RR 0.69, 95% CI 0.39 to 1.20, p=0.19)
pubmed.ncbi.nlm.nih.gov/40252959/
April 22, 2025 at 1:44 PM
Contrary to recent thought in #NeoSky circles dopamine vs norepinephrine RCT for empiric treatment of shock not much different
Neonates with shock reversal at 30 minutes was 32% vs 46% in NE and DA groups, (RR 0.69, 95% CI 0.39 to 1.20, p=0.19)
pubmed.ncbi.nlm.nih.gov/40252959/
Neonates with shock reversal at 30 minutes was 32% vs 46% in NE and DA groups, (RR 0.69, 95% CI 0.39 to 1.20, p=0.19)
pubmed.ncbi.nlm.nih.gov/40252959/
Are three doses of dextrose gel better than 2?
⬇️admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7%
pubmed.ncbi.nlm.nih.gov/40221610/
#NeoSky #PedSky
⬇️admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7%
pubmed.ncbi.nlm.nih.gov/40221610/
#NeoSky #PedSky
April 16, 2025 at 5:24 PM
Are three doses of dextrose gel better than 2?
⬇️admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7%
pubmed.ncbi.nlm.nih.gov/40221610/
#NeoSky #PedSky
⬇️admissions from 3.7% to 2.0% and IV dextrose fluid rates from 2.7% to 1.7%
pubmed.ncbi.nlm.nih.gov/40221610/
#NeoSky #PedSky
How commonly do you hear someone suggest that giving a blood transfusion to preterm infants with help decrease their oxygen desaturation episodes.
This study suggests more aggressive transfusion may not make a difference
pubmed.ncbi.nlm.nih.gov/40139741/
#NeoSky #MedSky
This study suggests more aggressive transfusion may not make a difference
pubmed.ncbi.nlm.nih.gov/40139741/
#NeoSky #MedSky
April 8, 2025 at 7:04 PM
How commonly do you hear someone suggest that giving a blood transfusion to preterm infants with help decrease their oxygen desaturation episodes.
This study suggests more aggressive transfusion may not make a difference
pubmed.ncbi.nlm.nih.gov/40139741/
#NeoSky #MedSky
This study suggests more aggressive transfusion may not make a difference
pubmed.ncbi.nlm.nih.gov/40139741/
#NeoSky #MedSky
Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns (≥35 weeks gestational age)
shorturl.at/21Bgm
Don't miss the Canadian "hyperbili" tool w/ the statement. Look for this link shorturl.at/h5tfG on side of the page 👇
#NeoSky #PedSky
shorturl.at/21Bgm
Don't miss the Canadian "hyperbili" tool w/ the statement. Look for this link shorturl.at/h5tfG on side of the page 👇
#NeoSky #PedSky
April 7, 2025 at 2:11 PM
Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns (≥35 weeks gestational age)
shorturl.at/21Bgm
Don't miss the Canadian "hyperbili" tool w/ the statement. Look for this link shorturl.at/h5tfG on side of the page 👇
#NeoSky #PedSky
shorturl.at/21Bgm
Don't miss the Canadian "hyperbili" tool w/ the statement. Look for this link shorturl.at/h5tfG on side of the page 👇
#NeoSky #PedSky