The Incubator

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In this episode of Journal Club, Ben and Daphna review a retrospective cohort study exploring the effects of higher caffeine maintenance dosing on BPD and neurodevelopmental outcomes. They discuss the transition from the standard CAP trial doses to higher regimens for infants born at or before 28 weeks gestation. Does an average daily dose of over six milligrams per kilogram reduce severe BPD or improve Bayley cognitive scores at six months? Tune in as they debate the safety, clinical implications, and their own unit's practices regarding caffeine management in the NICU!

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Effects of higher caffeine dosing on rates of bronchopulmonary dysplasia and neurodevelopmental outcomes. Fleishaker S, Kazmi SH, Mavrogiannis N, Street H, Ravuri H, Moinuddin T, Pierce K, Verma S.J Perinatol. 2026 Feb 23. doi: 10.1038/s41372-026-02593-1. Online ahead of print.PMID: 41731043

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies!

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Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902.

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna review a large cohort study from the Journal of Perinatology on the prevalence and safety of diazoxide in the NICU. With neonatal hypoglycemia seemingly on the rise, they discuss off-label use for transient hyperinsulinism and evaluate real-world data from over 340 Pediatrix units. They dive into the rates of concurrent diuretic therapy, respiratory support, and the dreaded risk of pulmonary hypertension. Tune in for a clinical breakdown of when and how this medication is being utilized across centers, plus Ben's echocardiography struggles with cranky term babies on diazoxide!

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Prevalence and safety of diazoxide in the neonatal intensive care unit. Collins LC, Daniel KB, Tolia VN, Parikh P, Gray KD, Greenberg RG.J Perinatol. 2026 Feb 3. doi: 10.1038/s41372-026-02568-2. Online ahead of print.PMID: 41634357

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna review the highly anticipated TREOCAPA trial results exploring the prophylactic use of acetaminophen for PDA closure in extremely preterm infants. They break down the study's tailored dosing regimens, safety outcomes like cholestasis, and discuss why achieving a higher rate of early ductal closure didn't necessarily translate to improved survival without severe morbidity. Plus, they share a nod to recent Neo Conference interviews and the realities of conducting clinical research in private practice. Tune in for a nuanced discussion on individualizing PDA management in the NICU!

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Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. Rozé JC, Cambonie G, Flamant C, Patkaï J, Mühlbacher T, Gascoin G, Rideau Batista Novais A, Tauzin M, Le Duc K, Beuchée A, Joye S, Babacheva E, Bouissou A, Ligi I, Tammela O, Plourde M, Dempsey E, Tosello B, Nguyen K, Vincent M, Andresson P, Binder C, Kruse C, Barcos Munoz F, Kuhn P, Proença E, Bartocci M, Kermorvant-Duchemin E, Nellis G, Lumia M, Giapros V, Rigo V, Sankilampi U, Mendes da Graça A, Rønnestad A, Soukka H, Mondì V, Aikio O, Torre-Monmany N, Rüegger C, Baud O, Zeitlin J, Morgan AS, Baruteau AE, Ancel PY, Carbajal R, Bouazza N, Diallo A, Levoyer L, Kemper R, Hallman M, Alberti C, Ursino M; TREOCAPA Study Group.JAMA Pediatr. 2026 Feb 16:e256150. doi: 10.1001/jamapediatrics.2025.6150. Online ahead of print.PMID: 41697673

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Live from the NEO Conference in Las Vegas, Ben and Daphna sit down with Dr. Tarek Nakhla to discuss his new book, Saving Babies Behind the Doors of the Neonatal Intensive Care Unit. Moving beyond standard medical textbooks, Dr. Nakhla shares how chronicling nearly 30 years of challenging patient encounters and complex family dynamics can serve as an essential guide for new trainees. The conversation highlights the therapeutic power of narrative medicine for clinicians and the profound impact of non-clinical staff on the family experience. Discover why capturing the human side of neonatology is just as critical as the clinical science.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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How can a database tracking 20% of all US NICU admissions change the way we practice neonatology? Live from the NEO Conference, Ben and Daphna sit down with Dr. Veeral Tolia to discuss his groundbreaking work with the Pediatrix Clinical Data Warehouse. Dr. Tolia dives into the power of leveraging decades of observational data to supplement randomized trials—from analyzing the 50-fold increase in Precedex usage to studying natural experiments like the vitamin A shortage. The group also looks ahead to the Newborn Express dataset, exploring how socioeconomic metrics like the Child Opportunity Index might help us understand the alarming rise in neonatal vitamin K refusals.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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How will artificial intelligence fundamentally change the way we chart, teach, and monitor patients in the NICU? Live from the NEO Conference, Ben and Daphna sit down with Dr. James Barry to explore the critical need for "AI literacy" among bedside clinicians. Dr. Barry draws parallels between driver's education and safe AI use, highlighting the hidden dangers of automation complacency with AI scribes. They also discuss the exciting potential of computer vision in respiratory monitoring and how the CONCERN early warning system is quantifying nursing intuition. Join us as we navigate the guardrails of neonatology's technological future.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Can groundbreaking neonatal research thrive outside of academic medicine? Live from the NEO Conference, Ben and Daphna sit down with Dr. Kaashif Ahmad, Vice President of Research at Pediatrix. Dr. Ahmad shatters the myth that community NICUs can't drive clinical science, discussing how everyday documentation in systems like Baby Steps quietly fuels hundreds of publications. He also unveils "The Parent Network," a revolutionary initiative designed to partner with family-led organizations from day one to establish comparative effectiveness trial priorities. Tune in to discover how private practice clinicians are successfully balancing bedside care with robust, meaningful research.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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How does individualized medicine shape both patient trust and neonatal careers? Live from the NEO Conference, Ben and Daphna catch up with Dr. Zubin Shah, Clinical Ambassador for Pediatrix. The team explores the power of tailoring bedside conversations to individual babies—whether discussing targeted hemodynamics or framing RSV prevention with nirsevimab—rather than relying solely on generalized trial data. Dr. Shah also sheds light on the evolving landscape of neonatal recruitment, emphasizing how peer mentorship and direct networking can help new physicians find practices that balance rigorous clinical care with research and quality improvement.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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When parents fundamentally disagree on life-saving interventions in the delivery room, how do clinical teams decide the next step? Live from the NEO Conference, Ben and Daphna sit down with Dr. Mark Mercurio, Executive Director of the new Center for Pediatric Bioethics at Boston Children’s Hospital. Dr. Mercurio dissects a highly complex ethical case regarding parental disagreement over resuscitation at the border of viability. Emphasizing the distinction between parental "preference" and parental "judgment," he explores the necessity of clinical humility, the hidden margins of error in gestational age dating, and how admitting our own medical uncertainty is the first step toward honest family counseling.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!