The Incubator

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In this episode of the Incubator podcast, host Dr. Ben Courchia is joined by two distinguished guests: Dr. Neil Patel, a neonatologist from the Royal Hospital for Children in Glasgow, UK, and Dr. Srirupa Hari Gopal, a third year neonatology fellow at Baylor College of Medicine.

The discussion delves into the complexities of congenital diaphragmatic hernia (CDH). Drs. Patel and Gopal share their passion for caring for these patients and the multidisciplinary approach required to optimize outcomes.

The conversation highlights the evolving understanding of CDH pathophysiology, with a focus on the increasingly recognized role of cardiac dysfunction alongside pulmonary hypoplasia and pulmonary hypertension. The guests also discuss recent advances in prenatal care for CDH, including the use of fetal endotracheal occlusion (FETO) to promote lung growth, and the challenges of counseling families facing a CDH diagnosis.

Looking to the future, Drs. Patel and Gopal express excitement about tailoring CDH management to different disease phenotypes, establishing consensus definitions for CDH-associated pulmonary hypertension, and investigating novel approaches such as physiologic cord clamping.

Throughout the episode, the guests' dedication to improving care for newborns with CDH shines through, leaving listeners with a deeper understanding of the challenges and opportunities in this field. This informative and engaging discussion is a must-listen for anyone interested in the latest developments in neonatal medicine and the tireless efforts of clinicians and researchers to give every baby the best possible start in life.

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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 our latest Tech Tuesday episode, Daphna and I spoke with Nancy Addison from Locus Health about their remote patient monitoring (RPM) platform. We learned how Locus Health bridges the gap between hospital and home for medically complex pediatric patients, including NICU babies, substance-exposed newborns, and infants on oxygen.

We discussed the potential benefits of RPM, such as empowering families, reducing length of stay, and preventing readmissions. Nancy emphasized the importance of maintaining close family-provider relationships during the transition to home.

We also explored the technical aspects of the platform, like data entry, EHR integration, and alert systems. While limitations exist in wireless home monitoring for infants, the potential for real-time data streaming is intriguing.

Finally, we touched on the research implications of capturing post-discharge data through RPM. Tools like Locus Health could accelerate research and quality improvement efforts to help medically complex infants thrive at home. This thought-provoking discussion left us excited about the future of RPM in pediatrics

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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In this jam-packed episode of Journal Club, Ben & Daphna discuss several impactful new studies in neonatology.

First up is an important clinical report from the AAP on infant feeding for people living with HIV. The hosts dive into the nuanced recommendations, which state that while avoiding breastfeeding is still the only way to completely eliminate HIV transmission risk, breastfeeding can be supported in certain cases where the parent has a strong desire after comprehensive counseling and meeting strict criteria like sustained viral suppression.

Next, they examine a study linking congenital CMV infection with an increased risk of autism spectrum disorder diagnoses, highlighting the importance of screening for this common congenital infection.

A randomized trial comparing video laryngoscopy to direct laryngoscopy for urgent neonatal intubation is also discussed. While video laryngoscopy resulted in higher first-attempt success rates, the hosts note some adverse events to consider as this technology becomes more widespread for these critical procedures.

The effectiveness of NICU music therapy on neurodevelopmental outcomes is also covered, with a study finding no significant language benefits at 24 months. The hosts question the impact and necessity of these programs.

Practical coding tips for NICU consultations from a recent paper are shared, with an emphasis on the financial impact of proper billing.

Lastly, the increasing frequency of heat waves and their association with preterm and early-term births is explored, underscoring the environmental factors that influence neonatal health.

With insightful analysis and engaging discussion, Ben & Daphna provide a fantastic overview of some of the most noteworthy recent publications in neonatology. Be sure to tune in for this informative and thought-provoking installment of Journal Club!

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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Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants. Geraghty LE, Dunne EA, Ní Chathasaigh CM, Vellinga A, Adams NC, O'Currain EM, McCarthy LK, O'Donnell CPF.N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Epub 2024 May 5.PMID: 38709215 Clinical Trial.

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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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Autism Spectrum Disorder Diagnoses and Congenital Cytomegalovirus. Pesch MH, Leung J, Lanzieri TM, Tinker SC, Rose CE, Danielson ML, Yeargin-Allsopp M, Grosse SD.Pediatrics. 2024 May 29:e2023064081. doi: 10.1542/peds.2023-064081. Online ahead of print.PMID: 38808409

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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Infant Feeding for Persons Living With and at Risk for HIV in the United States: Clinical Report. Abuogi L, Noble L, Smith C; COMMITTEE ON PEDIATRIC AND ADOLESCENT HIV; SECTION ON BREASTFEEDING.Pediatrics. 2024 May 20:e2024066843. doi: 10.1542/peds.2024-066843. Online ahead of print.PMID: 38766700

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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Elizabeth Simonton shares her experience of unexpected NICU admission for her full-term baby, Ben. The journey includes pregnancy complications, NICU stay, and the emotional challenges faced by NICU parents. Elizabeth's story highlights the importance of hope, self-care, and community support in the NICU experience.

Takeaways:

• Full-term babies can also require NICU admission due to unexpected complications.
• Hope and self-care are essential for NICU parents to navigate the emotional challenges of the experience.
• Community support and understanding play a crucial role in providing comfort and strength to NICU families.

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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In this special episode of the Incubator Podcast, hosts Ben and Daphna are joined by Dr. Alex Stevenson, a neonatologist from Zimbabwe who serves as the president of the African Neonatal Association (ANA) and principal investigator for the African Neonatal Network. Dr. Stevenson shares his journey into neonatology and highlights the stark differences in neonatal care and outcomes between well-resourced private hospitals and less well-resourced public hospitals in Africa.

The discussion focuses on the objectives and accomplishments of the ANA, which aims to improve neonatal mortality, morbidity, quality of care, education, collaboration, and advocacy across the continent. Dr. Stevenson emphasizes the importance of unifying African neonatologists, nurses, and parents to advocate for better resources and care for newborns. He also touches on the ethical considerations of conducting research in low and middle-income countries, stressing the need for research to directly benefit the communities involved.

Throughout the episode, Dr. Stevenson expresses hope for the future of neonatal care in Africa, citing advancements like the African Neonatal Network and the potential for African-led innovations in care. The conversation concludes with a call for greater collaboration and support between high-income and low-income countries to address the global burden of neonatal mortality and morbidity.

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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In this episode of the Incubator, At the bench, we talk with Dr. Krithika Lingappan who is a neonatologist and physician-scientist at the Children’s Hospital of Philadelphia and the University of Pennsylvania. Join us as we hear what inspired Dr. Lingappan to build her cutting-edge research program investigating sex-specific differences in preterm lung disease. She explains that every cell in the lung shows sex bias, including epithelial cells, endothelial cells, and immune cells. She explores the role of the X and Y chromosomes in determining susceptibility to lung diseases and the ongoing research to understand the dosage of the X chromosome and genes on the Y chromosome. Dr. Lingappan also discusses the use of multi-omics approaches, such as single-cell RNA sequencing and spatial transcriptomics, to study lung development and disease. We are fortunate to learn from her experiences including finding mentorship, building a research career that addresses a common clinical question, and establishing and then moving a research group. Dr. Lingappan also discusses her work promoting neonatology physician-scientist career development. We are thrilled to bring you this inside look into what it takes to become a neonatology physician-scientist!

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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In this episode, hosts Ben and Daphna discuss several recent neonatology studies. First, they examine an algorithm developed by Shah et al. for the timely detection of hypothyroidism in preterm infants based on gestational age and TSH levels. Next, Daphna reviews a study by Halling et al. comparing initial endotracheal versus intravenous epinephrine administration during neonatal resuscitation. While endotracheal epinephrine was given faster, IV epinephrine achieved return of spontaneous circulation more quickly.

They also discuss studies on the feasibility of using intranasal human milk as stem cell therapy for intraventricular hemorrhage, the association between relaxation interventions and human milk outcomes, and the timing of red blood cell transfusions in relation to necrotizing enterocolitis risk. Finally, Daphna highlights a one-year follow-up of the WISER intervention, showing sustained reductions in burnout and depression among NICU healthcare workers.

Throughout the discussion, Ben and Daphna provide thoughtful analysis and identify areas needing further research. They conclude by reminding listeners about a survey with prize giveaways in honor of The Incubator's 3-year anniversary. This informative and engaging episode provides a helpful overview of some of the latest neonatology 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.

Enjoy!