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7 Dec, 4 tweets, 4 min read
Last in the Rx for BPD trio at #HotTopicsNeo2020: Dr. Reese Clark of @MEDNAX with: "What Drugs are we Using? Practice Variability and Potential Harm." Read more about Dr. Clark's distinguished care:
blog.mednax.com/mednax-neonato…
@HotTopicsNeo
Reese: Talk to focus on steroid use. To begin, what postnatal steroids are we using? Dexamethasone and hydrocortisone most common systematic exposures, budenoside most common inhaled exposure.

#HotTopicsNeo2020 @HotTopicsNeo
The unstoppable pendulum of postnatal steroid use; data from @MEDNAX clinical data warehouse suggests use again on the rise.

#HotTopicsNeo2020 @HotTopicsNeo
Does timing matter? Clark highlights recent paper in @JPerinatology suggesting decreasing utility for preventing severe BPD with later vs earlier exposures: nature.com/articles/s4137…

#HotTopicsNeo2020 @HotTopicsNeo

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More from @EBNEO

Evidence-Based Neo Profile picture
7 Dec
Next up in "New Approaches to Cooling" Deirdre Murray of @CUH_Cork discussing “Neurodevelopmental Outcomes after Mild HIE.” Read more about Prof. Murray and her work: infantcentre.ie/who-we-are-2/o…

#HotTopicsNeo2020 @HotTopicsNeo
Murray begins by defining the population discussed in her lecture: those with encephalopathy 2/2 perinatal asphyxia.

#HotTopicsNeo2020 @HotTopicsNeo
How do infants with different HIE severity grades perform on IQ testing at 5 years of age? Summary from:
pubmed.ncbi.nlm.nih.gov/27650049/, which includes additional outcomes measures.

Take home point: mild and moderate HIE infants similar.

#HotTopicsNeo2020 @HotTopicsNeo
Read 6 tweets
Evidence-Based Neo Profile picture
7 Dec
Next up in #HotTopicsNeo2020: Erik Jensen of @ChildrensPhila discussing how the baseline risk of BPD impacts the number needed to treat when considering effective therapies.

chop.edu/doctors/jensen…

@HotTopicsNeo
Presentation builds on recently published report in @JPediatr: drugs to Prevent Bronchopulmonary Dysplasia: Effect of Baseline Risk on the Number Needed to Treat
jpeds.com/article/S0022-…

#HotTopicsNeo2020
Jensen: objectives of talk:

#HotTopicsNeo2020 @HotTopicsNeo
Read 8 tweets
Evidence-Based Neo Profile picture
7 Dec
From the last session on periviability at @HotTopicsNeo, let’s get the pulse of the #neoEBM community with a few surveys (thread) #HotTopicsNeo2020
What is the earliest gestational age, assuming dating is correct, where you (or your hospital) routinely offer active postnatal resuscitation if desired by the family
If an infant at 22-24 weeks GA has evidence of inadequate organ perfusion (low urine output, decreasing BP), what is your first line treatment:
Read 6 tweets
Evidence-Based Neo Profile picture
7 Dec
First up in: "Pharmacotherapy for BPD: We Know Less than We Think We Do" at #HotTopicsNeo2020 is Dr. Gerri Baer (@thegerribaer), Team Leader for Neonatology @US_FDA, discussing "Challenges in Studying Drugs for BPD"
@HotTopicsNeo #neoEBM
Baer: no (zero, zilch, none!) drugs approved in the USA to prevent or treat BPD.

Highlights various cohorts demonstrating the ongoing high burden of BPD:

#HotTopicsNeo2020 @HotTopicsNeo
Baer: broad view of challenges to BPD Rx, illustrated by 3 buckets: understanding phenotypes/endotypes, definitions and classification and choosing adequate endpoints.
#HotTopicsNeo2020 @HotTopicsNeo
Read 5 tweets
Evidence-Based Neo Profile picture
7 Dec
Dr. Mikael Norman discuss care of periviable infants in Sweden #HotTopicsNeo2020
Changes in survival in Sweden, with survival at 22 weeks' gestation around 50% and increasing thereafter
Differences in respiratory support at 22 wk GA

22 wk: 100% mechanically ventilated, mean duration 47 d
26 wk: 1 or 3 mechanically ventilated, mean duration 2 d
Read 6 tweets
Evidence-Based Neo Profile picture
7 Dec
Dr. Bührer discusses active care of tiny preterm infants in Germany #HotTopicsNeo2020 #neoEBM
Highlights that this is a grey zone, where parental desires should be support
There is a substantial variability in in active care approaches by gestational age among European countries
Read 8 tweets

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