The Incubator

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5 days ago

#457 - Are We Rethinking When and How We Give Surfactant (ft Dr. Roger Soll)

Send us Fan Mail When is surfactant "early," and when is it too early, or too late? In this second installment of our two-part series with the Neonatal Resuscitation Symposium, Ben Courchia sits down with Dr. Roger Soll, a leading voice in surfactant research since the 1980s, to trace how our thinking on timing has evolved, from aggressive prophylactic dosing to selective rescue therapy to today's less invasive approaches like LISA and SALSA. Dr. Soll unpacks why head-to-head trials keep favoring less invasive administration over InSurE, and how the rise of "nanopreemies" is quietly pulling the pendulum back toward earlier treatment. The conversation also touches on video laryngoscopy and aerosolized surfactant's unfulfilled promise. A candid, technically rich conversation for anyone who has stood at a warmer wondering whether, and when, to reach for surfactant. Dr. Soll expands on these themes at the Neonatal Resuscitation Symposium, September 10 to 11, 2026, at Indiana University School of Medicine. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
28 Jul

#456 - [Journal Club] - 🫀 From The Heart - Why Is CHD Mortality Rising Again After 15 Years of Progress?

Send us Fan Mail In this retrospective national study, Adrianne and Nim look at 25 years of congenital heart disease mortality in the US using CDC WONDER data. Infant mortality remains staggeringly high (54 per 100,000), and after years of steady decline, it has been climbing again since 2014. Disparities run throughout: higher deaths among males, non-Hispanic Black and American Indian/Alaska Native populations, and in rural, Midwestern regions, pointing more to gaps in access and resources than to disease biology. The conversation also flags a growing, under-discussed problem, an aging adult congenital population outpacing the pediatric one for the first time, with too few specialists trained to care for them. ---- National Trends and Disparities in Congenital Heart Disease Mortality in the United States, 1999-2024.Raja S, Albrahim MMS, Aldhafeeri BF, Omar AA, Alqadeeb BA, Alhuways MM, Bangaryd AA, Alqahtany MG, Alfaraj AB, Almughyir RS, AlRasheed ST, Alfaifi M. Pediatr Cardiol. 2026 Jan 13. doi: 10.1007/s00246-025-04156-1. Online ahead of print.PMID: 41528440 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
27 Jul

#456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD?

Send us Fan Mail In this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predict, kids who went to surgery earlier (days 4-6) had higher rates of white matter injury than those who waited longer. MRI remained the most sensitive tool for picking up these lesions, well ahead of ultrasound or CT. But the data stops well short of proving these findings predict long-term outcomes, and Nim pushes back on the idea that an abnormal scan alone should steer decisions about whether to operate. ---- Prevalence of Ischemic Brain Injury in Neonates With Congenital Heart Disease: A Systematic Review and Meta-Analysis. Kim C, Chetan D, Kazazian V, Alzamil J, Chau V, Seed M, Miller SP, Selvanathan T.Neurology. 2026 Feb 10;106(3):e214569. doi: 10.1212/WNL.0000000000214569. Epub 2026 Jan 9.PMID: 41512205 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
20 Jul

#454 - PEEP, Tidal Volume, and Physiology, How Far Has Resuscitation Science Traveled? (ft Dr. Charles Roehr)

Send us Fan Mail How far has delivery room ventilation really come? In this special episode, recorded in collaboration with the Neonatal Resuscitation Symposium, Ben sits down with Dr. Charles Roehr, professor of neonatology and perinatal medicine at the University of Bristol, clinical trialist at the University of Oxford, and member of ILCOR. Together they trace the evolution of respiratory support at birth, from the era of fixed inflation breaths to today's focus on physiologic stability and gentle cardiopulmonary transition. Dr. Roehr reflects on a quarter century of resuscitation science, the enduring challenge of human factors in the delivery room, and where the field may be heading, from better intrapartum monitoring to increasingly specialized resuscitation teams. Dr. Roehr will be delivering a keynote, "Optimizing Effective Ventilation Strategies in the Delivery Room," at the Neonatal Resuscitation Symposium, taking place September 10 to 11 at Indiana University in Indianapolis. Learn more and register here: https://medicine.iu.edu/pediatrics/specialties/neonatal-perinatal/education/resuscitation-symposium Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
18 Jul

#453 - 📑 Journal Club - The Complete Episode from July 18th 2026

Send us Fan Mail Which PDAs actually need treatment? Can maternal voice and scent shape language outcomes? Should we cool at 35 weeks? And did stepping away from probiotics come at a cost? This week’s Journal Club takes on five papers that push back on standard practice. Ben reviews the SMART-PDA trial and a comparative study of PDA pharmacotherapy, Daphna covers the MIND trial on multisensory maternal interventions and a Pediatrix database study on NEC after the FDA probiotic warning, and Ben rounds out the main segment with a national look at hypothermia in 35-week infants with HIE. Ben and Eli wrap the week with Neo News on rising vitamin K refusal. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
6 Jul

#451 - On with VON (EPS 3) - Re-examining the Evidence for Erythropoiesis-Stimulating Agents in Preterm Infants

Send us Fan Mail Does the latest Cochrane evidence finally tip the balance in favor of erythropoiesis stimulating agents in preterm infants? In this VON Grand Rounds follow-up episode, Ben sits down with Dr. Roger Soll and Dr. Souvik Mitra to review the 2026 Cochrane systematic review on early ESA use in preterm newborns. Across 37 trials and over 6,000 infants, early ESAs consistently reduce the need for red blood cell transfusion. The review also confirms with high certainty that ESAs do not increase retinopathy of prematurity. The conversation covers shared decision making, drug selection, dosing, iron supplementation, and which patient populations should be prioritized. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
31/12/2025

#273 - [Journal Club Shorts] - 📌 When to expect BPD patients to come off respiratory support?

Liberation from Respiratory Support in Bronchopulmonary Dysplasia. Kielt MJ, Zaniletti I, Lagatta JM, Padula MA, Grover TR, Porta NFM, Wymore EM, Jensen EA, Leeman KT, Levin JC, Evans JR, Yallapragada S, Nelin LD, Vyas-Read S, Murthy K; Children’s Hospitals Neonatal Consortium Severe BPD Focus Group.J Pediatr. 2024 Nov 7:114390. doi: 10.1016/j.jpeds.2024.114390. Online ahead of print.PMID: 39521174 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
16/08/2023 • Subscribers Only

#197 - Cardiology - TGA and TOF

To learn more and have access to show notes and articles mentioned in this episode, go to www.the-incubator.org/review Please subscribe to the podcast for access to daily episodes. If you have any questions feel free to email the show at nicupodcast@gmail.com You can also contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd.
10 Feb

#396 - [Journal Club] - 📌 Surfactant Thresholds: Is 40% FiO2 as Safe as 30%?

Send us Fan Mail In this episode of Journal Club, Ben and Daphna review a non-inferiority trial from the European Journal of Pediatrics exploring surfactant administration thresholds in preterm neonates. The study, conducted in India, compares a 30% versus 40% FiO2 threshold for babies 26-32 weeks gestational age. The hosts break down the counterintuitive findings regarding respiratory support duration in younger subgroups and discuss the broader implications of using rigid FiO2 heuristics versus individualized patient assessment. They also debate how resource availability influences clinical protocols and the potential benefits of "LISA" (Less Invasive Surfactant Administration) for avoiding intubation. ---- Higher (40%) versus lower (30%) FiO2 threshold for surfactant administration in preterm neonates between 26 and 32 weeks of gestational age: a non-inferiority randomized controlled trial. Haq MI, Datta V, Bandyopadhyay T, Nangia S, Anand P, Murukesan VM.Eur J Pediatr. 2025 Nov 25;184(12):793. doi: 10.1007/s00431-025-06628-1.PMID: 41288797 Clinical Trial. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!
14 Jul

#453 - [Journal Club] - 📌 Can We Rewire a Preterm Baby's Brain for Language?

Send us Fan Mail In this Journal Club, Daphna takes the reins with the MIND randomized controlled trial from Nathalie Maitre and colleagues in The Journal of Pediatrics. Can a multisensory bundle, combining infant-directed voice, a parent's scent, holding, and gentle containment, do more for a preterm baby's developing brain than recorded voice alone? Using event-related potentials to track how infants tell speech sounds apart, the team followed language outcomes all the way to age two. Daphna and Ben unpack the design, the Bayley and PLS-5 findings, and a takeaway every clinician can act on tomorrow. Talk to the baby, every single time. ---- The MIND Randomized Controlled Trial: An Intervention to Improve Neural Speech Processing and 2-Year Language Outcomes of Infants Born Preterm. Maitre NL, Kjeldsen CP, Jeanvoine A, Lukemire J, Slaughter JL, Key AP.J Pediatr. 2026 Jun 5:115187. doi: 10.1016/j.jpeds.2026.115187. Online ahead of print.PMID: 42250747 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Ben and Daphna go through daily neonatal board questions. If you are studying for the upcoming neonatal boards exam or just want to keep your neonatal knowledge sharp, this is the podcast for you. This show is done in collaboration with Neonatology Review (Dr. Dara Brodsky and Dr. Camilia Martin).

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The neonatology focused podcast hosted by Dr. Ben Courchia MD & Dr. Daphna Yasova Barbeau.