The Incubator

The Incubator
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A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.

  1. 17 hr ago

    #450 - 📑 [Journal Club] - 🫀From The Heart - The Complete Episode from July 4th 2026

    Send us Fan Mail Neonatal sepsis physiology, steroids, vasopressors, and moms.gov. A full week on The Incubator Journal Club. Adrianne and Nim open with a retrospective study from Toronto challenging the assumption that hypoxemic respiratory failure in septic preterm infants is driven by elevated pulmonary vascular resistance. The data points instead to left ventricular dysfunction as a key contributor, raising questions about the reflex to reach for nitric oxide first. Nim then reviews a double-blind RCT from northern India evaluating early hydrocortisone versus placebo in neonatal fluid-refractory shock. The primary outcome did not reach statistical significance, but an 11 percent absolute reduction in mortality and a 70 percent open-label crossover rate tell a story of their own. Adrianne closes the journal club with a double-blind RCT comparing norepinephrine to dopamine for neonatal septic shock, finding no significant difference in shock reversal at 30 minutes, though significant methodological limitations make the findings hard to act on. Eli and Ben close the week on Neo News with a look at the newly launched moms.gov and what clinicians should know before their patients bring it up. 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!

    1hr 10min

  2. 2 days ago

    #450 - [Neo News] - 📌 What Does the Launch of moms.gov Mean for Your Patients?

    Send us Fan Mail In this episode of Neo News, Ben and Eli discuss the federal government's Mother's Day press conference and the launch of moms.gov, a new website aimed at supporting new and expecting mothers. They examine what the administration got right, including the real barriers families face in accessing maternal care and the economic challenges of having children in America today. They also dig into what the website links to, including Option Line, run by Heartbeat International, an organization with a specific position on abortion, and what that means for the information patients will actually receive. A grounded, clinically relevant conversation about a website your patients are already seeing. 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!

    21 min

  3. 3 days ago

    #450 - [Journal Club] - 🫀 From The Heart - Is Dopamine Still Defensible as First-Line for Neonatal Septic Shock?

    Send us Fan Mail In this double-blind randomized controlled trial, Adrianne and Nim examine whether norepinephrine outperforms dopamine as a first-line vasoactive agent in neonates with fluid-refractory septic shock. The primary outcome, shock reversal at 30 minutes, was not significantly different between groups, at 32 percent for norepinephrine and 46 percent for dopamine. Secondary outcomes including mortality, IVH, NEC, and need for additional vasoactive support were also similar. The episode critically examines the methodological limitations of the study, including unclear sepsis definitions, absence of echo phenotyping, and unusually high starting doses, and asks whether the field needs better tools before these questions can be properly answered. ---- Norepinephrine versus Dopamine for Septic Shock in Neonates: A Randomized Controlled Trial.Mazhari MYA, Priyadarshi M, Singh P, Chaurasia S, Basu S.J Pediatr. 2025 Jul;282:114599. doi: 10.1016/j.jpeds.2025.114599. Epub 2025 Apr 17.PMID: 40252959 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!

    17 min

  4. 4 days ago

    #450 - [Journal Club] - 🫀 From The Heart - Does Early Hydrocortisone Actually Move the Needle in Fluid-Refractory Shock?

    Send us Fan Mail In this double-blind randomized controlled trial from northern India, Nim and Adrianne review whether early hydrocortisone reduces 14-day all-cause mortality in preterm infants with fluid-refractory shock. The primary outcome showed no statistically significant difference between groups, though an 11 percent absolute reduction in mortality in the hydrocortisone group raised clinical interest. A major limitation was the high rate of open-label steroid crossover, with over 70 percent of both groups ultimately receiving hydrocortisone. The study highlights the difficulty of achieving equipoise when clinicians already believe strongly in a therapy, and raises important questions about study design in neonatal shock research. ---- Early hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial. Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Mar;45(3):342-349. doi: 10.1038/s41372-025-02222-3. Epub 2025 Feb 13.PMID: 39948354 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!

    17 min

  5. 5 days ago

    #450 - [Journal Club] - 🫀From The Heart - When Nitric Oxide Fails: Is the Left Ventricle the Culprit in Septic Preterm Infants?

    Send us Fan Mail In this retrospective single-center study from Toronto, Adrianne and Nim explore the echo findings of preterm infants with septic shock and hypoxemic respiratory failure. Contrary to the common assumption that elevated pulmonary vascular resistance drives hypoxemia in sepsis, the data points to left ventricular dysfunction as a key contributor. Babies with hypoxemic respiratory failure showed lower LV systolic and diastolic performance, while pulmonary pressures were similar between groups. Mortality was significantly higher in the hypoxemic group. This challenges the reflex to reach for nitric oxide first and asks clinicians to look at the whole heart. ---- Cardiopulmonary Physiology of Hypoxemic Respiratory Failure Among Preterm Infants with Septic Shock. Kharrat A, Nissimov S, Zhu F, Deshpande P, Jain A.J Pediatr. 2025 Mar;278:114384. doi: 10.1016/j.jpeds.2024.114384. Epub 2024 Nov 6.PMID: 39510164 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!

    23 min

  6. 22 Jun

    #449 - What Do Division Heads Think About the Shortened Fellowship Proposal?

    Send us Fan Mail What would it really mean to shorten neonatology fellowship training to two years? In this episode, Ben and co-host Dr. Shetal Shah sit down with three division heads, Dr. Jill Maron (Brown), Dr. Patrick McNamara (University of Iowa), and Dr. Sarah Taylor (Yale), to examine the ABP's proposed changes from the perspective of those who run major academic NICUs. From the operational and financial strain of losing an entire class of third-year fellows, to the erosion of scholarly development, dwell time, and faculty wellbeing, the conversation makes clear that the costs of this proposal go far deeper than the curriculum. How do you staff an 80-bed NICU without junior fellows? Who funds the gap? And what happens to the next generation of academic neonatologists if we train them in isolation from the very experiences that shape their identity as clinicians and scholars? 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!

    45 min

  7. 16 Jun

    #448 - Are NICU Outcomes Actually Getting Better Over Time? (ft Dr. Joseph Kaempf)

    Send us Fan Mail What does it mean to truly improve outcomes for very low birth weight infants, and are we actually doing it? In this episode, Daphna sits down with Dr. Joseph Kaempf, neonatologist and Medical Director of Value Research and Innovation at Providence Health System in Oregon, to examine some uncomfortable truths about neonatal quality improvement. Dr. Kaempf shares findings from a study spanning 16 NICUs over 14 years showing that composite morbidity outcomes have remained flat while length of stay has increased. He explores why traditional QI tools like driver diagrams and PDSA cycles may no longer be sufficient, and why augmented intelligence may be the next frontier. The conversation also touches on culture as a driver of NICU performance and the gap between institutional interests and true shared decision-making with families. A candid episode for anyone invested in the future of neonatology. 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!

    49 min

  8. 13 Jun

    #447 - 📑 Journal Club - The Complete Episode from June 13th 2026

    Send us Fan Mail Phototherapy duration, jaundice and UTIs, extended CPAP, and The Pitt. A full week on the Incubator Journal Club. Ben opens with a nationwide Swedish cohort study from JAMA Network Open examining phototherapy duration in nearly 5,000 very preterm infants. Longer phototherapy was not significantly associated with late neonatal mortality, but six to seven days was associated with significantly higher rates of severe neonatal morbidity. With 95% of the cohort receiving phototherapy, Ben and Daphna question how much evidence actually supports the near-universal practice. Daphna follows with a retrospective study from Istanbul showing that 31% of term and near-term neonates hospitalized for unexplained hyperbilirubinemia had culture-proven UTIs, with pathological renal ultrasound findings independently associated with a 4.6-fold increased odds of UTI. Ben then reviews the extended CPAP secondary analysis by Mamidi and McEvoy, showing that two additional weeks of bubble CPAP reduced intermittent hypoxemia episodes from 151.7 to 57.6 compared to discontinued CPAP. Daphna closes with the NEOASP five-day UTI treatment guideline from Nationwide Children's Hospital, where a structured stewardship approach yielded a 1% failure rate. Ben and Eli close the week reflecting on The Pitt and what it reveals about the broken realities of American healthcare. 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!

    1hr 30min
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About

A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.

Information

  • Channel
    The Incubator
  • Creator
    Ben Courchia & Daphna Yasova Barbeau
  • Years Active
    2021 - 2026
  • Episodes
    909
  • Rating
    Explicit
  • Copyright
    © 2026 CATO NEONATAL INNOVATIONS INC.
  • Show Website
    The Incubator
  • Provider

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