Dr. Michael Narvey Neonatologist MD

I never met a baby I didn't like.

I didn't always appreciate how they behaved in the #NICU but with age I learned not to take it too personally.
#NeoSky

In the NICU, time bends — minutes can feel like eternities, and eternities can change in a single breath.
#NeoSky

Darbepoetin for Neuroprotection in Preterm Infants This randomized clinical trial investigates if darbepoetin initiated less than 36 hours after birth improves red blood cell mass and cognitive outcome at 2 years’ corrected gestational age in infants ...

Although darbepoetin for newborns 23-29 weeks increased RBCs and decreased transfusions sadly it didn’t translate into better neurodevelopmental outcome
The silver bullet remains elusive!
#NeoSky #MedSky
jamanetwork.com/journals/jam...

Study finds that non-pharmacological care prior to LISA for surfactant administration may be enough without giving fentanyl. No difference between saline or fentanyl on COMFORTNeo score
#NeoSky

pubmed.ncbi.nlm.nih.gov/40753114/

Applications of point-of-care ultrasonography in the NICU: A Canadian perspective | Canadian Paediatric Society Point-of-care ultrasonography (POCUS) is an adjunctive, portable clinical assessment tool that in the hands of trained clinicians can support differential diagnosis, clarify therapeutic options, and i...

Delighted to see our statement “Applications of point-of-care ultrasonography in the NICU: A Canadian perspective” in print!
#NeoSky

cps.ca/en/documents...

Use of postnatal betamethasone to ⬇️ hosp stay for O2.
Of the infants receiving betamethasone, those weaned from oxygen were discharged home at an earlier PMA (39.6 ± 5.0 vs. 42.0 ± 3.7 week, p < 0.001)
Risks of added steroids in long term?
#NeoSky

pubmed.ncbi.nlm.nih.gov/40671420/

Managing newborns at risk for neonatal abstinence syndrome (NAS)/neonatal opioid withdrawal syndrome (NOWS): Updates and emerging best practices Abstract. The incidence of newborns at risk for withdrawal due to antenatal substance exposure has increased rapidly, presenting significant health and ear

Our new statement on managing newborns at risk of neonatal abstinence/neonatal opioid withdrawal from the CPS
academic.oup.com/pch/advance-...
#NeoSky #Pedsky

In #preemies, furosemide did not ⬆️ adverse events, hearing loss, or nephrocalcinosis, but ⬆️ incidence of electrolyte abnormalities.
Furosemide given for 28 consecutive days was not associated with a difference in mod-to-severe BPD or death at 36 weeks PMA.
pubmed.ncbi.nlm.nih.gov/40306549/
#NeoSky

High Oxygen During Cord Clamping Helps Extremely Preterm Infants Pilot randomized trial shows safety and reduced early hypoxemia

Pilot study giving 100% O2 during deferred cord clamping for extreme #preemies ⬇️ risk of hypoxemia 5 min after birth compared with 30% oxygen
No ⬆️ risk of severe IVH or death
#NeoSky
www.medpagetoday.com/obgyn/pregna...

Is atropine really required in addition to fentanyl & succinylcholine prior to intubation to prevent severe bradycardia in neonates?

We found yes...

Severe bradycardia during the whole procedure was signif > in placebo vs atropine group; RR 6.3(95% CI 1.2 - 34.1)

t.co/TKJovw24BQ

#NeoSky #PedSky

Umbilical arterial catheter.

Don’t think they specified cream or ointment but followed UAC placement. UAC removed once ischemia started

Vasospasm and applied “topically to affected areas”

Distal limb ischemia in a 26 week infant treated with topical nitroglycerin.
Toes saved! Pretty amazing before and after results
pubmed.ncbi.nlm.nih.gov/40589288/
#NeoSky #DermSky

After adjusting for preterm birth there is no association between neonatal jaundice and #autism
I repeat jaundice does not cause autism
#AutismAwareness #NeoSky
pubmed.ncbi.nlm.nih.gov/40590769/

Pilot study finds diaphragmatic thickness worsens with intubation in infants born < 28 wks but even > when sedation is given.
Pause & consider if sedation is required on the ventilator & ask if non-pharmacological strategies are maximized?
pubmed.ncbi.nlm.nih.gov/40365938/ssss
#NeoSky #MedSky

Cognitive and Motor Decline in Children With Asphyxia Therapeutic hypothermia for NE was linked to declining motor, cognitive, and behavioral outcomes, emphasizing the need for long-term monitoring.

Concerning signal ☹️
Serial f/u of neurodevelopment up to 8-10 years following HIE treated w/ cooling.
Motor Z-scores ⬇️ nonlinearly throughout visits, & cognitive Z-scores ⬇️ linearly inchildren with mammillary body abnormalities on neonatal MRI
www.physiciansweekly.com/cognitive-an...
#NeoSky

Permissive hypercapnia (60-75 mmHg & pH ≥ 7.20 vs (40-55 mmHg and pH ≥ 7.25) for 28 days from day 7-14 in #preemies may shorten the total days of ventilation but doesn't change the big outcome of survival without moderate to severe BPD
pubmed.ncbi.nlm.nih.gov/40525736/
#NeoSky

Could a little #yoga be just what the doctor ordered to reduce stress for parents in the NICU?
Pilot study suggest there just might be some benefit
pubmed.ncbi.nlm.nih.gov/40480276/
#NeoSky #PedSky

Delighted to announce that I have joined the board of the Canadian Paediatric Society / Société canadienne de pédiatrie as Vice President! I look forward to working with the other fantastic board members to improve the health of children nationwide!
#NeoSKy #PedSky

Meta-analysis of eat, sleep, console approach to withdrawal vs Finnegan scoring

Is there any reason not to adopt ESC?

ESC ⬇️hospitalisation days (MD -4.11 days, p<0.0001 & the proportion treated with withdrawal medications (OR 0.36, p<0.0001
#NeoSky #PedSky
pubmed.ncbi.nlm.nih.gov/40393782/

YouTube video by Michael Narvey Conjoined #twins Many varieties but timing is everything! #pediatrics #obstetrics #pregnancy

#conjoined twins are a rarity. How many types are there and how might ethics play into their separation?

Starting to post longer form educational videos on YouTube. If you are interested in keeping up-to-date, please consider subscribing to the channel.

youtu.be/GOxDeK63Jj4?... #NeoSky #PedSky

Even if survival is quite unlikely, I see the need of parents to at least try.
You lose 100% who aren’t resuscitated in the 500g range.
Parents may not know what lies ahead but they may be certain they don’t want to spend the rest of their lives asking “what if?”
#NeoSky

YouTube video by Michael Narvey Case of the limp baby! What did the mother have which led to this problem? #newborn #nicu

An unusual reason for a limp baby!

youtu.be/PMNQNVg4ktA

#NeoSky #MedSky #PedSky

Source: shorturl.at/rqKZB

YouTube video by Michael Narvey Caffeine is truly a wonder drug for #preemies and yet pregnant women avoid it. Huh? #pediatrics

In #pregnancy mothers often avoid excessive #caffeine & yet we give it so readily to #preemies after birth
Why is that?👇
youtu.be/OYPP_sxQ9SY
#nicu #neonatal #meded #medsky #medstudent #PedSky

Pilot study finds that fentanyl as sedation for newborns born < 28 weeks reduces diaphragmatic thickness at both end inspiration and expiration.
Does sedation impact not just drive but respiratory muscle function?
doi.org/10.1002/ppul...
#NeoSky

It’s international #kangaroocare day again. Doing my part to represent all the kangaroo fanatics out there supporting akin to skin care for babies!
#NeoSky

Got data? Breastfeeding device measures babies' milk intake in real time While breastfeeding has many benefits for a mother and her baby, it has one major drawback: It's incredibly difficult to know how much milk the baby is consuming. To take the guesswork out of breastfe...

A device to measure how much breastmilk is fed to a baby would certainly take the guess work out & stop pre/post weights to estimate volumes!
medicalxpress.com/news/2025-05...
#NeoSKy #PedSky

The last decade of the war with #syphilis in Canada has not been great but is the tide starting to turn for congenital and infections?
www.sciencedirect.com/science/arti...
#NeoSky #PedSky #STBBI

Pre-term babies, love skin to skin care. Take a look at that smile‼️

Don’t forget to make a mother in the NICU smile today and wish them a happy Mother’s Day !
#mothersday #NeoSky #PedSky