Keith J. Barrington

Some babies will, if I can use the term, declare themselves over the first few hours and days of their life.

That's a neonatologist we spoke to, Keith Barrington.

You get a gut feeling.

And that's Diane Lazzell again, the nurse practitioner.

As my wife, the professional ethicist, often says, we don't make important decisions in our life for rational reasons very often.

often.Keith and his wife, Annie Janvier, have done a huge amount of research into the ethics of extremely premature births.

But one of the primary reasons we wanted to talk to him is that in addition to being a neonatologist and a guy who publishes a lot of stuff in this area, he and his wife recently had a baby girl who was born at 24 weeks and five days.

She weighed, uh, 720 grams.

... on, you know, blood pressure targets and autoregulation in this type of, uh, patient?

Oh, boy This is, uh, this is Keith Barrington's world, right? And he spent a career doing it, and he still hasn't given us a good answer, right? What's the blood pressure to do? But, um, there are really interesting and novel things coming to get forward, you know, like the-- We're all looking forward to the HIPP trial, right? Which had to stop a little bit early because of recruitment issues and, um, and it's a problem, but I think new technology is giving us, um, some answers.

So, uh, you know, in the mid two thousand tens, some groups from both Texas and, uh, uh, and, uh, Hopkins were looking at autoregulation, right? It's now a feature that we can use to guide what blood pressure looks like as it reacts to the brain.

And so Jennifer Lee's group out of, uh, DC, uh, and, uh, Hopkins, uh, looked at therapeutic hypothermia, right? They looked at what autoregulation using things like NIRS devices and blood pressure, um, to evaluate, uh, what is optimal blood pressure in this group while cooling, going onto cooling, while cooling, and after cooling, and neurodevelopmental outcomes.