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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.

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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

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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.

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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.

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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!