The Incubator

Latest Episodes:

#415 - Finding Optimal PEEP at the Bedside With Electrical Impedance Tomography? Mar 16, 2026

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In this episode, we sit down with Dr. Jessica Shui, attending neonatologist at Mass General for Children, to explore the game-changing potential of Electrical Impedance Tomography (EIT) in the NICU. We dive into her recent paper in the Journal of Perinatology on using non-invasive EIT to identify optimal PEEP in infants with severe bronchopulmonary dysplasia. Dr. Shui explains how this real-time, radiation-free technology allows clinicians to visualize lung mechanics, dynamically titrate ventilator settings, and confidently reduce PEEP without risking atelectasis. Join us as we discuss moving beyond blind adjustments and stepping into the future of personalized neonatal respiratory care.

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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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📑 Journal Club - The Complete Episode from March 14th 2026 Mar 14, 2026

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The PDA debate has a new data point. TREOCAPA, a phase 3 multicenter European RCT, tested prophylactic acetaminophen in infants born at 23 to 28 weeks. The ductus closed more reliably. Whether that translated into better survival without severe morbidity at 36 weeks is where the conversation gets interesting.

Also this week: a large multicenter cohort study puts real numbers on diazoxide use across US NICUs and the pulmonary hypertension risk that has driven so much practice variation. The NeoDry trial tests whether drying very preterm infants before plastic wrapping improves normothermia at admission, with results that are a good reminder of why we run trials. And a retrospective from NYU raises the question of whether standard caffeine dosing in the most premature infants is leaving something on the table.

The episode closes with Ben and Eli on Florida’s infant formula heavy metal report and why publishing findings without methods may be as much a public health problem as the data itself.

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#414 - [Neo News] - 📌 How Can Clinicians Navigate Unverified Formula Safety Data? Mar 13, 2026

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In this Neo News episode, Ben and Eli dive into the recent controversial announcement from the state of Florida regarding heavy metals and pesticides found in infant formulas. They discuss the implications of releasing testing data without transparent methodology or clinical context, especially for unregulated or recalled brands like ByHeart and Similac Soy Isomil. How should NICU clinicians counsel parents who want to bring their own formulas from home? Tune in as they unpack the regulatory loopholes, the evolving public health initiatives, and the ongoing challenge of navigating unverified reports in neonatal care!

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https://www.miamiherald.com/news/politics-government/article314266407.html

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#413 - [Journal Club] - 📌 Should We Increase Caffeine Dosing for Extremely Preterm Infants? Mar 12, 2026

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In this episode of Journal Club, Ben and Daphna review a retrospective cohort study exploring the effects of higher caffeine maintenance dosing on BPD and neurodevelopmental outcomes. They discuss the transition from the standard CAP trial doses to higher regimens for infants born at or before 28 weeks gestation. Does an average daily dose of over six milligrams per kilogram reduce severe BPD or improve Bayley cognitive scores at six months? Tune in as they debate the safety, clinical implications, and their own unit's practices regarding caffeine management in the NICU!

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Effects of higher caffeine dosing on rates of bronchopulmonary dysplasia and neurodevelopmental outcomes. Fleishaker S, Kazmi SH, Mavrogiannis N, Street H, Ravuri H, Moinuddin T, Pierce K, Verma S.J Perinatol. 2026 Feb 23. doi: 10.1038/s41372-026-02593-1. Online ahead of print.PMID: 41731043

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#412 - [Journal Club] - 📌 Does Drying Very Preterm Infants Before Wrapping Improve Normothermia? Mar 11, 2026

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In this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies!

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Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902.

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#411 - [Journal Club] - 📌 Is Diazoxide Use Increasing for NICU Hypoglycemia? Mar 10, 2026

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In this Journal Club episode, Ben and Daphna review a large cohort study from the Journal of Perinatology on the prevalence and safety of diazoxide in the NICU. With neonatal hypoglycemia seemingly on the rise, they discuss off-label use for transient hyperinsulinism and evaluate real-world data from over 340 Pediatrix units. They dive into the rates of concurrent diuretic therapy, respiratory support, and the dreaded risk of pulmonary hypertension. Tune in for a clinical breakdown of when and how this medication is being utilized across centers, plus Ben's echocardiography struggles with cranky term babies on diazoxide!

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Prevalence and safety of diazoxide in the neonatal intensive care unit. Collins LC, Daniel KB, Tolia VN, Parikh P, Gray KD, Greenberg RG.J Perinatol. 2026 Feb 3. doi: 10.1038/s41372-026-02568-2. Online ahead of print.PMID: 41634357

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#410 - [Journal Club] - 📌 Prophylactic Acetaminophen for PDA, Does Early Closure Improve Outcomes? Mar 09, 2026

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In this Journal Club episode, Ben and Daphna review the highly anticipated TREOCAPA trial results exploring the prophylactic use of acetaminophen for PDA closure in extremely preterm infants. They break down the study's tailored dosing regimens, safety outcomes like cholestasis, and discuss why achieving a higher rate of early ductal closure didn't necessarily translate to improved survival without severe morbidity. Plus, they share a nod to recent Neo Conference interviews and the realities of conducting clinical research in private practice. Tune in for a nuanced discussion on individualizing PDA management in the NICU!

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Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. Rozé JC, Cambonie G, Flamant C, Patkaï J, Mühlbacher T, Gascoin G, Rideau Batista Novais A, Tauzin M, Le Duc K, Beuchée A, Joye S, Babacheva E, Bouissou A, Ligi I, Tammela O, Plourde M, Dempsey E, Tosello B, Nguyen K, Vincent M, Andresson P, Binder C, Kruse C, Barcos Munoz F, Kuhn P, Proença E, Bartocci M, Kermorvant-Duchemin E, Nellis G, Lumia M, Giapros V, Rigo V, Sankilampi U, Mendes da Graça A, Rønnestad A, Soukka H, Mondì V, Aikio O, Torre-Monmany N, Rüegger C, Baud O, Zeitlin J, Morgan AS, Baruteau AE, Ancel PY, Carbajal R, Bouazza N, Diallo A, Levoyer L, Kemper R, Hallman M, Alberti C, Ursino M; TREOCAPA Study Group.JAMA Pediatr. 2026 Feb 16:e256150. doi: 10.1001/jamapediatrics.2025.6150. Online ahead of print.PMID: 41697673

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#409 - 🔵 [NEO CONFERENCE] - Saving Babies, a book that capture the stories from the NICU (Dr. Tarek Nakhla) Mar 06, 2026

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Live from the NEO Conference in Las Vegas, Ben and Daphna sit down with Dr. Tarek Nakhla to discuss his new book, Saving Babies Behind the Doors of the Neonatal Intensive Care Unit. Moving beyond standard medical textbooks, Dr. Nakhla shares how chronicling nearly 30 years of challenging patient encounters and complex family dynamics can serve as an essential guide for new trainees. The conversation highlights the therapeutic power of narrative medicine for clinicians and the profound impact of non-clinical staff on the family experience. Discover why capturing the human side of neonatology is just as critical as the clinical science.

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#408 - 🔵 [NEO CONFERENCE] - How does structured bedside data power multicenter comparative effectiveness research? (Dr. Veeral Tolia) Mar 06, 2026

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How can a database tracking 20% of all US NICU admissions change the way we practice neonatology? Live from the NEO Conference, Ben and Daphna sit down with Dr. Veeral Tolia to discuss his groundbreaking work with the Pediatrix Clinical Data Warehouse. Dr. Tolia dives into the power of leveraging decades of observational data to supplement randomized trials—from analyzing the 50-fold increase in Precedex usage to studying natural experiments like the vitamin A shortage. The group also looks ahead to the Newborn Express dataset, exploring how socioeconomic metrics like the Child Opportunity Index might help us understand the alarming rise in neonatal vitamin K refusals.

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#407 - 🔵 [NEO CONFERENCE] - How can we build AI literacy among bedside clinicians (Dr. James Barry) Mar 05, 2026

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How will artificial intelligence fundamentally change the way we chart, teach, and monitor patients in the NICU? Live from the NEO Conference, Ben and Daphna sit down with Dr. James Barry to explore the critical need for "AI literacy" among bedside clinicians. Dr. Barry draws parallels between driver's education and safe AI use, highlighting the hidden dangers of automation complacency with AI scribes. They also discuss the exciting potential of computer vision in respiratory monitoring and how the CONCERN early warning system is quantifying nursing intuition. Join us as we navigate the guardrails of neonatology's technological future.

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