The Incubator

Latest Episodes:

#396 - [Journal Club] - 📌 Surfactant Thresholds: Is 40% FiO2 as Safe as 30%? Feb 10, 2026

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In this episode of Journal Club, Ben and Daphna review a non-inferiority trial from the European Journal of Pediatrics exploring surfactant administration thresholds in preterm neonates. The study, conducted in India, compares a 30% versus 40% FiO2 threshold for babies 26-32 weeks gestational age. The hosts break down the counterintuitive findings regarding respiratory support duration in younger subgroups and discuss the broader implications of using rigid FiO2 heuristics versus individualized patient assessment. They also debate how resource availability influences clinical protocols and the potential benefits of "LISA" (Less Invasive Surfactant Administration) for avoiding intubation.

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Higher (40%) versus lower (30%) FiO2 threshold for surfactant administration in preterm neonates between 26 and 32 weeks of gestational age: a non-inferiority randomized controlled trial. Haq MI, Datta V, Bandyopadhyay T, Nangia S, Anand P, Murukesan VM.Eur J Pediatr. 2025 Nov 25;184(12):793. doi: 10.1007/s00431-025-06628-1.PMID: 41288797 Clinical Trial.

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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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#396 - [Journal Club] - 📌 TORPIDO 30/60: Is Higher Initial Oxygen Safer for Preterm Infants? Feb 09, 2026

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In this episode of The Incubator, Ben and Daphna return from the Delphi Conference to dive back into Journal Club. They review the highly anticipated TORPIDO 30/60 trial published in JAMA, comparing initial oxygen concentrations of 30% versus 60% for preterm resuscitation. The hosts discuss the primary outcomes of survival and brain injury, while highlighting intriguing secondary findings regarding chest compressions and epinephrine use in the delivery room. They also share exciting updates on the Vermont Oxford Network collaboration and a new family study from the GFCNI.

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Targeted Oxygen for Initial Resuscitation of Preterm Infants: The TORPIDO 30/60 Randomized Clinical Trial. Oei JL, Kirby A, Travadi J, Davis P, Wright I, Ghadge A, Yeung C, Cruz M, Keech A, Hague W, Lui K, Vento M, Gordon A, De Waal K, Chaudhari T, Hong TSL, Morris S, Kushnir A, Bonney D, Tracy M, Kumar K, Chhnia AS, Baral VR, Muniyappa P, Cheah FC, Sarnadgouda P, Rajadurai VS, Balakrishnan U, Oleti TP, Aldecoa-Bilbao V, Couce ML, Collados CT, Fernández RE, Moliner E, Ruiz Gonzalez MD, Singhal M, Agrawal G, Singh J, Pal S, Nayya S, Arora R, Amboiram P, Simes J, Tarnow-Mordi W; TORPIDO30/60 Collaborative Group.JAMA. 2025 Dec 10:e2523327. doi: 10.1001/jama.2025.23327. Online ahead of print.PMID: 41369162

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#395 - [DELPHI PANEL] - How is Artificial Intelligence Transforming Neonatal Care? Jan 29, 2026

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This recording captures the AI panel discussion from the 2026 Delphi Neonatal Innovation Conference, held live on Monday afternoon. Dr. Jim Barry (University of Colorado), Dr. Thao Ho (UCSF), Lindsey Knake (University of Iowa), Selva Selvaraj (Nicklaus Children's Health System), and Dr. Ryan McAdams (University of Wisconsin-Madison) discuss where AI stands in the NICU today.

The panelists cover predictive models for sepsis and NEC, AI documentation tools, and the gap between research prototypes and clinical implementation. They address challenges with generalizability across different units, ethical considerations, parent-facing AI applications, and what might be standard practice in ten years. If you're trying to figure out what's actually working versus what's still theoretical, this conversation covers the current state of play.

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#394 - The Pxxs: Pampers Creates the World's Smallest Diaper for 22-Week Preemies Jan 18, 2026

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What if the smallest patients finally had a diaper designed just for them? For years, NICUs have struggled to find appropriately sized diapers for extremely premature infants, often resorting to makeshift solutions that compromised skin integrity and care quality. That changes now. In this breaking news episode, Ben sits down with Harry McCusker, Director of Research and Development for North America Pampers Diapers, to discuss the groundbreaking launch of the Pxxs diaper—the world's smallest commercially available diaper, specifically engineered for micropreemies born as early as 21-23 weeks gestation. Weighing less than a nickel and designed with input from NICU professionals worldwide, the Pxxs addresses critical challenges in skin protection, fluid management, and developmental care for our most vulnerable patients. Join us as we explore how this innovation represents more than just a smaller diaper—it's Pampers' commitment that every preemie deserves products designed with their unique needs in mind.

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#393 - 📑 Journal Club - The Complete Episode from January 17th 2026 Jan 17, 2026

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Could a simple blood test help identify chronic pulmonary hypertension when echo access is limited? This week on The Incubator Podcast, Ben and Daphna explore this question and others relevant to daily NICU practice. A Toronto study examines NT-proBNP as a practical diagnostic tool in extremely preterm infants.

They also examine a puzzling finding from Italy and Belgium: despite near-universal antibiotic use in neonates with HIE undergoing cooling, actual culture-positive sepsis rates are surprisingly low. What does this mean for our approach to empiric antibiotics?

Ben presents Norwegian data showing that serial physical exams cut antibiotic exposure in half for term and late preterm infants—without compromising safety. Daphna follows with research connecting NICU capacity strain to patient outcomes, underscoring why adequate staffing isn’t just about comfort, but about survival.

The episode concludes with Ben, Daphna, and Eli discussing the recent CDC changes to Hepatitis B birth dose recommendations. With federal guidance now diverging from AAP recommendations, how do we navigate conversations with families? They explore transmission risks parents may overlook and share approaches to shared decision-making when expert opinions conflict.

A full week of neonatal medicine research and real-world clinical challenges, all in one episode

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#393 - [Neo News] - 📌 CDC vs. AAP: What Is the Right Approach to Hep B Vaccination at Birth? Jan 16, 2026

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This week on Neo News, we tackle the recent and controversial divergence between CDC and AAP guidelines regarding the birth dose of the Hepatitis B vaccine. With the CDC now recommending a deferred schedule for infants of Hepatitis B-negative mothers, we explore the clinical implications, the risks of vertical transmission, and the challenge of navigating discordant public health advice. We discuss how to handle shared decision-making in an era of waning vaccine confidence and why the "birth dose" remains a critical safety net in a community setting. Join us as we break down the data behind the headlines.

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American Academy of Pediatrics. (2025, December 15). AAP: CDC decision on universal birth dose of hepatitis B vaccine irresponsible and purposely misleading. AAP News. https://publications.aap.org/aapnews/news/33980/AAP-CDC-decision-on-universal-birth-dose-of?searchresult=1?autologincheck=redirected

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#393 - [Journal Club] - 📌 Are We Too Busy? NICU Strain and Adverse Outcomes Jan 15, 2026

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In this episode of Journal Club, Ben and Daphna review a retrospective cohort study from the Journal of Perinatology examining the association between NICU capacity strain and neonatal outcomes. We discuss how high census and acuity on admission day correlate with increased mortality and morbidity when adjusted for hospital and patient factors. Join us as we explore why being "slammed with admissions" is more than just a badge of honor—it’s a critical safety metric for our patients.

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The association of NICU capacity strain with neonatal mortality and morbidity. Salazar EG, Passarella M, Formanowski B, Rogowski J, Edwards EM, Halpern SD, Phibbs C, Lorch SA.J Perinatol. 2025 Dec;45(12):1801-1808. doi: 10.1038/s41372-025-02449-0. Epub 2025 Oct 20.PMID: 41116036 Free PMC article.

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#393 - [Journal Club] - 📌 Replacing Sepsis Screens with Serial Physical Exams: Is It Safe? Jan 14, 2026

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In this episode of The Incubator Podcast, Ben and Daphna review a pivotal population-based study from Norway examining a new approach to Early-Onset Sepsis (EOS). The hosts discuss whether serial physical examinations can safely replace routine antibiotic prophylaxis in at-risk term and late-preterm infants. With antibiotic exposure often far exceeding sepsis incidence, this study offers compelling data for a "less is more" strategy. Tune in as Ben and Daphna explore the safety, efficacy, and bedside implications of substituting automatic treatment with structured clinical monitoring—and what this means for reducing unnecessary interventions in the NICU.

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Serial physical examination to reduce unnecessary antibiotic exposure in newborn infants: a population-based study. Vatne A, Eriksen BHH, Bergqvist F, Fagerli I, Guthe HJT, Iversen KV, Ud Din FS, van der Weijde J, Kvaløy JT, Rettedal S.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 19:fetalneonatal-2025-329639. doi: 10.1136/archdischild-2025-329639. Online ahead of print.PMID: 41260908

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#393 - [Journal Club] - 📌 Antibiotic Use in HIE, A Tale of Two Strategies Jan 13, 2026

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In this episode of Journal Club, Ben and Daphna dive into a multicenter retrospective study from the European Journal of Pediatrics questioning the necessity of universal empiric antibiotics in neonates undergoing therapeutic hypothermia for HIE. Comparing Italian and Belgian cohorts, the team discusses the reality of a 111 Number Needed to Treat (NNT) for a single case of culture-proven sepsis. From the diagnostic challenges of overlapping clinical markers to the fascinating "asymptote" of postnatal leukocyte trends, we explore whether it's time to shift from routine to selective antibiotic use in our most complex patients.

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Antibiotic use in neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia: time to rethink universal empirical treatment. De Rose DU, Piersigilli F, Auriti C, Campi F, Cortazzo V, Samaey A, Carkeek K, Martini L, Maddaloni C, Santisi A, Ronci S, Iacona G, Bersani I, Savarese I, Danhaive O, Cilio MR, Bernaschi P, Dotta A, Ronchetti MP.Eur J Pediatr. 2025 Nov 22;184(12):781. doi: 10.1007/s00431-025-06652-1.PMID: 41275063

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#393 - [Journal Club] - 📌 Can NT-proBNP Guide Clinical Suspicion of Chronic Pulmonary Hypertension? Jan 12, 2026

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In this Journal Club episode of the Incubator Podcast, Ben Courchia and Daphna Yasova-Barbeau review a study from the Journal of Perinatology evaluating NT-proBNP as a diagnostic tool for chronic pulmonary hypertension in extremely preterm infants. The discussion walks through the clinical burden of pulmonary hypertension in babies with bronchopulmonary dysplasia, the limitations of echocardiography, and the appeal of accessible biomarkers. Using data from a SickKids Toronto cohort, the hosts unpack sensitivity, specificity, cutoff values, and real-world applicability, while exploring how NT-proBNP could support screening, risk stratification, and bedside decision-making in everyday NICU practice.

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Can N-terminal pro-brain natriuretic peptide accurately diagnose chronic pulmonary hypertension among extremely low gestational age neonates: A Retrospective Cohort Study. Garcia-Gozalo M, Jain A, Weisz DE, Jasani B.J Perinatol. 2025 Nov 13. doi: 10.1038/s41372-025-02462-3. Online ahead of print.PMID: 41233504

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