The Incubator

• #300 - 🌍 Neonatal Care in Trinidad & Tobago: Challenges & Triumphs (ft. Dr. Marlon Timothy)

  Send us a textIn this episode, Dr. Marlon Timothy shares his journey as a neonatologist, discussing his experiences in Trinidad and Tobago and the evolution of neonatal care. He highlights the challenges faced upon returning from training in Toronto, the establishment of neonatal units, and the implementation of therapeutic hypothermia. Dr. Timothy emphasizes the importance of training and collaboration in improving neonatal outcomes and shares insights into the ongoing efforts to enhance maternal and neonatal health in Trinidad and Tobago. In this conversation, Dr. Marlon Timothy discusses various innovative interventions in neonatal care, the importance of funding and government support, the training and development of neonatologists, the role of research and data in improving care, and the challenges of maintaining work-life balance in a demanding field. He emphasizes the need for global collaboration to enhance neonatal outcomes and shares insights from his experiences in Trinidad and Tobago.As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!

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• #299 - The Hidden Language of NICU Billing with Dr. Scott Duncan

  Send us a textIn this episode of The Incubator, Ben and Daphna speak with Dr. Scott Duncan, Division Chief at the University of Louisville, about the critical importance of medical billing and coding in neonatology. The discussion explores how accurate documentation and thoughtful use of codes can impact everything from individual reimbursement to hospital funding and staffing. Dr. Duncan explains the key differences between critical care and intensive care coding, highlighting how misunderstanding these definitions can lead to missed opportunities for appropriate billing. The conversation also delves into the complexities of CPT and ICD-10 codes, bundled versus unbundled services, and how Diagnosis-Related Group (DRG) systems influence hospital revenue. They discuss how proper coding affects downstream resources, including staffing, and why the financial viability of neonatal units depends in part on getting this right. Dr. Duncan reflects on the need for better education in this area, particularly for trainees, and shares practical resources and upcoming initiatives aimed at helping clinicians build this essential skill set. This episode offers an eye-opening look at a topic often overlooked in medical training, but vital to the sustainability of neonatal care. As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!

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• #298 - 🚀 New solution for non-invasive blood pressure monitoring in the NICU

  Send us a textIn this Tech Tuesday episode, Ben and Daphna welcome Xina Quan, co-founder and CEO of PyrAmes, to introduce a groundbreaking neonatal device: the Boppli. Developed from Stanford research, the Boppli is a non-invasive, wearable blood pressure monitor that provides continuous, real-time readings—without the need for cuffs or arterial catheters.FDA-cleared for babies under five kilograms, the Boppli uses a soft, adhesive-free band that wraps gently around an extremity. Backed by 3,400 hours of clinical validation, the Boppli has shown accuracy approaching that of invasive arterial lines according to the team at Pyrames.Ben and Daphna explore how this innovation could reshape blood pressure monitoring for hypotensive and unstable neonates. Quan shares her vision of the Boppli becoming as commonplace as pulse oximetry in NICUs—empowering care teams with precise, painless data they can finally trust.As she puts it, “Half the battle is having good data—this is a way to finally get it.” As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!

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• #297 - 📑 Journal Club - The Complete Episode from April 6th 2025

  Send us a textIn this week’s Journal Club, Ben and Daphna dissect six critical studies reshaping our understanding of neonatal care. Kicking off with the Canadian Neonatal Network’s multicenter cohort on inhaled nitric oxide (iNO), they explore how early pulmonary hypertension responsiveness to iNO may predict survival in preterm infants. They then examine a poignant study on maternal decision regret following extremely preterm births, revealing elevated regret across all pathways—comfort, active care, or otherwise—underscoring the emotional complexity of shared decision-making. The duo dives into data from the NICHD Neonatal Research Network on how even a single dose of antenatal steroids improves outcomes incrementally by the hour, strengthening the case for early administration. Ben highlights an AI-driven TPN algorithm that may outperform clinicians in individualized nutrition planning, while Daphna introduces an unexpected intervention—xylitol chewing gum—to reduce preterm birth in low-resource settings. Rounding out the discussion is a provocative look at intermittent hypoxemia as a predictor of systemic hypertension and the landmark NICHD trial on therapeutic hypothermia for infants 33–35 weeks GA. With a striking 87% probability of harm, this trial challenges the current drift toward “cooling creep.” Essential listening for any neonatologist seeking evidence-based clarity in an ever-evolving field. As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!

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• #297 - [Journal Club Shorts] - 📌 Whole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.

  Send us a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Feb 24:e246613. doi: 10.1001/jamapediatrics.2024.6613. Online ahead of print.PMID: 39992674As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!

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