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The Incubator

Ben Courchia & Daphna Yasova Barbeau
The Incubator
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1001 episodes

  • The Incubator

    #456 - [Journal Club] - 🫀 From The Heart - Do These Newborns Have Diastolic Dysfunction, or Just Different Physiology?

    2026/07/30 | 14 mins.
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    In this prospective study, Adrianne and Nim dig into an area with almost no normative pediatric data: right ventricular diastolic function. Comparing 57 infants with RV pressure overload after intervention for pulmonic stenosis or tetralogy of Fallot to 134 healthy controls, the authors found a consistent pattern, reduced beat-to-beat variability, a higher atrial contribution to filling, and an E/A ratio inversion that was nearly universal in the CHD group versus about half of controls. It's one of the first real attempts to define what a right-sided diastolic pattern actually looks like in this population. But without a comparison against cardiac catheterization, the hosts agree the findings are hypothesis-generating at best, a starting point for a multi-parametric approach, not a reason to skip an invasive workup.
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    Echocardiographic Markers of Right Ventricle Diastolic Dysfunction in Neonates and Infants with Congenital Heart Disease. Cantinotti M, Capponi G, Scalese M, Palladino E, Giordano R, Franchi E, Viacava C, Corana G, Marchese P, Pizzuto A, Assanta N, Santoro G. J Clin Med. 2025 Dec 23;15(1):98. doi: 10.3390/jcm15010098. PMID: 41517351 Free PMC article.
    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!
  • The Incubator

    #456 - [Journal Club] - 🫀 From The Heart - Why Does a Sicker Mom Sometimes Mean a Stronger Neonatal Heart?

    2026/07/29 | 14 mins.
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    In this small prospective pilot study, Adrianne and Nim explore a domain rarely discussed on rounds, how a mother's cardiovascular function in preeclampsia shapes her newborn's circulatory transition. Using maternal echo and neonatal electrical cardiometry across 13 mother-baby dyads, the authors found an inverse relationship: the worse the mother's cardiac function, the higher the neonate's cardiac output, though vascular tone barely budged. It's a compelling hypothesis about placental strain and fetal adaptation. But Nim pushes back hard on the methodology, pairing this paper with a companion study showing electrical cardiometry consistently overestimates cardiac output in neonates, and questioning why daily echoes were performed on these babies but the results never reported.
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    Linking maternal and neonatal circulation in preeclampsia. Piani F, Annesi L, Degli Esposti D, Vincenzi S, De Crescenzo S, Della Gatta AN, Simonazzi G, Corvaglia L, Martini S.Am J Physiol Heart Circ Physiol. 2026 Mar 1;330(3):H708-H716. doi: 10.1152/ajpheart.00945.2025. Epub 2026 Jan 12.PMID: 41525138 Free article.
    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!
  • The Incubator

    #456 - [Journal Club] - 🫀 From The Heart - Why Is CHD Mortality Rising Again After 15 Years of Progress?

    2026/07/28 | 12 mins.
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    In this retrospective national study, Adrianne and Nim look at 25 years of congenital heart disease mortality in the US using CDC WONDER data. Infant mortality remains staggeringly high (54 per 100,000), and after years of steady decline, it has been climbing again since 2014. Disparities run throughout: higher deaths among males, non-Hispanic Black and American Indian/Alaska Native populations, and in rural, Midwestern regions, pointing more to gaps in access and resources than to disease biology. The conversation also flags a growing, under-discussed problem, an aging adult congenital population outpacing the pediatric one for the first time, with too few specialists trained to care for them.
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    National Trends and Disparities in Congenital Heart Disease Mortality in the United States, 1999-2024.Raja S, Albrahim MMS, Aldhafeeri BF, Omar AA, Alqadeeb BA, Alhuways MM, Bangaryd AA, Alqahtany MG, Alfaraj AB, Almughyir RS, AlRasheed ST, Alfaifi M. 
    Pediatr Cardiol. 2026 Jan 13. doi: 10.1007/s00246-025-04156-1. Online ahead of print.PMID: 41528440
    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!
  • The Incubator

    #456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD?

    2026/07/27 | 20 mins.
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    In this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predict, kids who went to surgery earlier (days 4-6) had higher rates of white matter injury than those who waited longer. MRI remained the most sensitive tool for picking up these lesions, well ahead of ultrasound or CT. But the data stops well short of proving these findings predict long-term outcomes, and Nim pushes back on the idea that an abnormal scan alone should steer decisions about whether to operate.
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    Prevalence of Ischemic Brain Injury in Neonates With Congenital Heart Disease: A Systematic Review and Meta-Analysis.
    Kim C, Chetan D, Kazazian V, Alzamil J, Chau V, Seed M, Miller SP, Selvanathan T.Neurology. 2026 Feb 10;106(3):e214569. doi: 10.1212/WNL.0000000000214569. Epub 2026 Jan 9.PMID: 41512205
    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!
  • The Incubator

    #455 - [Neo News] - Is Communication a Procedural Skill We're Failing to Train?

    2026/07/24 | 39 mins.
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    What if communication were treated as a procedure, something we train for and get feedback on, just like an intubation?  In this episode of Neo News, Eli Cahan talks with Dr. Jessica Fry of Northwestern University and Lurie Children's Hospital about her NeoReviews piece, "Recognizing Communication as a Procedural Skill in Neonatology." Dr. Fry shares the personal loss that shaped her career, the ethical stakes of getting family communication right, and how trauma-informed care can guide something as simple as how we address parents on rounds. They discuss the critical first 48 hours after admission and how simulation-based training can build real skill over time. A candid look at a skill every NICU provider uses daily, and how we can all get better at it.
    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!
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About The Incubator
A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.
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