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The transfusion threshold consensus is here — but practice hasn't fully caught up. In the second episode of On with VON, Ben and Daphna sit down with Dr. Roger Soll and Dr. Ravi Patel to extend the conversation from the Vermont Oxford Network Grand Rounds on evidence to practice for transfusion thresholds.

The core finding across trials is consistent: lower thresholds for both packed red blood cells and platelets appear safe. The guidelines are freely available in JAMA Network Open and actionable — 11, 10, 9 grams per deciliter across the first three weeks for infants on respiratory support. So why hasn't practice shifted uniformly?

The group works through the populations the trials didn't fully capture — hypoxic-ischemic encephalopathy, the most premature infants, and babies in the first week of life when intraventricular hemorrhage risk peaks. On NEC and feeding during transfusion: the data may surprise you. On transfusion volume and infusion duration: an underappreciated variable, particularly for platelets.

The episode closes with practical guidance on implementing transfusion guidelines at the unit level — who needs to be in the room, how informatics tools can support decision-making, and why understanding protocol deviations matters as much as the guidelines themselves.

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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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The AAP has weighed in on therapeutic hypothermia for HIE, and Daphna walks through the clinical report in full. The core eligibility criteria haven't moved — but the edges have gotten more nuanced. Late initiation, the 35-week zone, mild HIE, sentinel events, MRI timing, and feeding during cooling are all addressed.

Also this week: a prospective pilot from Australia tests whether adding bedside ultrasound to plain radiography improves surgical risk stratification in NEC. The X-ray-only model couldn't separate the clusters. The combined model produced a more than six-fold difference in odds of surgery — complex ascites, absent peristalsis, and abnormal bowel perfusion did the heavy lifting.

Daphna then covers F-NeoBright, a small but compelling feasibility study testing intranasal fresh breast milk in infants with moderate to severe HIE. Ten babies, high adherence, no safety signals, and parents administering doses at home.

Ben rounds out Journal Club with the two-year follow-up of the CALI trial examining outcomes after early caffeine plus LISA versus CPAP alone. Mortality trended toward LISA. The statistics didn't get there — but the direction held.

The week closes with Ben and Eli on the Guttmacher Institute study linking restrictive abortion laws to higher maternal mortality across two decades of US data.

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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In this episode of Neo News, Ben and Eli discuss a sobering Guttmacher Institute study recently featured in Bloomberg. Analyzing data from 2005 to 2023, the research reveals a troubling association between restrictive abortion laws and increased maternal mortality, specifically driven by cardiovascular complications and violent deaths. The hosts explore the clinical and social pathophysiology behind these findings, emphasizing how a lack of prenatal care and compounded social stressors disproportionately affect birthing people. Tune in for an important conversation on the "package" of restrictions driving these outcomes and practical ways neonatal professionals can advocate for maternal health equity!

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https://www.bloomberg.com/news/articles/2026-02-12/pregnant-women-die-at-higher-rates-when-states-restrict-abortion?srnd=phx-industries-health

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!