The Incubator #393 - đ Journal Club - The Complete Episode from January 17th 2026
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Jan 17, 2026 They discuss using NT-proBNP as a blood-screen for chronic pulmonary hypertension in extremely preterm infants. They puzzle over low culture-positive sepsis despite near-universal antibiotics during therapeutic cooling. A Norwegian trial shows serial bedside exams can halve antibiotic exposure. Research links NICU capacity strain to worse outcomes. They finish with conflicting CDC and AAP guidance on the Hepatitis B birth dose and how to counsel families.
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ProBNP Offers Moderate Diagnostic Value
- NT-proBNP levels were higher in extremely preterm infants with chronic pulmonary hypertension compared to those without.
- A low cutoff (â1,129 ng/L) yields high sensitivity while a high cutoff (â2,674 ng/L) yields high specificity, so thresholds trade off misses vs false positives.
Use ProBNP As Adjunct, Not Replacement
- Consider using NT-proBNP as an adjunct when echo access or hemodynamics expertise is limited.
- Use stepwise cutoffs for screening (sensitive) versus confirmation (specific) rather than a single threshold.
Sepsis Is Rare In Cooled Infants
- In two European centers, <1% of infants cooled for HIE had culture-proven early-onset sepsis despite almost universal empiric antibiotics.
- Biomarkers (CRP, PCT) often rise after 24â48h during cooling, limiting early interpretation.