Document Detail


Can delivery room management impact the length of hospital stay in premature infants?
MedLine Citation:
PMID:  16855619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the impact of initiating early nasal continuous positive airway pressure (ENCPAP) on the length of hospital stay (LOS) for the very low birth weight (VLBW) infants. STUDY DESIGN: LOS at the George Washington University Hospital (GW) after the institution of ENCPAP policy was compared to benchmark values using two-tail t-tests. The incidence of neonatal morbidity was calculated using Bonferroni corrected 95% confidence interval as compared to benchmark rates (alpha=0.001). Comparisons were repeated after stratification of the population into four birth weight subcategories: group A (GrpA) (501 to 750 g), GrpB (751 to 1000 g), GrpC (1001 to 1250 g) and GrpD (1251 to 1500 g). RESULTS: We studied 228 consecutive VLBW infants (birth weight: 995+/-294 g and gestational age: 27.7+/-2.7 weeks). Compared to benchmark values, the GW experience was associated with a significant reduction of 5.1 days in LOS (55.9+/-25.2 vs 61+/-32 days; P=0.04). The decrease in LOS was consistent in all subgroups, but was most noticeable in infants of the smallest weight subcategory (LOS in GrpA=86+/-21 vs 104+/-32, P=0.004; in GrpB=69.9+/-16.7 vs 79+/-27, P=0.018; in GrpC=48.2+/-13 vs 56+/-22, P<0.001 and in GrpD=31.7+/-12.5 vs 40+/-19, P=0.003). In the overall population, a lower incidence of chronic lung disease (CLD) (17.8 vs 29%, P<0.001) was also noted. There were no differences in mortality rates (9 vs 14%), or the incidence of necrotizing enterocolitis (NEC) (8 vs 6%) or intraventricular hemorrhage (6.2 vs 9%) between GW and the established benchmark rates. CONCLUSION: ENCPAP may reduce LOS in VLBW infants in our study population. This relatively shorter LOS was associated with a lower incidence of CLD, which may be a contributing factor.
Authors:
H Aly; A N Massaro; A A E El-Mohandes
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2006-07-20
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  26     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-28     Completed Date:  2007-01-09     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-6     Citation Subset:  IM    
Affiliation:
Department of Newborn Services, The George Washington University Hospital, 900 23rd Street, Washington, DC 20037, USA. haly@mfa.gwu.edu
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MeSH Terms
Descriptor/Qualifier:
Continuous Positive Airway Pressure*
Delivery, Obstetric
Female
Gestational Age
Humans
Incidence
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology,  prevention & control*
Infant, Very Low Birth Weight*
Length of Stay*
Lung Diseases / epidemiology,  prevention & control*
Male
Outcome Assessment (Health Care)
Postnatal Care / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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