Document Detail


Improving surveillance for hyperammonemia in the newborn.
MedLine Citation:
PMID:  23746553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Prompt ascertainment is crucial for the management of hyperammonemic infants. Because these patients are rare and recognition of hyperammonemia is often delayed, we designed and implemented an electronic medical record (EMR)-based tool to assist physicians in the detection of hyperammonemia.
METHODS: We retrospectively evaluated the hospitalizations of prior hyperammonemic infants to identify codable elements that could trigger an EMR-based warning. An alert was designed and implemented and its utilization was prospectively analyzed.
RESULTS: Blood gas studies were obtained universally and early in the retrospectively evaluated infants (x¯=26h before ammonia level). Prompting physicians to evaluate ammonia after ordering blood gas studies would have accelerated the initial ammonia order in 89% of retrospective cases. The alert has activated 184 times over the first six months of operation leading to 63 laboratory evaluations and detection of one hyperammonemic infant.
CONCLUSION: Implementation of an EMR-based warning system can improve surveillance for hyperammonemia in a susceptible population.
Authors:
Samantha A Vergano; Jonathan M Crossette; Frederick C Cusick; Bimal R Desai; Matthew A Deardorff; Neal Sondheimer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-05-18
Journal Detail:
Title:  Molecular genetics and metabolism     Volume:  110     ISSN:  1096-7206     ISO Abbreviation:  Mol. Genet. Metab.     Publication Date:    2013 Sep-Oct
Date Detail:
Created Date:  2013-08-26     Completed Date:  2014-03-17     Revised Date:  2014-09-02    
Medline Journal Info:
Nlm Unique ID:  9805456     Medline TA:  Mol Genet Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Ammonia / metabolism*
Electronic Health Records*
Epidemiological Monitoring
Female
Humans
Hyperammonemia / diagnosis*,  metabolism,  pathology
Infant
Infant, Newborn
Male
Retrospective Studies
Urea / metabolism*
Grant Support
ID/Acronym/Agency:
K08 HD058022/HD/NICHD NIH HHS; K08HD058022/HD/NICHD NIH HHS; T32 GM008638/GM/NIGMS NIH HHS; T32GM008638/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
7664-41-7/Ammonia; 8W8T17847W/Urea
Comments/Corrections

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


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