| Incubator weaning in preterm infants and associated practice variation. | |
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MedLine Citation:
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PMID: 19461592 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the relationship of weight of preterm infants when first placed into an open crib with days to full oral feedings, growth velocity and length of stay (LOS), and to identify unwarranted variation in incubator weaning after adjusting for severity indices. STUDY DESIGN: A retrospective study using the ParadigmHealth neonatal database from 2003 to 2006 reviewed incubator weaning to an open crib in appropriate-for-gestational-age (AGA) infants from 22 to weeks gestation. Primary outcome measurements included days to full oral (PO) feeding, weight gain from open crib to discharge and length of stay. Models were severity adjusted. To understand hospital practice variation, we also used a regression model to estimate the weight at open crib for the top 10 volume hospitals. RESULT: In all 2908 infants met the inclusion criteria for the study. Their mean weight at open crib was 1850 g. On average every additional 100 g an infant weighed at the open crib was associated with increased time to full PO feeding by 0.8 days, decreased weight gained per day by 1 gram and increased LOS by 0.9 days. For the top 10 volume hospitals, severity variables alone accounted for 9% of the variation in weight at open crib, whereas the hospital in which the baby was treated accounted for an additional 19% of the variation. CONCLUSION: Even after controlling for severity, significant practice variation exists in weaning to an open crib, leading to potential delays in achieving full-volume oral feeds, decreased growth velocity and prolonged LOS. |
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Authors:
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R Schneiderman; S Kirkby; W Turenne; J Greenspan |
Publication Detail:
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Type: Journal Article Date: 2009-05-21 |
Journal Detail:
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Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 29 ISSN: 1476-5543 ISO Abbreviation: J Perinatol Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-29 Completed Date: 2009-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 570-4 Citation Subset: IM |
Affiliation:
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Alere (formerly ParadigmHealth), Marietta, GA, USA. roy.schneiderman@alere.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bottle Feeding* Breast Feeding* Databases, Factual Female Humans Incubators, Infant Infant, Newborn Infant, Premature / growth & development* Infant, Very Low Birth Weight Male Physician's Practice Patterns* Ventilator Weaning* Weight Gain |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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