| Medical management of extremely low-birth-weight infants in the first week of life: a survey of practices in the United States. | |
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MedLine Citation:
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PMID: 19301226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We sought to determine the current practices of neonatologists in their management of extremely low-birth-weight (< 1000 g) infants. We directly mailed an anonymous survey to the medical directors of 809 neonatal intensive care units in the United States. More than one-third of those surveyed responded, with a substantial majority from intensive care (level III) nurseries or extracorporeal membrane oxygenation centers. Academic centers and private practice environments were both well represented. Some traditional practices have changed, such as beginning resuscitation with 40% rather than 100% oxygen. Many practices vary based on whether neonates are cared for in private versus academic centers, including initial resuscitation method, type of ventilation used, use of intraventricular hemorrhage prophylaxis, and routine antibiotic therapy. Parenteral nutrition composition and the use of inhaled nitric oxide differ based on the responding center's participation in clinical trials. The number of years in practice as a neonatologist does not affect practice decisions. Among all our findings, the prevalence of one potentially harmful practice, the continued use of dexamethasone for corticosteroid therapy, was particularly noteworthy. In conclusion, the strength of evidence does not always predict whether practices are adopted or abandoned. Further research is necessary to clarify the optimal management for this high-risk patient population. |
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Authors:
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Autumn S Kiefer; Andrea C Wickremasinghe; Jonathan N Johnson; Tyler K Hartman; Susan R Hintz; William A Carey; Christopher E Colby |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-03-19 |
Journal Detail:
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Title: American journal of perinatology Volume: 26 ISSN: 1098-8785 ISO Abbreviation: Am J Perinatol Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-19 Completed Date: 2009-09-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 407-18 Citation Subset: IM |
Affiliation:
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Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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therapeutic use Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Cerebral Hemorrhage / prevention & control Ductus Arteriosus, Patent / drug therapy Health Care Surveys Humans Infant, Low Birth Weight* Infant, Newborn Infection / diagnosis, drug therapy Neonatology / methods*, statistics & numerical data* Parenteral Nutrition, Total / utilization Physician's Practice Patterns / statistics & numerical data* Respiratory Therapy / utilization United States |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents, Non-Steroidal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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