Document Detail


Medical management of extremely low-birth-weight infants in the first week of life: a survey of practices in the United States.
MedLine Citation:
PMID:  19301226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-19
Journal Detail:
Title:  American journal of perinatology     Volume:  26     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-19     Completed Date:  2009-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  407-18     Citation Subset:  IM    
Affiliation:
Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / 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:
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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