Document Detail


Understanding variation in vitamin A supplementation among NICUs.
MedLine Citation:
PMID:  20603256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We examined and characterized variation among NICUs in the use of vitamin A supplementation for the prevention of bronchopulmonary dysplasia in extremely low birth weight infants. METHODS: An historical cohort study of extremely low birth weight infants admitted within 7 days after birth to NICUs participating in the Pediatric Health Information System database, between January 1, 2005, and March 31, 2008, was performed. NICU medical directors were surveyed to determine attitudes and decision-making regarding adoption of vitamin A supplementation. The proportion of infants receiving vitamin A at each center was measured over time. Patient and hospital characteristics associated with vitamin A use were examined. RESULTS: Among 4184 eligible infants cared for in 30 NICUs, 1005 infants (24%) received vitamin A. Eighteen centers (60%) used vitamin A for some patients. Infants discharged in 2007 (odds ratio: 2.7 [95% confidence interval: 1.4-5.3]) and 2008 (odds ratio: 2.8 [95% confidence interval: 1.4-5.8]), compared with 2005, were more likely to receive vitamin A. NICU medical directors from centers using vitamin A, compared with centers that did not adopt vitamin A supplementation, reported stronger beliefs in the efficacy of vitamin A to reduce the incidence of bronchopulmonary dysplasia (83% vs 33%; P = .03) and in the ease with which vitamin A could be implemented (75% vs 22%; P = .02). CONCLUSIONS: Although the use of vitamin A is increasing, marked variation across NICUs remains. Provider attitudes and system characteristics seem to influence vitamin A adoption.
Authors:
Heather C Kaplan; Meredith E Tabangin; Diana McClendon; Jareen Meinzen-Derr; Peter A Margolis; Edward F Donovan
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Publication Detail:
Type:  Journal Article     Date:  2010-07-05
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e367-73     Citation Subset:  AIM; IM    
Affiliation:
Divisions of Neonatology, Cincinnati Children's Hospital Medical Center, Division of Neonatology, ML 7009, Cincinnati, OH 45229, USA. heather.kaplan@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Bronchopulmonary Dysplasia / drug therapy*
Decision Making, Organizational
Dietary Supplements*
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal*
Male
Physician Executives
Questionnaires
Vitamin A / therapeutic use*
Chemical
Reg. No./Substance:
11103-57-4/Vitamin A

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


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