دورية أكاديمية
Eliminating Risk of Intubation in Very Preterm Infants with Noninvasive Cardiorespiratory Support in the Delivery Room and Neonatal Intensive Care Unit
| العنوان: | Eliminating Risk of Intubation in Very Preterm Infants with Noninvasive Cardiorespiratory Support in the Delivery Room and Neonatal Intensive Care Unit |
|---|---|
| المؤلفون: | Balaji Govindaswami, Matthew Nudelman, Sudha Rani Narasimhan, Angela Huang, Sonya Misra, Gilbert Urquidez, Alganesh Kifle, Monica Stemmle, Cathy Angell, Rupalee Patel, Christina Anderson, Dongli Song, Glenn DeSandre, James Byrne, Priya Jegatheesan |
| المصدر: | BioMed Research International, Vol 2019 (2019) |
| بيانات النشر: | Hindawi Limited |
| سنة النشر: | 2019 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Medicine |
| الوصف: | Introduction. Avoiding intubation and promoting noninvasive modes of ventilator support including continuous positive airway pressure (CPAP) in preterm infants minimizes lung injury and optimizes neonatal outcomes. Discharge home on oxygen is an expensive morbidity in very preterm infants (VPI) with lung disease. In 2007 a standardized bundle was introduced for VPI admitted to the neonatal care unit (NICU) which included delayed cord clamping (DCC) at birth and noninvasive ventilation as first-line cardiorespiratory support in the delivery room (DR), followed by bubble CPAP upon NICU admission. Objective. Our goal was to evaluate the risk of (1) intubation and (2) discharge home on oxygen after adopting this standardized DR bundle in VPI born at a regional perinatal center and treated in the NICU over a ten-year period (2008-2017). Materials and Methods. We compared maternal and neonatal demographics, respiratory care processes and outcomes, as well as neonatal mortality and morbidity in VPI (< 33 weeks gestation) and extremely low birth weight (ELBW, < 1000 g) subgroup for three consecutive epochs: 2008-2010, 2011-2013, and 2014-2017. Results. Of 640 consecutive inborn VPI, 55% were < 1500 g at birth and 23% were ELBW. Constant through all three epochs, DCC occurred in 83% of VPI at birth. There was progressive increase in maternal magnesium during the three epochs and decrease in maternal antibiotics during the last epoch. Over the three epochs, VPI had less risk of DR intubation (23% versus 15% versus 5%), NICU intubation (39% versus 31% versus 18%), and invasive ventilation (37% versus 30% versus 17%), as did ELBW infants. Decrease in postnatal steroid use, antibiotic exposure, and increase in early colostrum exposure occurred over the three epochs both in VPI and in ELBW infants. There was a sustained decrease in surfactant use in the second and third epochs. There was no significant change in mortality or any morbidity in VPI; however, there was a significant decrease in pneumothorax (17% versus ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2314-6133 2314-6141 |
| العلاقة: | http://dx.doi.org/10.1155/2019/5984305Test; https://doaj.org/toc/2314-6133Test; https://doaj.org/toc/2314-6141Test; https://doaj.org/article/37b8312e2bf84fdca71d1878efd16c80Test |
| DOI: | 10.1155/2019/5984305 |
| الإتاحة: | https://doi.org/10.1155/2019/5984305Test https://doaj.org/article/37b8312e2bf84fdca71d1878efd16c80Test |
| رقم الانضمام: | edsbas.17F8F0E3 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 23146133 23146141 |
|---|---|
| DOI: | 10.1155/2019/5984305 |