Literature DB >> 19117859

Reduction in the incidence of chronic lung disease in very low birth weight infants: results of a quality improvement process in a tertiary level neonatal intensive care unit.

Howard J Birenbaum1, Abby Dentry, Jane Cirelli, Sabah Helou, Maria A Pane, Karen Starr, Clifford F Melick, Linda Updegraff, Cynthia Arnold, Angela Tamayo, Virma Torres, Norma Gungon, Stephen Liverman.   

Abstract

OBJECTIVE: Our objective was to reduce the incidence of chronic lung disease by introducing potentially better practices in our delivery room and NICU.
METHODS: We compared the incidences of chronic lung disease in infants with birth weights of 501 to 1500 g in 2002 and 2005, after implementation of the changes. Medical records for infants of 501 to 1500 g who were born in 2002 and 2005 were reviewed for maternal characteristics, care of the infant in the delivery room and the NICU (including surfactant usage, duration of ventilation, duration of continuous positive airway pressure therapy, and duration of oxygen treatment), length of stay, and short-term clinical outcomes (eg, pneumothorax, severe intracranial hemorrhage, retinopathy of prematurity, and weight gain).
RESULTS: There was a significant reduction in our incidence of chronic lung disease, from 46.5% in 2002 to 20.5% in 2005. The number of infants discharged from the hospital with oxygen therapy also decreased significantly, from 16.4% in 2002 to 4.1% in 2005. The overall relative risk reduction for chronic lung disease in 2005, compared with 2002, was 55.8%.
CONCLUSIONS: By using a quality improvement process that included avoidance of intubation, adoption of new pulse oximeter limits, and early use of nasal continuous positive airway pressure therapy, we demonstrated a significant reduction in the incidence of chronic lung disease in infants with birth weights of <1500 g in 2005, in comparison with 2002. These results have persisted to date. There were no significant short-term complications.

Entities:  

Mesh:

Year:  2009        PMID: 19117859     DOI: 10.1542/peds.2007-2872

Source DB:  PubMed          Journal:  Pediatrics        ISSN: 0031-4005            Impact factor:   7.124


  17 in total

Review 1.  CPAP review.

Authors:  Olie Chowdhury; Catherine J Wedderburn; Donovan Duffy; Anne Greenough
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2.  Predicting death or tracheostomy placement in infants with severe bronchopulmonary dysplasia.

Authors:  K Murthy; R C Savani; J M Lagatta; I Zaniletti; R Wadhawan; W Truog; T R Grover; H Zhang; J M Asselin; D J Durand; B L Short; E K Pallotto; M A Padula; F D Dykes; K M Reber; J R Evans
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Review 3.  Application of quality improvement approaches in health-care settings to reduce missed opportunities for childhood vaccination: a scoping review.

Authors:  Abdu A Adamu; Olalekan A Uthman; Elvis O Wambiya; Muktar A Gadanya; Charles S Wiysonge
Journal:  Hum Vaccin Immunother       Date:  2019-04-22       Impact factor: 3.452

4.  Intra-gastric pressures in neonates receiving bubble CPAP.

Authors:  Prashant Tyagi; Neeraj Gupta; Akanksha Jain; Pramod Upadhyay; Jacob Puliyel
Journal:  Indian J Pediatr       Date:  2014-09-04       Impact factor: 1.967

Review 5.  Quality improvement in neonatal care - a new paradigm for developing countries.

Authors:  Deepak Chawla; Gautham K Suresh
Journal:  Indian J Pediatr       Date:  2014-04-05       Impact factor: 1.967

6.  Effects of delivery room quality improvement on premature infant outcomes.

Authors:  W Lapcharoensap; M V Bennett; R J Powers; N N Finer; L P Halamek; J B Gould; P J Sharek; H C Lee
Journal:  J Perinatol       Date:  2016-12-22       Impact factor: 2.521

Review 7.  The new bronchopulmonary dysplasia.

Authors:  Alan H Jobe
Journal:  Curr Opin Pediatr       Date:  2011-04       Impact factor: 2.856

8.  NICU bedside caregivers sustain process improvement and decrease incidence of bronchopulmonary dysplasia in infants < 30 weeks gestation.

Authors:  Sara J Mola; David J Annibale; Carol L Wagner; Thomas C Hulsey; Sarah N Taylor
Journal:  Respir Care       Date:  2014-11-25       Impact factor: 2.258

Review 9.  Recent Advances in Bronchopulmonary Dysplasia: Pathophysiology, Prevention, and Treatment.

Authors:  Jung S Hwang; Virender K Rehan
Journal:  Lung       Date:  2018-01-27       Impact factor: 2.584

10.  Prevention of bronchopulmonary dysplasia.

Authors:  Matthew M Laughon; P Brian Smith; Carl Bose
Journal:  Semin Fetal Neonatal Med       Date:  2009-09-06       Impact factor: 3.926

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