Seetha Shankaran1, Edward F Bell2, Abbot R Laptook3, Shampa Saha4, Nancy S Newman5, S Nadya J Kazzi6, John Barks7, Barbara J Stoll8, Rebecca Bara6, Jenna Gabrio4, Kirsten Childs6, Abhik Das9, Rosemary D Higgins10, Waldemar A Carlo11, Pablo J Sánchez12, David P Carlton13, Lara Pavageau14, William F Malcolm15, Carl T D'Angio16, Robin K Ohls17, Brenda B Poindexter18, Gregory M Sokol19, Krisa P Van Meurs20, Tarah T Colaizy2, Ayman Khmour21, Karen M Puopolo22, Meena Garg23, Michele C Walsh5. 1. Department of Pediatrics, Wayne State University, Detroit, MI. Electronic address: sshankar@med.wayne.edu. 2. Department of Pediatrics, University of Iowa, Iowa City, IA. 3. Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI. 4. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC. 5. Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH. 6. Department of Pediatrics, Wayne State University, Detroit, MI. 7. Department of Pediatrics, University of Michigan, Ann Arbor, MI. 8. Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX. 9. Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD. 10. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD. 11. Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL. 12. Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH. 13. Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA. 14. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX. 15. Department of Pediatrics, Duke University, Durham, NC. 16. Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY. 17. Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM. 18. Department of Pediatrics, Perinatal Institute, Cincinnati Children's Hospital, Cincinnati, OH. 19. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN. 20. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA. 21. Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO. 22. Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA. 23. Department of Pediatrics, University of California, Los Angeles, CA.
Abstract
OBJECTIVE: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. STUDY DESIGN: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. RESULTS: Of 1565 infants screened, 885 were eligible, and 366 enrolled-187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P = .12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P = .005). Groups did not differ in adverse events. CONCLUSIONS: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02160002.
RCT Entities:
OBJECTIVE: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. STUDY DESIGN: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. RESULTS: Of 1565 infants screened, 885 were eligible, and 366 enrolled-187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P = .12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P = .005). Groups did not differ in adverse events. CONCLUSIONS: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02160002.
Authors: Karel O'Brien; Kate Robson; Marianne Bracht; Melinda Cruz; Kei Lui; Ruben Alvaro; Orlando da Silva; Luis Monterrosa; Michael Narvey; Eugene Ng; Amuchou Soraisham; Xiang Y Ye; Lucia Mirea; William Tarnow-Mordi; Shoo K Lee Journal: Lancet Child Adolesc Health Date: 2018-02-08
Authors: Michele C Walsh; Edward F Bell; Sarah Kandefer; Shampa Saha; Waldemar A Carlo; Carl T D'angio; Abbot R Laptook; Pablo J Sanchez; Barbara J Stoll; Seetha Shankaran; Krisa P Van Meurs; Noah Cook; Rosemary D Higgins; Abhik Das; Nancy S Newman; Kurt Schibler; Barbara Schmidt; C Michael Cotten; Brenda B Poindexter; Kristi L Watterberg; William E Truog Journal: Pediatr Res Date: 2017-05-24 Impact factor: 3.756
Authors: Edward F Bell; Barbara J Stoll; Nellie I Hansen; Myra H Wyckoff; Michele C Walsh; Pablo J Sánchez; Matthew A Rysavy; Jenna H Gabrio; Stephanie W Archer; Abhik Das; Rosemary D Higgins Journal: Semin Perinatol Date: 2022-06-10 Impact factor: 3.311
Authors: Janaina de Lima Menger; Letícia Reck Mafaldo; Daniele Schiwe; Camila Wohlgemuth Schaan; João Paulo Heinzmann-Filho Journal: Rev Paul Pediatr Date: 2020-11-30