OBJECTIVE: To determine the impact of neuroprotection interventions bundle on the incidence of severe brain injury or early death (intraventricular hemorrhage grade 3/4 or death by 7 days or ventriculomegaly or cystic periventricular leukomalacia on 1-month head ultrasound, primary composite outcome) in very preterm (270/7 to ≤ 296/7 weeks gestational age) infants. STUDY DESIGN: Prospective quality improvement initiative, from April 2017-September 2019, with neuroprotection interventions bundle including cerebral NIRS, TcCO2, and HeRO monitoring-based management algorithm, indomethacin prophylaxis, protocolized bicarbonate and inotropes use, noise reduction, and neutral positioning. RESULT: There was a decrease in the incidence of the primary composite outcome in the intervention period on unadjusted (N = 11/99, pre-intervention to N = 0/127, intervention period, p < 0.001) and adjusted analysis (adjusted for birthweight and Apgar score <5 at 5 min, aOR = 0.042, 95% CI = 0.003-0.670, p = 0.024). CONCLUSIONS: Neuroprotection interventions bundle was associated with significant decrease in severe brain injury or early death in very preterm infants.
OBJECTIVE: To determine the impact of neuroprotection interventions bundle on the incidence of severe brain injury or early death (intraventricular hemorrhage grade 3/4 or death by 7 days or ventriculomegaly or cystic periventricular leukomalacia on 1-month head ultrasound, primary composite outcome) in very preterm (270/7 to ≤ 296/7 weeks gestational age) infants. STUDY DESIGN: Prospective quality improvement initiative, from April 2017-September 2019, with neuroprotection interventions bundle including cerebral NIRS, TcCO2, and HeRO monitoring-based management algorithm, indomethacin prophylaxis, protocolized bicarbonate and inotropes use, noise reduction, and neutral positioning. RESULT: There was a decrease in the incidence of the primary composite outcome in the intervention period on unadjusted (N = 11/99, pre-intervention to N = 0/127, intervention period, p < 0.001) and adjusted analysis (adjusted for birthweight and Apgar score <5 at 5 min, aOR = 0.042, 95% CI = 0.003-0.670, p = 0.024). CONCLUSIONS: Neuroprotection interventions bundle was associated with significant decrease in severe brain injury or early death in very preterm infants.
Authors: Athina Pappas; Ira Adams-Chapman; Seetha Shankaran; Scott A McDonald; Barbara J Stoll; Abbot R Laptook; Waldemar A Carlo; Krisa P Van Meurs; Susan R Hintz; Martha D Carlson; Jane E Brumbaugh; Michele C Walsh; Myra H Wyckoff; Abhik Das; Rosemary D Higgins Journal: JAMA Pediatr Date: 2018-01-01 Impact factor: 16.193
Authors: L R Ment; C C Duncan; R A Ehrenkranz; R C Lange; K J Taylor; C S Kleinman; D T Scott; J Sivo; P Gettner Journal: J Pediatr Date: 1984-03 Impact factor: 4.406
Authors: E Sabrina Twilhaar; Rebecca M Wade; Jorrit F de Kieviet; Johannes B van Goudoever; Ruurd M van Elburg; Jaap Oosterlaan Journal: JAMA Pediatr Date: 2018-04-01 Impact factor: 16.193
Authors: Thuy Mai Luu; Laura R Ment; Karen C Schneider; Karol H Katz; Walter C Allan; Betty R Vohr Journal: Pediatrics Date: 2009-03 Impact factor: 7.124
Authors: Allison H Payne; Susan R Hintz; Anna Maria Hibbs; Michele C Walsh; Betty R Vohr; Carla M Bann; Deanne E Wilson-Costello Journal: JAMA Pediatr Date: 2013-05 Impact factor: 16.193