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Braun D, Kaempf JW, Ho NJ, Nguyen MH, Passi R, Burgos AE, Volodarskiy M, Villosis MFB, Gupta M, Habeshian TS, Tam HK, Litam KB, Hong QL, Dong CC, Getahun D. Discontinuation of Car Seat Tolerance Screening and Postdischarge Adverse Outcomes in Infants Born Preterm. J Pediatr 2023; 261:113577. [PMID: 37353144 DOI: 10.1016/j.jpeds.2023.113577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/22/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To study the association between discontinuing predischarge car seat tolerance screening (CSTS) with 30-day postdischarge adverse outcomes in infants born preterm. STUDY DESIGN Retrospective cohort study involving all infants born preterm from 2010 through 2021 who survived to discharge to home in a 14-hospital integrated health care system. The exposure was discontinuation of CSTS. The primary outcome was a composite rate of death, 911 call-triggered transports, or readmissions associated with diagnostic codes of respiratory disorders, apnea, apparent life-threatening event, or brief resolved unexplained events within 30 days of discharge. Outcomes of infants born in the periods of CSTS and after discontinuation were compared. RESULTS Twelve of 14 hospitals initially utilized CSTS and contributed patients to the CSTS period; 71.4% of neonatal intensive care unit (NICU) patients and 26.9% of non-NICU infants were screened. All hospitals participated in the discontinuation period; 0.1% was screened. Rates of the unadjusted primary outcome were 1.02% in infants in the CSTS period (n = 21 122) and 1.06% after discontinuation (n = 20 142) (P = .76). The aOR (95% CI) was 0.95 (0.75, 1.19). Statistically insignificant differences between periods were observed in components of the primary outcome, gestational age strata, NICU admission status groups, and other secondary analyses. CONCLUSIONS Discontinuation of CSTS in a large integrated health care network was not associated with a change in 30-day postdischarge adverse outcomes. CSTS's value as a standard predischarge assessment deserves further evaluation.
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Affiliation(s)
- David Braun
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA.
| | - Joseph W Kaempf
- Women and Children's Services Institute, Providence Health System, Portland, OR
| | - Ngoc J Ho
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA
| | - Marielle H Nguyen
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA
| | - Rohit Passi
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Anthony E Burgos
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Marianna Volodarskiy
- Department of Patient Care Services, Kaiser Permanente Southern California, Pasadena, CA
| | - Maria Fe B Villosis
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Mandhir Gupta
- Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA
| | - Talar S Habeshian
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA
| | - Henry K Tam
- Department of Clinical Analysis, Southern California Permanente Medical Group, Pasadena, CA
| | - Kevin B Litam
- Department of Clinical Analysis, Southern California Permanente Medical Group, Pasadena, CA
| | - Quinn L Hong
- Department of Clinical Analysis, Southern California Permanente Medical Group, Pasadena, CA
| | - Calvin C Dong
- Department of Regional Ambulance Operations, Kaiser Permanente Southern California, Downey, CA
| | - Darios Getahun
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA; Department of Health Care Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
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Kadakia S, Isaiah A, El-Metwally D. Effects of semi-upright swings on vital signs in NICU infants. Pediatr Res 2023; 93:953-958. [PMID: 35752692 DOI: 10.1038/s41390-022-02161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to compare the impact of a semi-upright swing with a standard crib on vital signs in infants in the neonatal intensive care unit (NICU). METHODS We performed a within-subjects' comparison of vital signs of NICU infants corrected to ≥34 weeks of gestation and placed in the supine position versus the semi-upright position in a swing. The primary outcome was the mean oxygen saturation, and the secondary outcomes were the mean heart rate, the proportion of time with oxygen saturation (SpO2) <90%, and respiratory rate. RESULTS Of the 65 infants, 34 (57%) were male and 32 (50%) were black. The mean ± SD gestational age at birth was 32.4 ± 5.1 weeks. In all, 40% were on noninvasive respiratory support. There were no significant differences in oxygen saturation, heart rate, time with oxygen desaturation defined by SpO2 < 90%, or respiratory rate between the supine and semi-upright positions. A higher risk of desaturations was observed in infants without respiratory support (RR, 1.24, 95% CI, 1.15-1.33) and low-birth-weight infants (RR, 1.55, 95% CI, 1.42-1.69). CONCLUSIONS The placement of infants in a semi-upright swing resulted in no discernible differences in averaged vital signs compared to the supine position in NICU infants. IMPACT We identified no significant differences in averaged oxygen saturation, heart rate, or respiratory rate among NICU infants placed in a semi-upright swing compared to the supine position. Desaturation events occurred at a higher frequency in low-birth-weight infants and those on room air when placed in the swing, although none required oxygen supplementation. The results from the current study support that it is probably safe to use semi-upright swings in the NICU environment, although additional studies are necessary for generalization to the unmonitored home environment.
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Affiliation(s)
- Suhagi Kadakia
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amal Isaiah
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dina El-Metwally
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
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Hoffman BD, Gilbert TA, Chan K, Ennis B, Gallardo A, Carlson KF. Getting Babies Safely Home: A Retrospective Chart Review of Car Safety Seat Tolerance Screening Outcomes. Acad Pediatr 2021; 21:1355-1362. [PMID: 33631364 DOI: 10.1016/j.acap.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The American Academy of Pediatrics recommends pre-discharge Car Seat Tolerance Screening (CSTS) for all neonates born <37 weeks estimated gestational age (EGA), or otherwise at risk for cardiorespiratory compromise. Screening is burdensome and there remains tremendous variation in testing criteria and methodology. DESIGN/METHODS We conducted a retrospective chart review of 1,072 infants who underwent CSTS between 11/2013 and 7/2016 at a single academic health center. CSTS outcomes (failure and, separately, significant cardiorespiratory instability (CRI)), including those not meeting failure thresholds) were analyzed for all infants screened, and for preterm infants by screening location (Neonatal Intensive Care Unit (NICU) and Mother/Baby Unit (MBU)). Logistic regression was used to estimate associations between infant characteristics and CSTS outcomes. RESULTS Overall incidence of CSTS failure was 9.2%. Among all infants, hemodynamically significant congenital heart disease, apnea, chronic lung disease, and being small for EGA were associated with failure. Additionally, those born ≤28 weeks EGA had 2.4 times greater likelihood of failure than those 34-36 weeks EGA. Among preterm infants in the NICU and MBU, those of earlier EGA were also more likely to fail. Almost half (47.5%) of all preterm infants demonstrated CRI during CSTS. CONCLUSION We found high CSTS failure rates, and identified key infant characteristics that were associated with increased likelihood of failure. Significant CRI events were remarkably common. Larger, prospective studies are needed to elucidate risk factors for instability and failure and define practical criteria for CSTS recommendations.
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Affiliation(s)
- Benjamin D Hoffman
- Department of Pediatrics, School of Medicine, and Doernbecher Tom Sargent Safety Center, Doernbecher Children's Hospital, Oregon Health and Science University (BD Hoffman, TA Gilbert, K Chan, B Ennis, and A Gallardo), Portland, Ore.
| | - Tess A Gilbert
- Oregon Health and Science University-Portland State University (OHSU-PSU) School of Public Health, Oregon Health and Science University (KF Carlson), Portland, Ore
| | - Kelsi Chan
- Department of Pediatrics, School of Medicine, and Doernbecher Tom Sargent Safety Center, Doernbecher Children's Hospital, Oregon Health and Science University (BD Hoffman, TA Gilbert, K Chan, B Ennis, and A Gallardo), Portland, Ore
| | - Brianna Ennis
- Department of Pediatrics, School of Medicine, and Doernbecher Tom Sargent Safety Center, Doernbecher Children's Hospital, Oregon Health and Science University (BD Hoffman, TA Gilbert, K Chan, B Ennis, and A Gallardo), Portland, Ore
| | - Adrienne Gallardo
- Department of Pediatrics, School of Medicine, and Doernbecher Tom Sargent Safety Center, Doernbecher Children's Hospital, Oregon Health and Science University (BD Hoffman, TA Gilbert, K Chan, B Ennis, and A Gallardo), Portland, Ore
| | - Kathleen F Carlson
- Oregon Health and Science University-Portland State University (OHSU-PSU) School of Public Health, Oregon Health and Science University (KF Carlson), Portland, Ore
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Davis NL, Hoffman BD, Eichenwald EC. Variation in Car Seat Tolerance Screen Performance in Newborn Nurseries. Pediatrics 2020; 146:peds.2019-3593. [PMID: 32641358 DOI: 10.1542/peds.2019-3593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Currently, car seat tolerance screens (CSTSs) are recommended for all infants born prematurely in the United States. Although many late-preterm infants are cared for exclusively in newborn nurseries (NBNs), data on implementation of CSTS in nurseries are limited. Our objective for this study was to determine management strategies and potential variation in practice of CSTS in NBNs across the nation. METHODS We surveyed NBNs across 35 states using the Better Outcomes through Research for Newborns (BORN) network to determine what percentage perform CSTSs, inclusion and failure criteria, performance characteristics, follow-up of failed CSTSs including use of car beds, and provider attitudes toward CSTS. RESULTS Of the 84 NBNs surveyed, 90.5% performed predischarge CSTSs. The most common failure criteria were saturation <90%, bradycardia <80 beats per minute, and apnea >20 seconds. More than 55% noted hypotonia as an additional inclusion criterion for testing, and >34% tested any infant who had ever required supplemental oxygen. After an initial failed CSTS, >93% of NBNs retested in a car seat at a future time point, whereas only ∼1% automatically discharged infants in a car bed. When asked which infants should undergo predischarge CSTS, the most common recommendations by survey respondents included infants with hypotonia (83%), airway malformations (78%), hemodynamically significant congenital heart disease (63%), and prematurity (61%). CONCLUSIONS There is a large degree of variability in implementation of CSTS in NBNs across the United States. Further guidance on screening practices and failure criteria is needed to inform future practice and policy.
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Affiliation(s)
- Natalie L Davis
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Baltimore, Maryland;
| | - Benjamin D Hoffman
- Department of Pediatrics, Oregon Health and Science University School of Medicine, Doernbecher Children's Hospital, Portland, Oregon; and
| | - Eric C Eichenwald
- Division of Neonatology, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Cresi F, Cocchi E, Maggiora E, Pirra A, Logrippo F, Ariotti MC, Peila C, Bertino E, Coscia A. Pre-discharge Cardiorespiratory Monitoring in Preterm Infants. the CORE Study. Front Pediatr 2020; 8:234. [PMID: 32582583 PMCID: PMC7291855 DOI: 10.3389/fped.2020.00234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/17/2020] [Indexed: 12/26/2022] Open
Abstract
Objective: Ensuring cardiorespiratory (CR) stability is essential for a safe discharge. The aim of this study was to assess the impact of a new pre-discharge protocol named CORE on the risk of hospital readmission (RHR). Methods: Preterm infants admitted in our NICU between 2015 and 2018 were randomly assigned to CORE (exposed) or to standard (not-exposed) discharge protocol. CORE included 24 h-clinical observation, followed by 24 h-instrumental CR monitoring only for high-risk infants. RHR 12 months after discharge and length of stay represent the primary and secondary outcomes, respectively. Results: Three hundred and twenty three preterm infants were enrolled. Exposed infants had a lower RHR (log-rank p < 0.05). The difference was especially marked 3 months after discharge (9.09 vs. 21.6%; p = 0.004). The hospital length of stay in exposed and not-exposed infants was 39(26-58) and 43(26-68) days, respectively (p = 0.16). Conclusions: The CORE protocol could help neonatologists to define the best timing for discharge reducing RHR without lengthening hospital stay.
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Affiliation(s)
- Francesco Cresi
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Enrico Cocchi
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Elena Maggiora
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Alice Pirra
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Federica Logrippo
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Maria Chiara Ariotti
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Chiara Peila
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Enrico Bertino
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
| | - Alessandra Coscia
- Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy
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Holm KG, Clemensen J, Brødsgaard A, Smith AC, Maastrup R, Zachariassen G. Growth and breastfeeding of preterm infants receiving neonatal tele-homecare compared to hospital-based care. J Neonatal Perinatal Med 2019; 12:277-284. [PMID: 30856122 DOI: 10.3233/npm-18143] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Neonatal tele-homecare implies that parents of clinically stable preterm infants can manage tube feeding and establishment of oral feeding in the home. Support is provided from the neonatal intensive care unit (NICU) through a telehealth service. The aim of this study was to compare growth and breastfeeding rates amongst infants being managed in the NICU (conventional care) and by neonatal tele-homecare. METHODS A total of 96 preterm infants with tube feeding requirements participated in the observational study of neonatal tele-homecare. Retrospective data in 278 preterm infants receiving standard care in the same neonatal intensive care unit prior to implementation of neonatal tele-homecare were used for comparison. Rates of breastfeeding and growth were monitored during neonatal tele-homecare. Infant weights were converted to standard deviation weight-for-age z-scores based on a reference. RESULTS There was no significant difference in rates of exclusive breastfeeding between the neonatal tele-homecare infants and the controls. Among the very preterm singleton infants more neonatal tele-homecare infants were exclusively breastfed at discharge compared to the controls (p = 0.04). There was no significant difference in median weight for age z-scores at discharge. CONCLUSION This study demonstrates that neonatal tele-homecare may be an appropriate model of care for the management of preterm infants outside of the hospital environment; with the added benefit of higher rates of breastfeeding at time of discharge for very preterm infants.
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Affiliation(s)
- Kristina Garne Holm
- Hans Christian Andersen Hospital for Children and Adolescents,, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jane Clemensen
- Hans Christian Andersen Hospital for Children and Adolescents,, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Center for Innovative Medical Technology, Odense University Hospital, Odense, Denmark
| | - Anne Brødsgaard
- Department of Pediatrics, Amager Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, Department of Science in Nursing, Aarhus University, Aarhus, Denmark
| | - Anthony C Smith
- Center for Online Health, University of Queensland, Brisbane, Australia
| | - Ragnhild Maastrup
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Gitte Zachariassen
- Hans Christian Andersen Hospital for Children and Adolescents,, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Arya R, Williams G, Kilonback A, Toward M, Griffin M, Blair PS, Fleming P. Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch Dis Child Fetal Neonatal Ed 2017; 102:F136-F141. [PMID: 27694399 PMCID: PMC5339573 DOI: 10.1136/archdischild-2016-310730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE The American Academy of Pediatrics recommends that preterm infants complete a predischarge 'car seat challenge' observation for cardiorespiratory compromise while in a car seat. This static challenge does not consider the more upright position in a car or the vibration of the seat when the car is moving. This pilot study was designed to assess the cardiorespiratory effects of vibration, mimicking the effect of being in a moving car, on preterm and term infants. METHODS A simulator was designed to reproduce vertical vibration similar to that in a rear-facing car seat at 30 mph. 19 healthy newborn term and 21 preterm infants, ready for hospital discharge, underwent cardiorespiratory measurements while lying flat in a cot (baseline), static in the seat (30°), simulator (40°) and during motion (vibration 40°). RESULTS Median test age was 13 days (range 1-65 days) and median weight was 2.5 kg (IQR: 2.1-3.1 kg).Compared with baseline observations, only the total number of desaturations was significantly increased when infants were placed at 30° (p=0.03). At 40°, or with vibration, respiratory and heart rates increased and oxygen saturation decreased significantly. Profound desaturations <85% significantly increased during motion, regardless of gestational age. CONCLUSIONS This is the first study to assess the effect of motion on infants seated in a car safety seat. Term and preterm infants showed significant signs of potentially adverse cardiorespiratory effects in the upright position at 40°, particularly with simulated motion, not identified in the standard challenge. A larger study is required to investigate the significance of these results.
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Affiliation(s)
- Renu Arya
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Georgina Williams
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Anna Kilonback
- Department of Paediatrics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Martin Toward
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - Michael Griffin
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - Peter S Blair
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Peter Fleming
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Shah MD, Dookeran KA, Khan JY. Clinical Outcomes Associated with a Failed Infant Car Seat Challenge. J Pediatr 2017; 180:130-134. [PMID: 27810158 DOI: 10.1016/j.jpeds.2016.09.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/25/2016] [Accepted: 09/29/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess comorbid conditions and clinical outcomes among late preterm and low birth weight term infants (<2.5 kg) who failed the Infant Car Seat Challenge (ICSC) on the Mother-Baby Unit. STUDY DESIGN This was a retrospective chart review of consecutive infants who failed ICSC on the Mother-Baby Unit and were subsequently admitted to the neonatal intensive care unit at Prentice Women's Hospital between January 1, 2009, and December 31, 2015. Regression models were used to estimate risk differences (RDs) with 95% CIs for factors related to length of stay. RESULTS A total of 148 infants were studied (43% male; 37% delivered via cesarean). ICSC failure in the Mother-Baby Unit was due to desaturation, bradycardia, and tachypnea in 59%, 37%, and 4% of infants, respectively. During monitoring on the neonatal intensive care unit, 39% of infants experienced apnea (48% in preterm vs 17% in term infants) in the supine position, 19% received phototherapy, and 2% and 6.8% received nasogastric and thermoregulatory support, respectively. Univariate predictors of increased duration of stay (days) were younger gestational age, apnea, nasogastric support, intravenous fluids, and antibiotics (all P < .05). In multivariable analysis adjusted for gestational age and discharge weight, only apnea (RD, 4.87; 95% CI, 2.99-6.74; P < .001), administration of antibiotics (RD, 3.25; 95% CI, 0.29-6.21; P < .032), and intravenous fluid support (RD, 4.87; 95% CI, 0.076-9.66; P < .047) remained independent predictors of a longer duration of stay. CONCLUSION Infants who failed ICSC were at risk for comorbid conditions that prolonged hospital stay beyond the neonatal intensive care unit observation period. Almost one-half of late preterm infants who failed ICSC had apnea events in the supine position.
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Affiliation(s)
- Malika D Shah
- Division of Neonatology, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
| | - Keith A Dookeran
- Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee, WI
| | - Janine Y Khan
- Division of Neonatology, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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