Affiliations: Department of Neonatology, Baylor Scott and White Health, Temple, Texas, USA
Correspondence:
[*]
Address for correspondence: Muppala Raju, MBBS, MPH., Baylor Scott & White McLane Children’s Medical Center, 1901 SW H.K. Dodgen Loop Bldg 300 I Temple, TX 76502, USA. Tel.: +1 254 935 4836; E-mail: MuppalaNarasimharajuPrasanth.Raju@bswhealth.org.
Abstract: OBJECTIVE:To evaluate the implementation of a systematic approach to improve the resuscitation, stabilization, and admission of infants < 32 weeks gestation and also to ascertain its effect on organization, efficiency, and clinical outcomes during hospitalization. METHODS:Retrospective study involving a multidisciplinary team with checklists, role assignment, equipment organization, step by step protocol, and real time documentation for the care of infants < 32 weeks gestation in the delivery room to the neonatal intensive care unit. Pre-data collection (cases) period was from Aug, 2015 to July, 2017, and post-data collection(controls) period was from Aug, 2017 to Aug, 2019. RESULTS:337 infants were included (179 cases; 158 controls). Increase surfactant use in the resuscitation room (41% vs. 27%, p = 0.007) and reduction in median time to administer surfactant (34 minutes (range, 6–120) vs. 74 minutes (range, 7–120), p = 0.001) observed in control-group. There was a significant reduction in incidence of bronchopulmonary dysplasia (27% vs. 39%), intraventricular hemorrhage (11% vs. 17%), severe retinopathy of prematurity (3% vs. 9%), and necrotizing enterocolitis (4% vs. 6%), however these results were not statistically significant after controlling for severity of illness. CONCLUSIONS:A systematic approach to the care of infants < 32 weeks gestation significantly improved mortality rates and reduced rates of comorbidities.
Keywords: Delivery room, golden hour protocol, low gestational age infants, NICU admission, retrospective study
