AI Article Synopsis
- The study aimed to assess if a respiratory care bundle could reduce bronchopulmonary dysplasia (BPD) in preterm infants less than 30 weeks gestation.
- The results showed a significant decrease in BPD rates and an increase in BPD-free survival during the third time period after implementing the bundle, although these improvements were not sustained in the fourth period.
- Overall, the findings suggest that the respiratory care protocol, primarily led by bedside caregivers, was effective in improving outcomes for vulnerable preterm infants during the study, particularly in the short term.
Article Abstract
Background: The objective of this study was to investigate whether a respiratory care bundle, implemented through participation in the Vermont Oxford Network-sponsored Neonatal Intensive Care Quality Improvement Collaborative (NIC/Q 2005) and primarily dependent on bedside caregivers, resulted in sustained decrease in the incidence of bronchopulmonary dysplasia (BPD) in infants < 30 wk gestation.
Methods: A retrospective cohort study was conducted. Infants inborn between 23 wk and 29 wk + 6 d of gestation were included. Patients with congenital heart disease, significant congenital or lung anomalies, or death before intubation were excluded. Four time periods (T1-T4) were identified: T1: September 1, 2002 to August 31, 2004; T2: September 1, 2004 to August 31, 2006; T3: September 1, 2006 to August 31, 2008; T4: September 1, 2008 to August 31, 2010.
Results: A total of 1,050 infants were included in the study. BPD decreased significantly in T3 post-implementation of the respiratory bundle compared with T1 (29.9% vs 51.2%, respectively; adjusted odds ratio [aOR] = 0.06 [95% CI 0.03-0.13], P = < .001). The decrease was not sustained into T4. There was a significant increase in the rate of BPD-free survival to discharge in T3 compared with T1 (53.1% vs 47%; aOR = 1.68 [95% CI 1.11-2.56], P = .01) that was also not sustained. The rate of infants requiring O2 at 28 d of life decreased significantly in T3 versus T1 (40.3% vs 69.9%, respectively; aOR = 0.12 [95% CI 0.07-0.20], P = < .001). Increases in the rate of surfactant administration by 1 h of life and rate of caffeine use were observed in T4 versus T1, respectively. There was a significant decrease in median ventilator days and a significant increase in the median number of noninvasive CPAP days throughout the study period.
Conclusions: In this study, implementation of a respiratory bundle managed primarily by nurses and respiratory therapists was successful in increasing the use of less invasive respiratory support in a consistent manner among very low birthweight infants at a single institution. However, this study and others have failed to show sustained improvement in the incidence of BPD despite sustained process change.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480610 | PMC |
| http://dx.doi.org/10.4187/respcare.03235 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development and Validation of a Postprocedure Stroke Screening Tool in Children With Cardiac Disease.
J Child Neurol
January 2025
Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Background: Cardiac catheterization in children with heart disease is associated with an increased risk of arterial ischemic stroke. We created and evaluated the diagnostic performance of a bedside screening tool administered postprocedure to identify arterial ischemic stroke.
Methods: We developed a postprocedure stroke screen comprising history of stroke, responsiveness, command following, speech, facial and limb strength symmetry, new seizure, and caregiver concern.
Expert-Based Narrative Review on Compression UltraSonography (CUS) for Diagnosis and Follow-Up of Deep Venous Thrombosis (DVT).
Diagnostics (Basel)
January 2025
Research Center on Thromboembolic Diseases and Antithrombotic Treatment, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
Deep venous thrombosis (DVT) is a pathological condition that develops when a thrombus forms within the deep venous system. Typically, it involves the lower limbs and, less frequently, the upper extremities or other unusual districts such as cerebral or splanchnic veins. While leg DVT itself is rarely fatal and occasionally can lead to limb-threatening implications, its most fearsome complication, namely pulmonary embolism, is potentially fatal and significantly contributes to increased healthcare costs and impaired quality of life in affected patients and caregivers.
View Article and Find Full Text PDFIs Routine Discharge Enough? Needs and Perceptions Regarding Discharge and Readmission of Palliative Care Patients and Caregivers.
Am J Hosp Palliat Care
January 2025
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Context: The hospital discharge process is fraught for patients with serious illness and their caregivers.
Objectives: We sought to understand palliative care patient and caregiver concerns regarding the patient-centeredness of the hospital discharge process.
Methods: We conducted semi-structured interviews with 11 patients receiving palliative care and 4 caregivers.
Validation of the Abbreviated PTSD Checklist-Civilian as a Traumatic Stress Screener for Parents of Children With Cancer.
J Pediatr Hematol Oncol Nurs
December 2024
School of Nursing, Indiana University, Indianapolis, IN, USA.
Researchers and clinicians often use the six-item abbreviated Posttraumatic Stress Disorder Checklist-Civilian (PCL-6) for screening; however, the PCL-6 has not been validated for parents of children with cancer. A valid and reliable short screener like the PCL-6 would allow bedside and/or advanced practice nurses to quickly screen parents for traumatic stress and expedite referrals for support services. This study used data collected during a multisite trial examining an intervention for children with cancer and their parents.
View Article and Find Full Text PDFUnderstanding and addressing mental health challenges of families admitted to the neonatal intensive care unit.
J Perinatol
December 2024
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA.
This article reviews the psychological distress experienced by NICU families, including anxiety, postpartum depression (PPD), and post-traumatic stress disorder (PTSD), in addition to providing recommendations for clinicians at the individual, institutional, and national level. Currently, mental health screenings, specialized evaluations, and treatment options are not routinely offered to NICU families and are frequently under-utilized when offered. Here we provide expert opinion recommendations to address challenges in supporting universal screening, offering bedside interventions, including trained mental health professionals in care plans, updating neonatology training competencies, and advocating for policies that support the mental health of NICU families.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!