Quality improvement to reduce chronic lung disease rates in very-low birth weight infants: high compliance with a respiratory care bundle ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-03

AUTHORS

Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A. Feldman, John Fiascone

ABSTRACT

OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support. RESULTS: A total of 107 very-low birth weight infants were included in this project. Compliance with the respiratory care bundle was >90%. Chronic lung disease rates at 36 weeks postmenstrual age fell from 43 to 12% (P = 0.0006), rates of combined chronic lung disease/death decreased from 50 to 20% (P = 0.002, OR = 0.25, 95% CI 0.1-0.6), rates of severe intraventricular hemorrhage decreased from 13 to 0% (P = 0.005), and surgical ligation of patent ductus arteriosus decreased from 35 to 3% (P < 0.0001). CONCLUSION: High compliance with the respiratory care bundle was achieved and a 73% reduction in chronic lung disease rates in very-low birth weight infants occurred. More... »

PAGES

285-292

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41372-017-0008-4

DOI

http://dx.doi.org/10.1038/s41372-017-0008-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1099645813

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29234148


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