TY - JOUR
T1 - Evaluation of a practice guideline for the management of respiratory distress syndrome in preterm infants
T2 - A quality improvement initiative
AU - Read, Brooke
AU - Lee, David S.C.
AU - Fraser, Debbie
N1 - Publisher Copyright:
© 2016 Pulsus Group Inc. All rights reserved.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012. Objective: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia. METHODS: An historical cohort of very preterm infants (gestational age 26° to 326 weeks) born one year before guideline implementation was compared with a similar cohort of infants born one year following guideline implementation. Data were collected retrospectively from the local neonatal intensive care unit database. Results: A total of 272 preterm infants were included in the study: 129 in the preguideline cohort and 143 in the postguideline cohort. Following the implementation of the guideline, the proportion of infants treated with ongoing mechanical ventilation was reduced from 49% to 26% (P<0.001) and there was a trend toward a reduction in bronchopulmonary dysplasia (27% versus 18%; P=0.07). There was no difference in the proportion of infants treated with surfactant (54% versus 50%). Conclusion: The implementation of the practice guideline helped to minimize the use of ongoing mechanical ventilation in preterm infants.
AB - Background: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012. Objective: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia. METHODS: An historical cohort of very preterm infants (gestational age 26° to 326 weeks) born one year before guideline implementation was compared with a similar cohort of infants born one year following guideline implementation. Data were collected retrospectively from the local neonatal intensive care unit database. Results: A total of 272 preterm infants were included in the study: 129 in the preguideline cohort and 143 in the postguideline cohort. Following the implementation of the guideline, the proportion of infants treated with ongoing mechanical ventilation was reduced from 49% to 26% (P<0.001) and there was a trend toward a reduction in bronchopulmonary dysplasia (27% versus 18%; P=0.07). There was no difference in the proportion of infants treated with surfactant (54% versus 50%). Conclusion: The implementation of the practice guideline helped to minimize the use of ongoing mechanical ventilation in preterm infants.
KW - Bronchopulmonary dysplasia
KW - Mechanical ventilation
KW - Practice guideline
KW - Preterm infants
KW - Quality improvement
KW - Respiratory distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=84957698157&partnerID=8YFLogxK
U2 - 10.1093/pch/21.1.5a
DO - 10.1093/pch/21.1.5a
M3 - Journal Article
AN - SCOPUS:84957698157
SN - 1205-7088
VL - 21
SP - e4-e9
JO - Paediatrics and Child Health (Canada)
JF - Paediatrics and Child Health (Canada)
IS - 1
ER -