Evaluation of a practice guideline for the management of respiratory distress syndrome in preterm infants: A quality improvement initiative

Brooke Read, David S.C. Lee, Debbie Fraser

    Research output: Contribution to journalJournal Articlepeer-review

    4 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)e4-e9
    JournalPaediatrics and Child Health (Canada)
    Volume21
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan. 2016

    Keywords

    • Bronchopulmonary dysplasia
    • Mechanical ventilation
    • Practice guideline
    • Preterm infants
    • Quality improvement
    • Respiratory distress syndrome

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