心率特征监测对降低新生儿重症监护病房住院时间的影响。

Neonatal Intensive Care Unit Length of Stay Reduction by Heart Rate Characteristics Monitoring.

机构信息

Department of Pediatrics, Division of Neonatology, University of Virginia, Charlottesville, VA.

Medical Predictive Science Corporation, Charlottesville, VA.

出版信息

J Pediatr. 2018 Jul;198:162-167. doi: 10.1016/j.jpeds.2018.02.045. Epub 2018 Apr 24.

DOI:10.1016/j.jpeds.2018.02.045

PMID:29703576

Abstract

OBJECTIVE

To examine the effect of heart rate characteristics (HRC) monitoring on length of stay among very low birth weight (VLBW; <1500 g birth weight) neonates in the HeRO randomized controlled trial (RCT).

STUDY DESIGN

We performed a retrospective analysis of length of stay metrics among 3 subpopulations (all patients, all survivors, and survivors with positive blood or urine cultures) enrolled in a multicenter, RCT of HRC monitoring.

RESULTS

Among all patients in the RCT, infants randomized to receive HRC monitoring were more likely than controls to be discharged alive and prior to day 120 (83.6% vs 80.1%, P = .014). The postmenstrual age at discharge for survivors with positive blood or urine cultures was 3.2 days lower among infants randomized to receive HRC monitoring when compared with controls (P = .026). Although there were trends in other metrics toward reduced length of stay in HRC-monitored patients, none reached statistical significance.

CONCLUSIONS

HRC monitoring is associated with reduced mortality in VLBW patients and a reduction in length of stay among infected surviving VLBW infants.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT00307333.

摘要

目的

在 HeRO 随机对照试验（RCT）中，研究心率特征（HRC）监测对极低出生体重（VLBW；<1500g 出生体重）新生儿住院时间的影响。

研究设计

我们对 HRC 监测多中心 RCT 中纳入的 3 个亚组（所有患者、所有幸存者和血或尿培养阳性的幸存者）的住院时间指标进行了回顾性分析。

结果

在 RCT 的所有患者中，接受 HRC 监测的婴儿比对照组更有可能存活并在第 120 天前出院（83.6%比 80.1%，P=0.014）。与对照组相比，血或尿培养阳性的幸存者中接受 HRC 监测的婴儿出院时的校正胎龄低 3.2 天（P=0.026）。尽管 HRC 监测患者的其他住院时间指标有降低的趋势，但均未达到统计学意义。