Department of Pediatrics, Section of Neonatology, University of Calgary, Calgary, Alberta, Canada.
Department of Diagnostic Imaging, Division of Neuroradiology, University of Calgary, Calgary, Alberta, Canada.
J Perinatol. 2022 Oct;42(10):1368-1373. doi: 10.1038/s41372-022-01409-2. Epub 2022 May 4.
To evaluate impact of a quality improvement (QI) outreach education on incidence of acute brain injury in transported premature neonates.
Neonates born at <33 weeks gestation outside the tertiary center were included. The QI intervention was a combination of neuroprotection care bundle, in-person visits, and communication system improvement. Descriptive and regression (adjusting for Gestational Age, Birth Weight, Gender, and antenatal steroids, Mode of delivery, Apgars at 5 minutes, Prophylactic indomethacin, PDA, and Inotropes use) analyses were performed. The primary outcome was a composite of death and/or severe brain injury on cranial ultrasound using a validated classification.
181 neonates studied (93 before and 88 after). The rate and adjusted odds of death and/or severe brain injury reduced significantly post intervention (30% vs 15%) and (AOR 0.36, 95%CI, 0.15-0.85, P = 0.02) respectively.
Implementation of outreach education targeting neuroprotection can reduce acute brain injury in transported premature neonates.
评估质量改进（QI）外展教育对转运早产儿急性脑损伤发生率的影响。
纳入在三级中心以外出生的 <33 周胎龄的新生儿。QI 干预措施包括神经保护护理包、现场访问和沟通系统改进。进行描述性和回归（调整胎龄、出生体重、性别和产前类固醇、分娩方式、5 分钟时的 Apgar 评分、预防性吲哚美辛、PDA 和使用血管活性药物）分析。主要结局是使用经过验证的分类，通过头颅超声评估死亡和/或严重脑损伤的复合结果。
研究了 181 名新生儿（93 名在前，88 名在后）。干预后死亡率和调整后的死亡和/或严重脑损伤的比值显著降低（30%比 15%）和（优势比 0.36，95%置信区间，0.15-0.85，P=0.02）。
针对神经保护的外展教育的实施可以降低转运早产儿的急性脑损伤。
