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评估在区域转诊中心使用 Eat, Sleep, Console 模型管理新生儿戒断综合征。

Assessing the Eat, Sleep, Console model for neonatal abstinence syndrome management at a regional referral center.

机构信息

Department of Pediatrics, Charleston Area Medical Center /West Virginia University-Charleston, Charleston, WV, USA.

Charleston Area Medical Center Institute for Academic Medicine, Charleston, WV, USA.

出版信息

J Perinatol. 2023 Jul;43(7):916-922. doi: 10.1038/s41372-023-01666-9. Epub 2023 Apr 25.

Abstract

OBJECTIVE

We assessed the efficacy of the Eat, Sleep, Console (ESC) model for neonatal abstinence syndrome at a regional referral center by examining non-pharmacological treatments, parental presence, length of stay (LOS), and pharmacological therapy.

STUDY DESIGN

We retrospectively reviewed medical records from 2018 to 2020 to compare neonatal outcomes between the 12 months prior to 12 months post ESC implementation.

RESULT

A total of 71 neonates pre-ESC and 64 neonates post-ESC implementation were included. There were no statistical differences between pre-ESC vs. ESC periods for pharmacological therapy (34% vs. 27%, p = 0.36) or LOS (median: 5.0 vs. 5.5 days, p = 0.54). During the ESC period, 41% of examined 4-h periods had no parent/caregiver presence. Decreased parental presence associated with pharmacological treatment (p < 0.001).

CONCLUSION

At our hospital which serves a geographically dispersed patient population, ESC model implementation did not decrease pharmacological therapy rates or LOS. Parental/caregiver presence may be a factor in the ESC model producing maximal benefits.

摘要

目的

通过考察非药物治疗、父母陪伴、住院时间(LOS)和药物治疗,评估 ESC 模型在区域转诊中心治疗新生儿戒断综合征的疗效。

研究设计

我们回顾性地分析了 2018 年至 2020 年的医疗记录,比较 ESC 实施前 12 个月和后 12 个月的新生儿结局。

结果

共纳入 71 例 ESC 实施前和 64 例 ESC 实施后的新生儿。ESC 实施前后,药物治疗(34% vs. 27%,p=0.36)或 LOS(中位数:5.0 天 vs. 5.5 天,p=0.54)无统计学差异。在 ESC 期间,41%的 4 小时检查期间没有父母/照顾者陪伴。药物治疗与父母陪伴减少相关(p<0.001)。

结论

在我们服务于地域分布广泛的患者人群的医院,ESC 模型的实施并未降低药物治疗率或 LOS。父母/照顾者的陪伴可能是 ESC 模型产生最大效益的一个因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b43/10127154/5db02a2e5b94/41372_2023_1666_Fig1_HTML.jpg

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