Pricoco Rafael, Mayer-Huber Sandra, Paulick Johannes, Benstetter Franz, Zeller Michael, Keller Matthias
Department of Pediatrics, Technical University of Munich, School of Medicine, Munich, Germany.
Technische Hochschule Rosenheim, Rosenheim, Germany.
Acta Paediatr. 2023 Nov;112(11):2368-2377. doi: 10.1111/apa.16944. Epub 2023 Sep 1.
We evaluated the effects of a family-centred clinical care pathway and case management programme on short-term clinical outcome in a cohort of very low-birth weight (VLBW) infants.
The programme, named NeoPAss, was developed at the Department of Neonatology Children's hospital Passau in 2013. Short-term outcomes of infants were compared to matched controls from the Bavarian neonatology surveillance database before (n = 111; 2008-2012) and after implementation (n = 170; 2014-2017).
After implementation the rate of late-onset sepsis was significantly lower (2.5% vs. 10.7%, p = 0.005) and the length of stay was significantly shorter (VLBW 28 to 31 weeks' gestational age (GA) 47.5 vs. 53.1 days, p = 0.047; <28 weeks' GA 79.4 vs. 91.9 days, p = 0.007) in the intervention group compared to controls. Infants were discharged with significantly lower weight (mean 2351 vs. 2539 g, p = 0.013). There was no statistically significant difference in the rate of intraventricular haemorrhage (3.7% vs. 8.2%), necrotizing enterocolitis (0.6% vs. 1.9%) and bronchopulmonary dysplasia (0% vs. 6.9%).
Our data confirm that of other studies demonstrating a beneficial effect of family-centred care programmes and provides evidence that structured parental involvement is not associated with increased risk of infection in a VLBW cohort.
我们评估了以家庭为中心的临床护理路径和病例管理计划对一组极低出生体重(VLBW)婴儿短期临床结局的影响。
名为NeoPAss的计划于2013年在帕绍儿童医院新生儿科制定。将婴儿的短期结局与巴伐利亚新生儿监测数据库中实施该计划之前(n = 111;2008 - 2012年)和实施之后(n = 170;2014 - 2017年)的匹配对照组进行比较。
实施后,干预组的晚发性败血症发生率显著降低(2.5% 对10.7%,p = 0.005),住院时间显著缩短(胎龄28至31周的VLBW婴儿,干预组为47.5天,对照组为53.1天,p = 0.047;胎龄<28周的婴儿,干预组为79.4天,对照组为91.9天,p = 0.007)。婴儿出院时体重显著更低(平均2351克对2539克,p = 0.013)。脑室内出血发生率(3.7% 对8.2%)、坏死性小肠结肠炎发生率(0.6% 对1.9%)和支气管肺发育不良发生率(0% 对6.9%)无统计学显著差异。
我们的数据证实了其他研究中所表明的以家庭为中心的护理计划的有益效果,并提供了证据表明在VLBW队列中,有组织的父母参与与感染风险增加无关。