Neonatal Intensive Care Unit, UCLA Medical Center, Santa Monica, California (Ms Ribeiro, Sasinski, Hackett, and Manalo); and Center for Nursing Excellence, UCLA Health, Los Angeles, California (Drs Choi and Miller).
Adv Neonatal Care. 2023 Oct 1;23(5):435-441. doi: 10.1097/ANC.0000000000001098. Epub 2023 Aug 14.
For infants requiring intensive care, infant length is a primary gauge of nutrition and forms the basis for important future treatment decisions. However, existing evidence demonstrates discrepancies in infant length measurements between tape measure and length board.
To compare the accuracy and reliability of infant length measurements using tape measure (standard practice) and length board in a neonatal intensive care unit (NICU) at a public academic medical center.
Using a single-group, quasi-experimental, repeated-measures design, 108 infants (35.58 ± 3.68 weeks, male 59%, 2124.83 ± 881.69 g) admitted to the NICU were prospectively enrolled. Clinical nurses measured infants weekly per unit-based protocol using tape measures. Study team measured length using length boards within 24 hours of tape measurement. Primary outcome was infant length. Length measurements were converted to sex-specific Fenton or WHO growth percentiles. Linear mixed-effects regression, κ coefficient, intraclass correlation coefficient, and positive predictive value were calculated.
FINDINGS/RESULTS: The main effect of measurement conditions and time was significant. Predicted length was 0.38 cm lower for length board than for tape measure over time. Weighted κ coefficient and intraclass correlation coefficient indicated good to excellent agreement. More than 37% of infants shifted to a new percentile category based on both measurements. Positive predictive value of length board at time 1 was 63%.
Length board measurements are reliable for accurate classification of an infant's growth curve to influence diagnosis and future plan of care.
Future research warrants replication using a longitudinal design across multiple sites.
对于需要重症监护的婴儿来说，身长是衡量营养状况的主要指标，也是制定重要后续治疗决策的基础。然而，现有证据表明，在新生儿重症监护病房（NICU）中，卷尺和身长板测量的婴儿身长存在差异。
比较公共学术医疗中心 NICU 中使用卷尺（标准做法）和身长板测量婴儿身长的准确性和可靠性。
采用单组、准实验、重复测量设计，前瞻性纳入 108 名（35.58±3.68 周，男婴 59%，2124.83±881.69 g）入住 NICU 的婴儿。临床护士按照单位协议每周使用卷尺测量婴儿身长。研究团队在测量卷尺后 24 小时内使用身长板测量婴儿身长。主要结局为婴儿身长。将身长测量值转换为性别特异性 Fenton 或世界卫生组织（WHO）生长百分位数。计算线性混合效应回归、κ系数、组内相关系数和阳性预测值。
结果/发现：测量条件和时间的主效应具有统计学意义。与卷尺相比，身长板的预测身长随时间逐渐降低 0.38cm。加权 κ系数和组内相关系数表明，两种测量方法具有良好到极好的一致性。超过 37%的婴儿根据两种测量方法的结果进入了新的百分位类别。身长板在第 1 次测量时的阳性预测值为 63%。
身长板测量结果可靠，可准确分类婴儿的生长曲线，从而影响诊断和后续护理计划。
未来的研究需要在多个地点使用纵向设计进行复制。
