Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial.

OBJECTIVE: Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight (VLBW) infants. Secondary outcome measures were days of ventilation, incidence of chronic lung disease, and 18-month...

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Publicado en:Pediatrics Vol. 124; no. 4; pp. 1009 - 1021
Autores principales: Peters KL, Rosychuk RJ, Hendson L, Coté JJ, McPherson C, Tyebkhan JM
Formato: clinical trial research tables/charts Journal Article
Publicado: American Academy of Pediatrics Oct2009
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2009
      vid: 124
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      pub: American Academy of Pediatrics
      place: Elk Grove Village, Illinois
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        atl: Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial.
      aug:
        au:
          Peters KL
          Rosychuk RJ
          Hendson L
          Coté JJ
          McPherson C
          Tyebkhan JM
        affil: Faculty of Nursing, Perinatal Clinical Research Centre, University of Alberta, Edmonton, Canada.
      sug:
        subj:
          Infant, Very Low Birth Weight
          Intensive Care, Neonatal
          Canada
          Clinical Trials
          Confidence Intervals
          Developmental Disabilities
          Funding Source
          Infant, Newborn
          Intensive Care Units, Neonatal
          Length of Stay
          Lung Diseases
          Odds Ratio
          Outcomes (Health Care)
          Random Assignment
          Human
          Infant, Newborn: birth-1 month
      ab: OBJECTIVE: Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight (VLBW) infants. Secondary outcome measures were days of ventilation, incidence of chronic lung disease, and 18-month neurodevelopmental outcomes. METHODS: This cluster-randomized, controlled trial took place in a large NICU in Canada, with follow-up evaluation at 18 months of age, from September 1999 to September 2004. One hundred VLBW singleton infants and 10 VLBW twin sets were assigned randomly to NIDCAP-based or control care, and 90% participated in follow-up assessments. The intervention was NIDCAP-based care (N = 56), that is, care by NIDCAP-educated staff members and behavioral observations. The control group (N = 55) received standard NICU care. Statistical analyses were adjusted for cluster randomization. Although the intervention was not blinded, the pediatricians making the decisions to discharge the infants were not involved in the study, and the follow-up staff members were blinded with respect to group. RESULTS: NIDCAP group infants had reduced length of stay (median: NIDCAP: 74 days; control: 84 days; P = .003) and incidence of chronic lung disease (NIDCAP: 29%; control: 49%; odds ratio: 0.42 [95% confidence interval: 0.18-0.95]; P = .035). At 18 months of adjusted age, NIDCAP group infants had less disability, specifically mental delay (NIDCAP: 10%; control: 30%; odds ratio: 0.25 [95% confidence interval: 0.08-0.82]; P = .017). CONCLUSION: NIDCAP-based care for VLBW infants improved short- and long-term outcomes significantly.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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