scholarly journals Predictors of mortality and length of stay for neonates admitted to children's hospital neonatal intensive care units

2007 ◽  
Vol 28 (4) ◽  
pp. 297-302 ◽  
Author(s):  
M A Berry ◽  
P S Shah ◽  
R T Brouillette ◽  
J Hellmann
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Predictors Of Mortality ◽  
Children's Hospital ◽  
Children’S Hospital

Transfusion Practices and Infections At Four Level III Neonatal Intensive Care Units

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3657-3657 ◽  
Author(s):  
Elizabeth M Margolskee ◽  
Melissa M. Cushing ◽  
Yu-Hui Ferng ◽  
David Friedman ◽  
Debra Kessler ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Medical Center ◽  
Blood Bank ◽  
Neonatal Intensive Care Units ◽  
Transfusion Rate ◽  
Children's Hospital ◽  
Antimicrobial Prescribing ◽  
Children’S Hospital

Abstract Introduction Transfusions of packed red blood cell (pRBC) units to infants in Neonatal Intensive Care Units (NICUs) may predispose neonates to healthcare-associated infections (HAIs). We compared neonatal pRBC transfusion practices at four NICUs (Morgan Stanley Children’s Hospital of NewYork-Presbyterian, Columbia University Medical Center, Komansky Children’s Hospital of Weill Cornell Medical Center, Christiana Care Health System, and Children’s Hospital of Philadelphia). In addition, because prolonged refrigerator storage of pRBC may further predispose to HAIs, we tested the hypothesis that an increased mean RBC storage age was associated with a greater risk of infections. Design The interdisciplinary NICU Antimicrobial Prescribing (iNAP) study was conducted in four Level III NICUs from May 2009 to April 2012 to assess HAIs and improve antimicrobial prescribing in NICUs. Eligible infants were admitted <7 days of age and hospitalized ≥4 days. Demographic (e.g., sex, birth weight [BW]) and clinical data (e.g., HAIs and surgical procedures) were collected. HAI included culture negative sepsis defined by treating clinicians, necrotizing enterocolitis, or bacteremia treated for ≥ 4 days. pRBC transfusions were collected from blood bank records at each site. Descriptive statistics were performed using GraphPad Prism 6. Results All sites used irradiated, leukoreduced, CMV negative pRBCs and practiced donor limitation. Blood bank preparation procedures were similar at all sites except that one site stored 3% of units in CPDA-1 in addition to units stored in Additive Solutions (AS), and another site irradiated the parent unit instead of the aliquot; the other sites irradiated the aliquot prior to release. During the study period, 6411 pRBC transfusions were administered to 1381 (21.5%) of 6184 enrolled infants. The transfusion rate was 12.6%, 37.3%, 16.7%, and 25.1% at sites 1-4, respectively. The rate of transfusion by normal BW (≥2500g), low BW (1500-2499g), very LBW (<1500g), and extremely LBW (<1000g) was 0.8, 0.4, 2.8, and 5.5 per patient, respectively. Transfused infants received an average of 4.7 transfusions (range 1-63; average of 3.5, 4.5, 4.5, and 6.0 transfusions at each respective site) with a mean donor exposure of 2.1 (range 1-23). Overall, 50% of pRBC transfusions occurred in the first 17 days of life and 34% occurred during the first week of life. Surgical and post-surgical transfusions accounted for 1389 (21.7%) of 6411 transfusions in 486 (35%) of 1381 transfused infants. Infants undergoing congenital diaphragmatic hernia repair required the most transfusions; 34 infants received 537 ECMO-related transfusions. The average storage age of the pRBC transfused was 16.1 days, but differed by site (12.5, 14.6, 16.7, 19.9 days for each site, respectively, p< 0.001 by Kruskal-Wallis test with Dunns Multiple Comparison Test) and by aliquot (1st-5th aliquot average age 12, 16, 19, 21, and 23 days, respectively). The average age of units transfused in infants without HAIs (n=5693) was 15.2 days; while the average age of units transfused in infants with HAIs (n=491) that developed after transfusion was 15.4 (p=0.04). An ecological study comparing all sites did not find a significant association between the average storage age of units transfused per site (excluding units transfused after onset of infection) and the proportion of neonates with HAIs at the site (R2=0.29; p=0.46; see Figure). Conclusions To our knowledge, this is the largest cohort study of neonatal transfusion practices in Level III NICUs. Transfusion practices were similar at each site. The average storage age of transfused pRBC units varied among the four sites; however, the mean RBC storage age of RBCs transfused to patients with or without HAIs was not markedly different and hospitals with a longer mean storage age did not have a higher proportion of neonates with HAIs. Further analysis is needed to explore the relationship between pRBC storage and HAIs, while controlling for differences in patient characteristics. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Nosocomial Infection Surveillance in Neonatal Intensive Care Units of Bahrami Children’s Hospital

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Kajiyazdi ◽  
Shayan Dasdar ◽  
Nika Kianfar ◽  
Mahbod Kaveh
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Laboratory Data ◽  
Morbidity And Mortality ◽  
Neonatal Intensive Care Units ◽  
Children's Hospital ◽  
Increased Risk ◽  
Children’S Hospital

Background: Nosocomial Infection (NI) is one of the leading causes of short- and long-term morbidity and mortality among neonates, especially in Neonatal Intensive Care Units (NICUs). Objectives: We aimed to evaluate the epidemiology of NIs and associated factors. Methods: From March 2017 to September 2018, all the neonates who were admitted to the NICUs of Bahrami Children’s Hospital were enrolled. Nosocomial infections were identified based on the definition of CDC-NNIS. Demographic, clinical, and laboratory data of the patients were extracted from the medical records. Results: A total of 979 neonates were admitted to the NICU, of whom 60 were diagnosed with NI. The incidence of NI was 6.1 per 100 hospitalized patients. The most prevalent NI was bloodstream infection (30%), followed by pneumonia (21.7%). The most frequent presentations were respiratory distress (31.7%) and poor feeding (26.7%). Major pathogens were Gram-positive bacteria such as Staphylococcus aureus (25.7%) and Coagulase-negative staphylococci (25.7%). The mean hospital stay was 25.2 ± 20.89 days. The mortality rate of patients with NI was 16.7%. The factors associated with an increased risk of mortality among patients with NI were a lack of ventilation support, low birth weight, and WBCs with an abnormal range. Conclusions: The results of the present study showed that the incidence of NI was high, and the cultures collected from body fluids had a particular role in the diagnosis and treatment of NI. Standard infection control practices should be applied to reduce the incidence of NI and subsequent morbidity and mortality.

scholarly journals Persistence of Clones of Coagulase-Negative Staphylococci among Premature Neonates in Neonatal Intensive Care Units: Two-Center Study of Bacterial Genotyping and Patient Risk Factors

1998 ◽  
Vol 36 (9) ◽  
pp. 2485-2490 ◽  
Author(s):  
Clementien L. Vermont ◽  
Nico G. Hartwig ◽  
André Fleer ◽  
Peter de Man ◽  
Henri Verbrugh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
The Netherlands ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Blood Cultures ◽  
Neonatal Intensive Care Units ◽  
Bacterial Isolates ◽  
Coagulase Negative Staphylococci ◽  
Children's Hospital

From 1 January 1995 until 1 January 1996, we studied the molecular epidemiology of blood isolates of coagulase-negative staphylococci (CoNS) in the Neonatal Intensive Care Units (NICUs) of the Sophia Children’s Hospital (SCH; Rotterdam, The Netherlands) and the Wilhelmina Children’s Hospital (WCH; Utrecht, The Netherlands). The main goal of the present study was to detect putatively endemic clones of CoNS persisting in these NICUs. Pulsed-field gel electrophoresis was used to detect the possible presence of endemic clones of clinical significance. In addition, clinical data of patients in the SCH were analyzed retrospectively to identify risk factors for the acquisition of positive blood cultures. In both centers, endemic CoNS clones were persistently present. Thirty-three percent of the bacterial isolates derived from blood cultures in the SCH belonged to a single genotype. In the WCH, 45% of all bacterial strains belonged to a single clone. These clones were clearly different from each other, which implies that site specificity is involved. Interestingly, we observe that the clonal type in the SCH differed significantly from the incidentally occurring strains with respect to both the average pH and partial CO2 pressure of the patient’s blood at the time of bacterial culture. We found that the use of intravascular catheters, low gestational age, and a long hospital stay were important risk factors for the development of a putative CoNS infection. When the antibiotic susceptibility of the bacterial isolates was assessed, a clear correlation between the nature of the antibiotics most frequently used as a first line of defense versus the resistance profile was observed. We conclude that the intensive use of antibiotics in an NICU setting with highly susceptible patients causes selection of multiresistant clones of CoNS which subsequently become endemic.

scholarly journals Variations in length of stay among survived very preterm infants admitted to Chinese neonatal intensive care units

2022 ◽  
Author(s):  
Min Zhang ◽  
Yan-Chen Wang ◽  
Jin-Xing Feng ◽  
Ai-Zhen Yu ◽  
Jing-Wei Huang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Multicenter Cohort Study ◽  
Very Preterm Infants ◽  
Very Preterm

Abstract Background This study aimed to describe length of stay (LOS) to discharge and site variations among very preterm infants (VPIs) admitted to 57 Chinese neonatal intensive care units (NICUs) and to investigate factors associated with LOS for VPIs. Methods This retrospective multicenter cohort study enrolled all infants < 32 weeks’ gestation and admitted to 57 NICUs which had participated in the Chinese Neonatal Network, within 7 days after birth in 2019. Exclusion criteria included major congenital anomalies, NICU deaths, discharge against medical advice, transfer to non-participating hospitals, and missing discharge date. Two multivariable linear models were used to estimate the association of infant characteristics and LOS. Results A total of 6580 infants were included in our study. The overall median LOS was 46 days [interquartile range (IQR): 35–60], and the median corrected gestational age at discharge was 36 weeks (IQR: 35–38). LOS and corrected gestational age at discharge increased with decreasing gestational age. The median corrected gestational age at discharge for infants at 24 weeks, 25 weeks, 26 weeks, 27–28 weeks, and 29–31 weeks were 41 weeks, 39 weeks, 38 weeks, 37 weeks and 36 weeks, respectively. Significant site variation of LOS was identified with observed median LOS from 33 to 71 days in different hospitals. Conclusions The study provided concurrent estimates of LOS for VPIs which survived in Chinese NICUs that could be used as references for medical staff and parents. Large variation of LOS independent of infant characteristics existed, indicating variation of care practices requiring further investigation and quality improvement.

scholarly journals Prevalence of Anxiety and Depression among Mothers of Newborns Admitted to Neonatal Intensive Care Units in Gaza Strip

2018 ◽  
pp. 10-14
Author(s):  
Motasem Salah ◽  
Rania Breaka ◽  
Areefa Alkasseh
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Family Income ◽  
Rating Scale ◽  
Gaza Strip ◽  
Neonatal Intensive Care Units ◽  
Anxiety And Depression

Objective: To determine the prevalence and level of anxiety and depression among mothers of newborns admitted to neonatal intensive care units in Gaza Strip. Methods: It is a cross-sectional study including 195 mothers who’s their neonates has been admitted to NICU at the three governmental hospitals in Gaza Strip between November 2017 to September 2018. Two psychological tests were applied, the Hamilton Anxiety Rating Scale and the Beck Depression Inventory. Collected data include sociodemographic profile for mother and neonates who include characteristic of mothers, number and types of deliveries, level of education, work status and family income. In addition, characteristics of neonates, gender, gestational age and birth weight, cause of admission and length of stay. Results: The results of our study indicated that 50.8% of mothers have severe to very severe symptoms of anxiety, 38.5% of mothers have severe to very severe symptoms of depression. There was a statistically significant differences in levels of anxiety (p = 0.044) and levels of depression (p = 0.005) among mothers related to hospital. The mothers of preterm and low birth weight babies had higher levels of anxiety (p = 0.010, 0.026), but there were insignificant differences in levels of depression, while there were no insignificant differences in levels of anxiety and depression among mothers related to gender of neonate, cause of admission, and length of stay in NICU. Conclusion: The effect of different maternal and neonatal factors on levels of anxiety and depression were examined and most of them revealed insignificant differences, which means that admission to NICU as a stressful event caused elevation in levels of anxiety and depression among mothers regardless of any other factors.

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