Journal article
Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial
The Journal of pediatrics, Vol.204, pp.96-102.e4
01/01/2019
DOI: 10.1016/j.jpeds.2018.08.079
PMCID: PMC6326364
PMID: 30337189
Abstract
Objective To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight.
Study design This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0 degrees C to 1.5 degrees C every 24 hours until 28.0 degrees C. The infants were weaned to the crib following stable temperature at 36.5 degrees C to 37.4 degrees C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored.
Results Of 1565 infants screened, 885 were eligible, and 366 enrolled-187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P = .12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P = .005). Groups did not differ in adverse events.
Conclusions Among moderately preterm neonates, weaning from in cubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning.
Details
- Title: Subtitle
- Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial
- Creators
- Seetha Shankaran - Wayne State UniversityEdward F. Bell - University of IowaAbbot R. Laptook - Women & Infants Hospital of Rhode IslandShampa Saha - RTI InternationalNancy S. Newman - Case Western Reserve UniversityS. Nadya J. Kazzi - Wayne State UniversityJohn Barks - Univ Michigan, Dept Pediat, Ann Arbor, MI 48109 USABarbara J. Stoll - The University of Texas Health Science Center at HoustonRebecca Bara - Wayne State UniversityJenna Gabrio - RTI InternationalKirsten Childs - Wayne State UniversityAbhik Das - RTI InternationalRosemary D. Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentWaldemar A. Carlo - University of Alabama at BirminghamPablo J. Sanchez - Nationwide Children's HospitalDavid P. Carlton - Children's Healthcare of AtlantaLara Pavageau - The University of Texas Southwestern Medical CenterWilliam F. Malcolm - Duke UniversityCarl T. D'Angio - University of RochesterRobin K. Ohls - University of New MexicoBrenda B. Poindexter - Perinatal InstituteGregory M. Sokol - Indiana UniversityKrisa P. Van Meurs - Lucile Packard Children's HospitalTarah T. Colaizy - University of IowaAyman Khmour - Children's Mercy HospitalKaren M. Puopolo - Children's Hospital of PhiladelphiaMeena Garg - University of California, Los AngelesMichele C. Walsh - Case Western Reserve UniversityEunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network
- Contributors
- Heidi Harmon (Contributor) - University of Iowa, Neonatology
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.204, pp.96-102.e4
- DOI
- 10.1016/j.jpeds.2018.08.079
- PMID
- 30337189
- PMCID
- PMC6326364
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier
- Number of pages
- 11
- Grant note
- UG1HD027904 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) NCT02160002 / Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353948902771
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