Neonatal Intensive Care Unit Length of Stay Reduction by Heart Rate Characteristics Monitoring

J Pediatr. 2018 Jul:198:162-167. doi: 10.1016/j.jpeds.2018.02.045. Epub 2018 Apr 24.

Abstract

Objective: To examine the effect of heart rate characteristics (HRC) monitoring on length of stay among very low birth weight (VLBW; <1500 g birth weight) neonates in the HeRO randomized controlled trial (RCT).

Study design: We performed a retrospective analysis of length of stay metrics among 3 subpopulations (all patients, all survivors, and survivors with positive blood or urine cultures) enrolled in a multicenter, RCT of HRC monitoring.

Results: Among all patients in the RCT, infants randomized to receive HRC monitoring were more likely than controls to be discharged alive and prior to day 120 (83.6% vs 80.1%, P = .014). The postmenstrual age at discharge for survivors with positive blood or urine cultures was 3.2 days lower among infants randomized to receive HRC monitoring when compared with controls (P = .026). Although there were trends in other metrics toward reduced length of stay in HRC-monitored patients, none reached statistical significance.

Conclusions: HRC monitoring is associated with reduced mortality in VLBW patients and a reduction in length of stay among infected surviving VLBW infants.

Trial registration: ClinicalTrials.gov: NCT00307333.

Keywords: UTI; blood stream infection; neonate; sepsis; very low birth weight.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Female
  • Heart Rate / physiology*
  • Heart Rate Determination*
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Intensive Care Units, Neonatal*
  • Length of Stay*
  • Male
  • Patient Discharge
  • Retrospective Studies

Associated data

  • ClinicalTrials.gov/NCT00307333