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• W2761978412 abstract "AOP is a significant problem for VLBWI, leading to prolonged hospital stays, ventilator dependence, need for medications, and possibly long-term neurodevelopmental disability. The Neonatal Individualised Developmental Care and Assessment Program (NIDCAP®) has been shown to be beneficial for VLBWI, eg, reduced length of stay. However, its effect on AOP in VLBWI has not been prospectively studied. An RCT to prospectively assess the impact of NIDCAP®-based developmental care on AOP in VLBWI. 120 VLBWI were randomly assigned to one of two groups: control (C) received standard NICU care; intervention (N) received the majority of NICU care by NIDCAP®-educated nurses. Sample size was calculated a priori on a reduction of indicators of AOP by 50%, (alpha=5%; power=0.95). Once randomised, nursing care (standard or NIDCAP®) was assigned according to group for the duration of the infant's stay at the study site. A minimum of 50% appropriate nursing assignment was required. A continuous 72-hour oxycardiorespirograph recording (OCR) was carried out within 24 hours of extubation, or if not intubated, at study entry. Index events were defined as: 1) Bradycardia, B≥30% HR decrease from the level measured over the preceding 2 minutes; 2) Desaturation, D=10% oxygen saturation decrease from the level measured over the previous minute, or saturation <88%; 3) Combined event, BD=concurrent B and D. These are accepted indicators of AOP. All events, reported/hour, were further categorised as short (10–20 sec; S) or long (>20 sec; L). Three experienced research nurses analysed the OCRs; inter-rater reliability was >90%. A p value of <0.01 was required to accommodate multiple testing with Student's non-paired T-test. OCRs were obtained from 57 N and 54 C infants. Groups did not differ significantly in BW; GA; gender; APGAR and SNAP-II(TM) scores; mode of delivery; use of antepartum steroids, inotropes, surfactant; need for ventilation; use of methylxanthines; age at study entry and when OCR was done. Significant event reductions (p<0.00001) were noted between groups in 1) overall S events/h (C=1.32±0.95; N=0.61±0.44); 2) overall L events/h (C=2.41±2.01; N=0.71±0.54), 3) total events/h (C=3.73±2.74; N=1.32±0.89); 4) S D/h (C=0.87±1.04; N=0.21±0.29) and 5) L D/h (C=1.88±2.03; N=0.34±0.47). NIDCAP®-based care significantly reduced indicators of AOP in these VLBWI. Implications for long-term outcomes and on health care resources are expected to be significant, and are under current study." @default.
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• W2761978412 date "2004-05-01" @default.
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• W2761978412 title "6 Nidcap Based Developmental Care Significantly Reduces Apnea of Prematurity (AOP) In Very Low Birth Weight Infants (VLBWI)" @default.
• W2761978412 doi "https://doi.org/10.1093/pch/9.suppl_a.15ab" @default.
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