[Treatment of very low birth weight infant: is it evidenced-based?].
OBJECTIVE
To determine what percentage of therapeutic interventions for very low birth weight infants undergoing neonatal intensive care is evidence based.


METHODS
The management of 80 very low birth weight infants admitted to our neonatal unit during 1998 was retrospectively reviewed. For each clinical diagnosis e.g. respiratory distress syndrome, patent ductus arteriosus or chronic lung disease all interventions were recorder. Each intervention was then categorised according to the level of supporting evidence. Level I was supported by evidence from randomised controlled trials or meta-analysis of multiple trials. Level II included interventions backed by convincing non-experimental evidence where randomised controlled trials would be unnecessary or unethical. Level III were treatments in common use without substantial supporting evidence. These categorizations were made after extensive researching of Medline, The Cochrane Database and the Randomised Controlled Trial Register, detailed hand-searching of the literature as well as using local expertise and knowledge.


RESULTS
943 separate interventions were recorded in the charts of the 80 babies. Overall 91.3% were shown to be evidence-based of which 58.7% were level I, 32.6% were level II and only 8.7% were level III.


CONCLUSIONS
91.3% of interventions for very low birth weight infants in our neonatal intensive care unit were evidence-based and only 8.7% had no substantial supporting evidence. Care of the very low birthweight infants is largely evidence-based.
Curley
A E
AE
Regional Neonatal Unit, Royal Maternity Hospital, Belfast, y Department of Child Health.The Queen's University of Belfast, Irlanda del Norte.
Tubman
T R
TR
Halliday
H L
HL
D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal; D012189:Retrospective Studies