Management during the first 72 h of age of the periviable infant: an evidence-based review.
After NICU admission the extremely immature newborn (EIN) requires evaluation and support of each organ system, and the integration of all those supports in a comprehensive plan of care. In this review, I attempt to analyze the evidence for treatment options after the initial transition, during the first 3 days of life, which have been shown to improve survival or short- or long-term morbidity. This review revealed several things: there is little available evidence from studies that have included significant numbers of EINs; interventions affecting different organ systems need to be co-ordinated as any intervention will have multiple effects; and future advances in treatment of this group of patients will require the installation of permanent research networks to have enough power to perform many studies needed to improve outcomes.
Sainte Justine University Hospital Center, 3175 Cote Ste Catherine, Montréal, Québec, Canada H3T 1C5. Electronic address: keith.barrington@umontreal.ca.
Keith J
KJ
Barrington
D004750:Enteral Nutrition / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D005328:Fetal Viability; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods / Q000458:organization & administration; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012178:Retinopathy of Prematurity / Q000628:therapy*; D013997:Time Factors; D014882:Water-Electrolyte Balance
Bronchopulmonary dysplasia; Extreme prematurity; Fluid balance; Intra-ventricular hemorrhage; Necrotizing enterocolitis; Survival