title: Feasibility of transferring intensive cared preterm infants from incubator to open crib at 1600 grams.
abstract: BACKGROUND
  Ability to maintain a normal body temperature in an open crib is an important physiologic competency generally requested to discharge preterm infants from the hospital. The aim of this study is to assess the feasibility of an early weaning protocol from incubator in preterm newborns in a Neonatal Intensive Care Unit.
  
  
  METHODS
  101 infants with birth weight < 1600 g were included in this feasibility study. We compared 80 newborns successfully transferred from an incubator to open crib at 1600 g with 21 infants transferred at weight ≥ 1700 g. The primary outcome was to evaluate feasibility of the protocol and the reasons for the eventual delay. Secondary outcomes were the identification of factors that would increase the likelihood of early weaning, the impact of an earlier weaning on discharge timing, and the incidence of adverse outcomes. Newborns in the study period were then compared with an historical control group with similar characteristics.
  
  
  RESULTS
  Early weaning was achieved in 79.2% of infants without significant adverse effects on temperature stability or weight gain. Delayed weaning was mainly due to the need of respiratory support. Gestational age affected the likelihood of early weaning (OR 1.7282 95% CI: 1.3071 - 2.2850). In the multivariate linear regression, early weaning reduced length of stay (LOS) by 25.8 days (p < 0.0001).
  
  
  CONCLUSIONS
  Preterm infants can be weaned successfully from an incubator to an open crib at weight as low as 1600 grams without significant adverse effect. Early weaning significantly reduces LOS in preterm newborns.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy. gbarone85@yahoo.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barone
authors.forename: Mirta
authors.initials: M
authors.lastname: Corsello
authors.forename: Patrizia
authors.initials: P
authors.lastname: Papacci
authors.forename: Francesca
authors.initials: F
authors.lastname: Priolo
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
authors.forename: Enrico
authors.initials: E
authors.lastname: Zecca
mesh_terms: D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007186:Incubators, Infant; D015370:Infant Equipment; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome