title: Neonatal intensive care unit discharge of infants with cardiorespiratory events: Tri-country comparison of academic centers.
abstract: OBJECTIVE
  Compare how NICUs within academic centers in Canada, France, and the United States make discharge decisions regarding cardiorespiratory recordings and home use of apnea monitors, oximeters and caffeine.
  
  
  METHODS
  An anonymous survey was sent to neonatologists through the member listserv of the American Academy of Pediatrics Section on Perinatal Pediatrics, the Canadian Fellowship Program Directory, and to Level 3 NICUs in France.
  
  
  RESULTS
  The response rates were 89% , 83% , and 79% for US, Canada and France respectively. In Canada, 45% perform pre-discharge recordings vs. 38% in France and 24% in the US. Apnea free days prior to discharge were required in 100% of centers in Canada, 96% in France, and 92% in the US. In Canada and France, 65% and 68% of units discharge patients on monitors vs. 99% in the US. 64% of the US centers sometimes use home caffeine compared to 40% in Canada and 34% in France. Over 60% of the centers in Canada and France wait until at least 40 weeks post menstrual age to discharge patients, whereas only about 33% of the US wait that late to discharge patients.
  
  
  CONCLUSIONS
  Discharge practices from NICUs are not well standardized across institutions or countries. Canada and France keep infants in the hospital longer and are less likely than the US to use home monitoring and home caffeine.
authors.affiliation: University of Chicago, Chicago, IL, USA.|Department of Pediatrics, Comer Children's Hospital, Chicago, IL, USA.
authors.forename: C
authors.initials: C
authors.lastname: Carlos
authors.affiliation: University of Chicago, Chicago, IL, USA.|Department of Pediatrics, NorthShore University Health System, Evanston, IL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Hageman
authors.affiliation: University of Chicago, Chicago, IL, USA.|Department of Pediatrics, Comer Children's Hospital, Chicago, IL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Pellerite
authors.affiliation: American SIDS Institute, Naples, FL, USA.
authors.forename: B
authors.initials: B
authors.lastname: McEntire
authors.affiliation: Division of Pediatric Pulmonology, Montreal Children's Hospital, Montreal, QC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Cóté
authors.affiliation: Pediatric Sleep Unit, Service Epilepsie, Sommeil, Explorations Fonctionnelles Neuropediatriques, Hôpital Femme Mère Enfant, University Lyon, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Raoux
authors.affiliation: Pediatric Sleep Unit, Service Epilepsie, Sommeil, Explorations Fonctionnelles Neuropediatriques, Hôpital Femme Mère Enfant, University Lyon, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Franco
authors.affiliation: Department of Pediatrics, NorthShore University Health System, Evanston, IL, USA.
authors.forename: C
authors.initials: C
authors.lastname: Rusciolelli
authors.affiliation: Department of Pediatrics, St. Joseph Hospital, Syracuse, NY, USA.
authors.forename: L
authors.initials: L
authors.lastname: Consenstein
authors.affiliation: Department of Pediatrics, Holyoke Medical Center, Mount Holyoke, MA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Kelly
mesh_terms: D000046:Academic Medical Centers / Q000379:methods* / Q000706:statistics & numerical data; D001049:Apnea / Q000175:diagnosis*; D002110:Caffeine / Q000008:administration & dosage; D002170:Canada; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D000066491:Clinical Decision-Making / Q000379:methods*; D005602:France; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012129:Respiratory Function Tests; D014481:United States
chemical_list: D000697:Central Nervous System Stimulants; D002110:Caffeine
keywords: Neonatal intensive care unit discharge; cardiorespiratory events; neonatal discharge