title: Analysis of the characteristics and management of critical values in a newborn tertiary center in China.
abstract: BACKGROUND
  Critical value reporting has been widely adopted by hospitals throughout the world, but there were few reports about neonatal critical values. This study aimed to analyze characteristics of the neonatal critical values considered at our center and to provide information on improving neonatal intensive care.
  
  
  METHODS
  A retrospective study of critical values at a newborn tertiary center in China was conducted to assess neonatal critical values according to test, distribution, reporting time, patient outcome and the impact to the therapy.
  
  
  RESULTS
  In total, 926 critical values were recorded. Overall, 66.52% (616/926) of the items were reported within 24 hours of admission, 50.28% (465/926) during duty times and 54.75% (507/926) in the neonatal intensive care unit (NICU). The routine coagulation test was the most frequent source of critical values. Electrocardiography, blood gas analysis and therapeutic drug monitoring of drug levels were associated with the highest rates of treatment intervention (100%); routine coagulation tests were the lowest (23.14%). Sample quality was the main cause of false-positive critical values.
  
  
  CONCLUSIONS
  The incidence of neonatal critical values peaked during the first 24 hours post-admission and during duty periods. Each newborn center needs to enact rapid treatment guidelines to address common critical values in order to facilitate clinical interventions. Periodically reviewing critical values could help to optimize clinical practices.
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Zheng-Li
authors.initials: ZL
authors.lastname: Wang
authors.affiliation: Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Du
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Yi-Yu
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Lu-Quan
authors.initials: LQ
authors.lastname: Li
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Lu-Ying
authors.initials: LY
authors.lastname: Cao
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing and Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China. yujialin486@126.com.|, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China. yujialin486@126.com.
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Yu
mesh_terms: D001784:Blood Gas Analysis; D002681:China; D015331:Cohort Studies; D003422:Critical Care / Q000592:standards* / Q000639:trends; D000066891:Critical Care Outcomes; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003955:Diagnostic Tests, Routine; D019468:Disease Management; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: critical care; critical value; management strategies; newborn