Clinically significant cardiopulmonary events and the effect of definition standardization on apnea of prematurity management.
To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge.



Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared.



Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (P<0.001). Infants discharged on caffeine reduced from 17% to 5% (P<0.001), and home monitor use also fell from 54% to 16% (P<0.001).



Standardizing definitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.
Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
M B F
MB
Powell
Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
C R
CR
Ahlers-Schmidt
Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
M
0000-0002-3331-4255
M
Engel
Department of Neonatology, Wichita Medical Research and Education Foundation, Wichita, KS, USA.
B T
BT
Bloom
D001049:Apnea / Q000175:diagnosis* / Q000628:therapy*; D001724:Birth Weight; D002110:Caffeine / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007902:Length of Stay; D008297:Male; D008991:Monitoring, Physiologic; D012121:Respiration, Artificial / Q000379:methods; D012189:Retrospective Studies; D014481:United States
D002110:Caffeine
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