TY - JOUR
T1 - Mortality reduction by heart rate characteristic monitoring in very low birth weight neonates
T2 - A randomized trial
AU - Moorman, Joseph Randall
AU - Carlo, Waldemar A.
AU - Kattwinkel, John
AU - Schelonka, Robert L.
AU - Porcelli, Peter J.
AU - Navarrete, Christina T.
AU - Bancalari, Eduardo
AU - Aschner, Judy L.
AU - Whit Walker, Marshall
AU - Perez, Jose A.
AU - Palmer, Charles
AU - Stukenborg, George J.
AU - Lake, Douglas E.
AU - Michael O'Shea, Thomas
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2011/12
Y1 - 2011/12
N2 - Objective: To test the hypothesis that heart rate characteristics (HRC) monitoring improves neonatal outcomes. Study design: We conducted a two-group, parallel, individually randomized controlled clinical trial of 3003 very low birth weight infants in 9 neonatal intensive care units. In one group, HRC monitoring was displayed; in the other, it was masked. The primary outcome was number of days alive and ventilator-free in the 120 days after randomization. Secondary outcomes were mortality, number of ventilator days, neonatal intensive care unit stay, and antibiotic use. Results: The mortality rate was reduced in infants whose HRC monitoring was displayed, from 10.2% to 8.1% (hazard ratio, 0.78; 95% CI, 0.61-0.99; P =.04; number needed to monitor = 48), and there was a trend toward increased days alive and ventilator-free (95.9 of 120 days compared with 93.6 in control subjects, P =.08). The mortality benefit was concentrated in infants with a birth weight <1000 g (hazard ratio, 0.74; 95% CI, 0.57-0.95; P =.02; number needed to monitor = 23). There were no significant differences in the other outcomes. Conclusion: HRC monitoring can reduce the mortality rate in very low birth weight infants.
AB - Objective: To test the hypothesis that heart rate characteristics (HRC) monitoring improves neonatal outcomes. Study design: We conducted a two-group, parallel, individually randomized controlled clinical trial of 3003 very low birth weight infants in 9 neonatal intensive care units. In one group, HRC monitoring was displayed; in the other, it was masked. The primary outcome was number of days alive and ventilator-free in the 120 days after randomization. Secondary outcomes were mortality, number of ventilator days, neonatal intensive care unit stay, and antibiotic use. Results: The mortality rate was reduced in infants whose HRC monitoring was displayed, from 10.2% to 8.1% (hazard ratio, 0.78; 95% CI, 0.61-0.99; P =.04; number needed to monitor = 48), and there was a trend toward increased days alive and ventilator-free (95.9 of 120 days compared with 93.6 in control subjects, P =.08). The mortality benefit was concentrated in infants with a birth weight <1000 g (hazard ratio, 0.74; 95% CI, 0.57-0.95; P =.02; number needed to monitor = 23). There were no significant differences in the other outcomes. Conclusion: HRC monitoring can reduce the mortality rate in very low birth weight infants.
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U2 - 10.1016/j.jpeds.2011.06.044
DO - 10.1016/j.jpeds.2011.06.044
M3 - Article
C2 - 21864846
AN - SCOPUS:84860389704
VL - 159
SP - 900-906.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 6
ER -