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[Treatment of very low birth weight infant: is it evidenced-based?]
A E Curley1, T R Tubman, H L Halliday
1Regional Neonatal Unit, Royal Maternity Hospital, Belfast, y Department of Child Health.The Queen's University of Belfast, Irlanda del Norte.
Insights
This study found that 91.3% of therapeutic interventions for very low birth weight infants in neonatal intensive care are evidence-based. Most care for these vulnerable infants relies on strong scientific support.
Area of Science:
- Neonatalogy
- Evidence-based medicine
- Pediatric intensive care
Context:
- Neonatal intensive care units (NICUs) manage extremely vulnerable very low birth weight infants.
- The quality of care is often determined by the evidence supporting therapeutic interventions.
- Retrospective review of 80 very low birth weight infants' management in 1998.
Purpose:
- To quantify the percentage of therapeutic interventions for very low birth weight infants that are evidence-based.
- To categorize interventions based on the strength of supporting scientific evidence.
Summary:
- A total of 943 interventions were analyzed.
- 91.3% of interventions were evidence-based: 58.7% Level I (RCTs/meta-analysis), 32.6% Level II (convincing non-experimental evidence).
- Only 8.7% of interventions were Level III (lacking substantial evidence).
Impact:
- Demonstrates that care for very low birth weight infants in this NICU is predominantly evidence-based.
- Highlights the high utilization of Level I and II evidence in neonatal intensive care.
- Provides a benchmark for assessing evidence-based practices in neonatal medicine.
Aim:
To determine what percentage of therapeutic interventions for very low birth weight infants undergoing neonatal intensive care is evidence based.
Methods:
The management of 80 very low birth weight infants admitted to our neonatal unit during 1998 was retrospectively reviewed. For each clinical diagnosis e.g. respiratory distress syndrome, patent ductus arteriosus or chronic lung disease all interventions were recorder. Each intervention was then categorised according to the level of supporting evidence. Level I was supported by evidence from randomised controlled trials or meta-analysis of multiple trials. Level II included interventions backed by convincing non-experimental evidence where randomised controlled trials would be unnecessary or unethical. Level III were treatments in common use without substantial supporting evidence. These categorizations were made after extensive researching of Medline, The Cochrane Database and the Randomised Controlled Trial Register, detailed hand-searching of the literature as well as using local expertise and knowledge.
Results:
943 separate interventions were recorded in the charts of the 80 babies. Overall 91.3% were shown to be evidence-based of which 58.7% were level I, 32.6% were level II and only 8.7% were level III.
Conclusions:
91.3% of interventions for very low birth weight infants in our neonatal intensive care unit were evidence-based and only 8.7% had no substantial supporting evidence. Care of the very low birthweight infants is largely evidence-based.