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[Predicting the occurrence of severe intraventricular hemorrhages and ways to prevent their development in preterm

Olena M Kovalova1, Valeriy I Pokhylko1, Andrey I Bielorus2

  • 1Ukrainian Medical Stomatological Academy, Poltava, Ukraine.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|January 27, 2019
PubMed

Insights

This study developed a bundle to predict and prevent severe intraventricular hemorrhages (IVH) in preterm infants. Implementing this bundle significantly reduced IVH incidence and associated disabilities in newborns.

Area of Science:

  • Neonatology
  • Pediatric Neurology
  • Public Health

Background:

  • Severe intraventricular hemorrhages (IVH) pose significant risks to preterm infants, leading to neurological impairment and mortality.
  • Effective prevention strategies are crucial for improving outcomes in high-risk neonates.

Purpose of the Study:

  • To develop and evaluate an algorithm for identifying high-risk preterm infants for IVH.
  • To create and implement a prevention bundle to reduce the incidence of severe IVH in preterm infants.

Main Methods:

  • A multicenter study involving 117 preterm infants (2013-2016).
  • Analysis of risk factors including gestational age, resuscitation methods, and leukocyte count.
  • Implementation of a multidisciplinary prevention bundle including checklists and risk identification algorithms.

Main Results:

  • Significant risk factors for severe IVH identified: low gestational age, anhydrous period <24 hours, 0.9% sodium chloride infusion, arterial hypertension episodes, and high leukocyte count.
  • The prevention bundle reduced IVH incidence from 18.9% to 11.4% (p=0.038).
  • Disability rates decreased from 9.6% to 2.4% (p=0.046) after bundle implementation.

Conclusions:

  • The developed bundle is an effective tool for preventing severe intraventricular hemorrhages in preterm infants.
  • Multidisciplinary collaboration and risk stratification are key to reducing IVH and subsequent disabilities.
Abstract

Keywords:
severe intraventricular hemorrhagebundlepredictionpreterm infantsprevention

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