Related Experiment Videos

Pre-discharge Cardiorespiratory Monitoring in Preterm Infants. the CORE Study

Francesco Cresi1, Enrico Cocchi1, Elena Maggiora1

  • 1Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy.

Frontiers in Pediatrics
|June 26, 2020
PubMed

Insights

The CORE protocol significantly reduced hospital readmissions in preterm infants by monitoring cardiorespiratory stability before discharge. This new approach ensures safer discharges without extending hospital stays.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Clinical Research

Background:

  • Cardiorespiratory (CR) stability is critical for safe infant discharge from neonatal intensive care units (NICUs).
  • Hospital readmission (RHR) is a significant concern for preterm infants post-discharge.
  • Optimizing discharge protocols is essential to improve infant outcomes and reduce healthcare burdens.

Purpose of the Study:

  • To evaluate the impact of a novel pre-discharge protocol, CORE, on the risk of hospital readmission in preterm infants.
  • To assess whether the CORE protocol influences the length of hospital stay for preterm infants.

Main Methods:

  • A randomized controlled trial involving preterm infants admitted to the NICU between 2015 and 2018.
  • Infants were assigned to either the CORE protocol (exposed) or a standard discharge protocol (not-exposed).
  • The CORE protocol involved 24-hour clinical observation and, for high-risk infants, 24-hour instrumental CR monitoring.

Main Results:

  • Three hundred twenty-three preterm infants were enrolled in the study.
  • Infants managed with the CORE protocol exhibited a significantly lower risk of hospital readmission (log-rank p < 0.05).
  • The reduction in RHR was particularly notable at 3 months post-discharge (9.09% vs. 21.6%; p = 0.004).

Conclusions:

  • The CORE protocol demonstrates potential in optimizing discharge timing for preterm infants.
  • Implementation of the CORE protocol may lead to a reduction in hospital readmissions.
  • The CORE protocol did not result in a significant increase in the length of hospital stay.

Keywords:
NICU dischargecardiorespiratory stabilityhospital readmissionlength of staysafe discharge

Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
2.1K
Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

Assessment of Ventilation II: Respiratory Depth and Rhythm

Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
2.3K
Assessment of Respiration01:23

Assessment of Respiration

The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.7K
Assessment of Ventilation I: Respiratory Rate01:20

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.7K
Holter Monitor: 24-Hour Monitoring01:23

Holter Monitor: 24-Hour Monitoring

Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...
1.4K
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
884