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Impact of a "Brain Protection Bundle" in Reducing Severe Intraventricular Hemorrhage in Preterm Infants <30 Weeks GA:
Nishkal Persad1, Edmond Kelly1, Nely Amaral2
1Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada.
Insights
A brain protection bundle did not reduce severe intraventricular hemorrhage (IVH) in preterm infants. This study found no significant difference in IVH incidence after bundle implementation in neonatal intensive care units.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Clinical Intervention Studies
Background:
- Periventricular/intraventricular hemorrhage (IVH) remains a significant concern in neonatal intensive care units (NICUs) despite advances in perinatal care.
- Antenatal, "golden hour" stabilization, and early postnatal interventions (first 72 hours) show promise in reducing IVH incidence.
Purpose of the Study:
- To evaluate the effectiveness of a "brain protection bundle" in reducing severe intraventricular hemorrhage (IVH ≥ Grade III) in preterm infants (<30 weeks gestational age).
- To compare the incidence of severe IVH before and after the implementation of a standardized brain protection protocol.
Main Methods:
- A pre- and post-implementation retrospective cohort study design was employed.
- Data collected included infant demographics, perinatal management, NICU care, cranial ultrasound findings, and short-term morbidities from 2015 to 2018.
- Severe IVH incidence was assessed via cranial scans performed after 72 hours of age.
Main Results:
- The study included 189 infants in the pre-implementation phase and 215 in the post-implementation phase.
- No statistically significant difference was observed in the incidence of severe IVH between the two groups (6.9% vs. 9.8%, p = 0.37).
Conclusions:
- The implemented "brain protection bundle" did not effectively decrease the incidence of severe IVH in preterm infants within the first 72 hours of life at this center.
- Further research may be needed to identify more effective strategies for preventing severe IVH in this vulnerable population.
Background:
despite advances in perinatal care, periventricular/intraventricular hemorrhage (IVH) continues to remain high in neonatal intensive care units (NICUs) worldwide. Studies have demonstrated the benefits of implementing interventions during the antenatal period, stabilization after birth (golden hour management) and postnatally in the first 72 h to reduce the incidence of IVH.
Objective:
to compare the incidence of severe intraventricular hemorrhage (IVH ≥ Grade III) before and after implementation of a "brain protection bundle" in preterm infants <30 weeks GA.
Study Design:
a pre- and post-implementation retrospective cohort study to compare the incidence of severe IVH following execution of a "brain protection bundle for the first 72 h from 2015 to 2018. Demographics, management practices at birth and in the NICU, cranial ultrasound results and short-term morbidities were compared.
Results:
a total of 189 and 215 infants were included in the pre- and post-implementation phase, respectively. No difference in the incidence of severe IVH (6.9% vs. 9.8%, p = 0.37) was observed on the first cranial scan performed after 72 h of age.
Conclusion:
the implementation of a "brain protection bundle" was not effective in reducing the incidence of severe IVH within the first 72 h of life in our centre.
