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Effectiveness of a care bundle for primary prevention of intraventricular hemorrhage in high-risk neonates: a

Benjamin J S Al-Haddad1, Brittany Bergam2, Alicia Johnson3

  • 1University of Minnesota Department of Pediatrics, Division of Neonatology, Minneapolis, MN, USA. haddad@umn.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|October 30, 2022
PubMed

Insights

An intraventricular hemorrhage (IVH) prevention bundle, including midline-elevated positioning, did not significantly reduce IVH rates in high-risk neonates. This retrospective study found no evidence of a protective effect in the NICU population studied.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Clinical Interventions

Background:

  • Intraventricular hemorrhage (IVH) is a significant concern in high-risk neonates, particularly those born prematurely.
  • Effective prevention strategies are crucial to improve outcomes for vulnerable infants.

Purpose of the Study:

  • To evaluate the efficacy of an intraventricular hemorrhage (IVH) prevention bundle incorporating midline-elevated positioning.
  • To determine if this bundle reduces the incidence of IVH in high-risk infants.

Main Methods:

  • Retrospective study comparing infants before and after bundle implementation (N=205 vs. N=360).
  • Infants were characterized by low birth weight (<1250g) or early gestation (<30 weeks).
  • Bayesian and frequentist logistic regression analyses were employed to assess IVH rates.

Main Results:

  • No statistically significant difference in the odds of any grade IVH was observed after bundle implementation (Bayesian OR 0.993; Frequentist OR 1.23).
  • Results remained robust against potential bias from deaths attributed to IVH.

Conclusions:

  • The implemented IVH prevention bundle, including midline-elevated positioning, did not demonstrate a significant protective effect on IVH incidence.
  • Further research may be needed to identify more effective strategies for preventing IVH in high-risk neonates.
Abstract

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