Diurnal variation in the quality and outcome of newborn intensive care

Variables related to both the process and the outcome of neonatal intensive care were studied to compare care given during the day (0901-2100 hours) with that at night (2101-0900 hours). At night, intravenous infiltrations occurred more often, and the tidal volume of respirator-treated infants was verified less often. Blood pH values less than 7.20, excluding values within 12 hours of admission, were recorded more often and in more patients at night. During a 12-month period, there were significantly more deaths among infants less than 1,500 gm during the night than during the day. The deterioration of infants at night may result in part from current nursery staffing practices.