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245864

Care Bundle Application Decreases The Frequency and Severity of Intraventricular Hemorrhage in Preterm Neonates: Single Center Study

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Last updated: 22 Jan 2023

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Abstract

Background: Intraventricular hemorrhage (IVH) is a severe complication in preterm babies admitted to Neonatal Intensive Care Units (NICU). Advanced stages of IVH predispose to neurological deficits such as cerebral palsy and hydrocephalus. There are numerous strategies and policies implemented in NICUs around the world to decrease the incidence of IVH in preterm babies and prevent its ensuing neurodevelopmental complications.
Aim of the Work: To study the effect of implementing a bundle of care on incidence and severity of IVH among preterm neonates.
Materials and Methods: Retrospective analysis of patient records for incidence and severity of IVH between May and August 2018 was done. This was followed by an educational interim period where NICU staff received training of pre-natal, natal, and postnatal care bundle guidelines to reduce IVH. The guidelines were then implemented on all preterm babies (28-34 weeks gestational age (GA)) born and admitted to Kasr Al Ainy Teaching Hospital NICU, Cairo University between October 2018 and January 2019 (n=58). Cranial ultrasonography was performed at week 1 and week 2-3 of life. Frequency and severity of IVH were compared among studied groups. Risk factors for IVH were analyzed and recorded.
Results: The frequency of IVH was significantly lower in the post-bundle group (44-46% pre-bundle, and 27% post-bundle) especially evidenced by the ultrasonography in week two of life.  Severity of IVH also improved post bundle since there were no grade III IVH patients in that group. Exposure to hypocapnia, blood pressure fluctuations, IV fluid boluses and administration of sodium bicarbonate were significantly correlated with development of IVH in preterm babies (p = 0.001). 
Conclusion: Implementation of an IVH care bundle that includes perinatal measures can positively affect the neurological outcome by decreasing incidence and severity of IVH in preterm babies.

DOI

10.21608/cupsj.2022.142531.1061

Keywords

Care Bundle, cranial ultrasonography, IVH, intraventricular hemorrhage, preterm

Authors

First Name

Sarah

Last Name

ElTatawy

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

statawy@cu.edu.eg

City

Cairo

Orcid

0000-0002-5131-5788

First Name

Amira

Last Name

Gad

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

amiragad930@gmail.com

City

Cairo

Orcid

-

First Name

Tamer

Last Name

Eissa

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Egypt

Email

tamereissa@live.com

City

Cairo

Orcid

-

First Name

Salma

Last Name

EL Houchi

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

salma.elhouchi@kasralainy.edu.eg

City

Cairo

Orcid

0000-0001-5257-7854

First Name

Amira

Last Name

Sabry

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

amirasabryelshafie@kasralainy.edu.eg

City

Cairo

Orcid

0000-0002-8232-2673

Volume

2

Article Issue

2

Related Issue

35212

Issue Date

2022-07-01

Receive Date

2022-06-04

Publish Date

2022-07-01

Page Start

112

Page End

119

Print ISSN

2805-279X

Online ISSN

2682-3985

Article File

CUPSJ_Volume 2_Issue 2_Pages 112-119.pdf

PDF . 701.7kB

Link

https://cupsj.journals.ekb.eg/article_245864.html

Detail API

https://cupsj.journals.ekb.eg/service?article_code=245864

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1

Type

Original Research

Type Code

1,229

Publication Type

Journal

Publication Title

Pediatric Sciences Journal

Publication Link

https://cupsj.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023