Neonatal Intensive Care Unit Length of Stay Reduction by Heart Rate Characteristics Monitoring

• Published in: The Journal of pediatrics Vol. 198; pp. 162 - 167
• Main Authors: Swanson, Jonathan R., King, William E., Sinkin, Robert A., Lake, Douglas E., Carlo, Waldemar A., Schelonka, Robert L., Porcelli, Peter J., Navarrete, Christina T., Bancalari, Eduardo, Aschner, Judy L., Perez, Jose A., O'Shea, T. Michael, Walker, M. Whit
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2018
• Subjects: blood stream infection; Female; Heart Rate - physiology; Heart Rate Determination; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Length of Stay; Male; neonate; Patient Discharge; Retrospective Studies; sepsis; UTI; very low birth weight; RCT; VLBW; PMA; very low birth weight; HRC; NICU; neonate; UTI; blood stream infection; sepsis
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2018.02.045

To examine the effect of heart rate characteristics (HRC) monitoring on length of stay among very low birth weight (VLBW; <1500 g birth weight) neonates in the HeRO randomized controlled trial (RCT).
We performed a retrospective analysis of length of stay metrics among 3 subpopulations (all patients, all survivors, and survivors with positive blood or urine cultures) enrolled in a multicenter, RCT of HRC monitoring.
Among all patients in the RCT, infants randomized to receive HRC monitoring were more likely than controls to be discharged alive and prior to day 120 (83.6% vs 80.1%, P = .014). The postmenstrual age at discharge for survivors with positive blood or urine cultures was 3.2 days lower among infants randomized to receive HRC monitoring when compared with controls (P = .026). Although there were trends in other metrics toward reduced length of stay in HRC-monitored patients, none reached statistical significance.
HRC monitoring is associated with reduced mortality in VLBW patients and a reduction in length of stay among infected surviving VLBW infants.
ClinicalTrials.gov: NCT00307333.