Pediatrics
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Randomized Controlled Trial
Resuscitation of preterm neonates with limited versus high oxygen strategy.
To determine whether a limited oxygen strategy (LOX) versus a high oxygen strategy (HOX) during delivery room resuscitation decreases oxidative stress in preterm neonates. ⋯ LOX is feasible and results in less oxygen exposure, lower oxidative stress, and decreased respiratory morbidities and thus is a reasonable alternative for resuscitation of preterm neonates in the delivery room.
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Randomized Controlled Trial
Reducing children's exposure to secondhand smoke at home: a randomized trial.
To develop and test an intervention to reduce children's exposure to secondhand smoke (SHS) at homes in Yerevan, Armenia. ⋯ Intensive intervention is effective in decreasing children's exposure to SHS through educating mothers and promoting smoking restrictions at home. However, superiority over minimal intervention to decrease children's exposure was not statistically significant.
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Multicenter Study Clinical Trial
Reducing central line-associated bloodstream infections in North Carolina NICUs.
Central lines in NICUs have long dwell times. Success in reducing central line-associated bloodstream infections (CLABSIs) requires a multidisciplinary team approach to line maintenance and insertion. The Perinatal Quality Collaborative of North Carolina (PQCNC) CLABSI project supported the development of NICU teams including parents, the implementation of an action plan with unique bundle elements and a rigorous reporting schedule. The goal was to reduce CLABSI rates by 75%. ⋯ A collaborative structure targeting team development, family partnership, unique bundle elements and strict reporting on line care produced the largest reduction in CLABSI rates for any multiinstitutional NICU collaborative.
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Randomized Controlled Trial
Intravenous magnesium sulfate for vaso-occlusive episodes in sickle cell disease.
Vaso-occlusive episodes (VOEs) are the most common complication of sickle cell disease in children. Treatment with magnesium seems to improve cellular hydration and may result in reduced vaso-occlusion. This study aimed to determine if intravenous (IV) magnesium sulfate (MgSO4) reduces length of stay (LOS) in hospital, pain scores, and cumulative analgesia when compared with placebo. ⋯ IV MgSO4 was well tolerated but had no effect on the LOS in hospital, pain scores, or cumulative analgesia use in admitted children with a VOE.
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Multicenter Study
Community household income and resource utilization for common inpatient pediatric conditions.
Child health is influenced by biomedical and socioeconomic factors. Few studies have explored the relationship between community-level income and inpatient resource utilization for children. Our objective was to analyze inpatient costs for children hospitalized with common conditions in relation to zip code-based median annual household income (HHI). ⋯ Lower community-level HHI is associated with higher inpatient costs of care for 4 of 5 common pediatric conditions. These findings highlight the need to consider socioeconomic status in health care system design, delivery, and reimbursement calculations.