Abstract:
OBJECTIVE:To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2] ≤ 80%) or hyperoxemic (SpO2 > 95% while on supplemental oxygen). STUDY DESIGN:In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders. Manual alarm tallies and electronic SpO2 data were collected throughout the project. RESULTS:Alarm tallies were collected for 158 patient care hours with SpO2 data available for 138 of those hours. Mean number of total nonactionable alarms per patient per hour decreased from 9 to 2 (78% decrease) and the mean number of nonactionable low alarms per patient per hour decreased from 5 to 1 (80% decrease). No change was noted in the balancing measures of percentage time with SpO2 ≤ 80% (mean 4.3%) or SpO2 > 95% (mean 23.7%). CONCLUSION:Through small changes in oximeter alarm settings, including revision of alarm limits, alarm delays, and age-specific alarm profiles, our NICUs significantly reduced nonactionable alarms without increasing hypoxemia.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Johnson KR,Hagadorn JI,Sink DWdoi
10.1055/s-0038-1653945subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1311-1318issue
13eissn
0735-1631issn
1098-8785journal_volume
35pub_type
杂志文章abstract:OBJECTIVE:Placenta previa and prior cesarean delivery are known risk factors for placenta accreta. However, other risk factors have not been identified. Our objective was to examine risk factors for accreta using data collected prospectively in a large multicenter cohort. STUDY DESIGN:Secondary analysis of women with ...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0033-1361833
更新日期:2014-10-01 00:00:00
abstract::Neonatal alloimmune thrombocytopenia (NAIT) is the most common cause of severe thrombocytopenia in an otherwise healthy newborn. The most serious complication is intracranial hemorrhage, which can occur either in the fetus or the newborn. Despite the known serious sequelae, both antenatal management and neonatal treat...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1263296
更新日期:2011-02-01 00:00:00
abstract::Acute kidney injury (AKI) refers to the rapid loss of renal function. In clinical practice, AKI is common among hospitalized patients of all age groups including neonates and remains an important cause of morbidity and mortality due to its late diagnosis and therefore delayed therapeutic intervention. Although the pre...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1326985
更新日期:2013-05-01 00:00:00
abstract::Neonatal intussusception in premature infants is uncommon and may mimic other abdominal disorders. We present a case of intussusception in a very low birthweight neonate. Presenting signs initially suggested necrotizing enterocolitis and meconium disease, and the diagnosis was confirmed at laparotomy. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999916
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate obstetric outcomes in relation to the extent of donor sperm exposure with and without egg donation. MATERIALS AND METHODS:This is a retrospective cohort study in a single tertiary care center. All women with a singleton pregnancy who conceived following sperm donation (S...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1667029
更新日期:2019-01-01 00:00:00
abstract::A previously healthy multigravida woman presenting with pyrexia was found to be pancytopenic at 32 weeks' gestation. The leukopenia and the thrombocytopenia responded to supportive therapy. The anemia, which was Coombs' negative, continued and was associated with a drop in fibrinogen, but both eventually returned to n...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994758
更新日期:1993-09-01 00:00:00
abstract::The primary objective of this study was to determine whether having the sickle cell trait is independently associated with preeclampsia. We performed a retrospective cohort study of 1998 pregnant patients who either did or did not have the sickle cell trait. All patients were screened for the sickle trait using the "S...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-37953
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE: To determine the association between total gestational weight gain and perinatal outcomes. STUDY DESIGN: Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 20...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1696640
更新日期:2021-01-01 00:00:00
abstract::To minimize the selection bias inherent in reporting results gathered only in neonatal intensive care units, this study presents survival and respiratory course data on all 299 infants of birthweight 501 to 1500 gm liveborn to residents of the North Central Illinois Perinatal Region in 1985-1986. The survival rate was...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999632
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:The aim of this article is to evaluate the accuracy, precision, and safety of transcutaneous carbon dioxide tension (TcPCO2) monitoring at different electrode temperatures in preterm infants in the early postnatal period. STUDY DESIGN:A total of 26 neonates with a median birth weight of 974 g (432-1,694 g) a...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0033-1352485
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE: This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates wi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1722328
更新日期:2021-01-04 00:00:00
abstract::The objective of this study was to determine if the rate of preeclampsia is increased in triplet as compared to twin gestations. Fifty-three triplet pregnancies between 1986 and 1993 at The New York Hospital-Cornell Medical Center were reviewed. These were matched for maternal age, parity, and race to twin gestations ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994140
更新日期:1997-05-01 00:00:00
abstract::The antioxidant enzyme paraoxonase 1 is a marker of oxidative stress and has been implicated in the pathogenesis of preeclampsia. Our objective was to determine if an association exists between low paraoxonase 1 activity at midgestation and the development of preeclampsia. We conducted a case-control study of 50 women...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1236438
更新日期:2010-03-01 00:00:00
abstract::A study was undertaken in 372 consecutive patients undergoing non-elective cesarean delivery to explore the incidence and nature of conflicts between physician and patient surrounding the decision to undergo non-elective cesarean delivery; to examine the adequacy of informed consent at the time of non-elective cesarea...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994319
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To determine the associations of measured protein, energy, and protein-to-energy (PER) intakes with body composition in human milk (HM)-fed preterm infants. STUDY DESIGN:Neonates born at < 33 gestational weeks were eligible. Standard fortification method with modular supplements was used and the HM compositi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1626717
更新日期:2018-07-01 00:00:00
abstract::We studied the relationships between fetal hemoglobin concentration, acid base status, and lactate concentration in umbilical venous and fetal heart blood in 157 fetuses affected by blood group incompatibility who had been exposed for 214 fetal blood sampling procedures (cordocentesis in 153 and intracardiac puncture ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994524
更新日期:1994-01-01 00:00:00
abstract::We sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223287
更新日期:2009-11-01 00:00:00
abstract::We have examined the safety and efficacy of an early postpartum discharge program in 289 patients who were identified prior to delivery and counseled and educated for discharge 12 to 36 hours after delivery. A total of 55% of the study patients were able to be discharged early. There were 4.3% significant maternal pro...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994768
更新日期:1993-09-01 00:00:00
abstract::The purpose of this study was to examine factors that were associated with uterine rupture in patients attempting vaginal birth after cesarean delivery. We analyzed the results of all patients attempting vaginal birth after cesarean delivery between September 1996 to December 1999 at a single institution using a conte...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2004-828608
更新日期:2004-05-01 00:00:00
abstract::This investigation was undertaken to determine whether histologic examination of the placenta contributed to a better understanding of the cause of intrauterine fetal growth retardation. Placentas were examined of 151 liveborn infants whose birthweights were in the lower 10th percentile for gestational age. One or mor...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999546
更新日期:1989-01-01 00:00:00
abstract::Studies of the effect of body position during and after bolus feeding upon gastric emptying or gastric residual have not had consistent results. We tested the hypotheses that right lateral decubitus leads to less gastric residual than left lateral decubitus and that the prone position leads to less gastric residual th...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2004-823778
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE: The acylcarnitine profile is analyzed in dried blood spots (DBS) to screen for inborn errors of metabolism. Hematocrit (Ht) is known to affect the result of quantitative analyses of DBS samples; however, the effects of Ht on the acylcarnitine profiles in DBS have not been studied in actual samples from newbo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1721849
更新日期:2020-12-29 00:00:00
abstract:OBJECTIVES:To describe the trend and factors associated with the autopsy over the past decade at a level III neonatal intensive care unit (NICU) where all patients are presented with an option. STUDY DESIGN:Retrospective study of the autopsy in a cohort of infants who died in the NICU from January 1, 2001, to December...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1332798
更新日期:2013-10-01 00:00:00
abstract::Obstetrical antiphospholipid syndrome (APS) is associated with maternal and fetal morbidity and mortality. Standard treatment with low-dose acetylsalicylic acid and unfractionated heparin has achieved up to a 70 to 80% likelihood of success. Conversely, up to 30% of women with APS will have further pregnancy losses, d...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2006-931805
更新日期:2006-02-01 00:00:00
abstract::We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patient...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0030-1247599
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS. STU...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0039-1678530
更新日期:2019-12-01 00:00:00
abstract::The objective of this article is to report obstetric outcomes of human immunodeficiency virus-1 (HIV-1)-serodiscordant couples who underwent in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) at a tertiary care center. We reviewed the outcomes of seronegative women after I...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-42694
更新日期:2003-08-01 00:00:00
abstract::We report the case of a term male infant with severe persistent pulmonary hypertension of the newborn, who developed massive neutrophilia of unknown etiology. An extensive evaluation failed to disclose an obvious cause for his neutrophilia. A bone marrow aspirate was performed and was consistent with a leukemoid react...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-45288
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Fetal tachyarrhythmias complicate 0.5% of pregnancies, with high morbidity and mortality. We hypothesized that maternal factors may predispose to fetal supraventricular tachycardia (SVT). STUDY DESIGN:We reviewed medical records of all 124 mothers who presented to the Vanderbilt Fetal Cardiology Clinic from ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1552942
更新日期:2015-11-01 00:00:00
abstract::Infection-related neonatal mortality due to omphalitis in developing country home births is an important public health problem. Three cluster randomized trials of 4% chlorhexidine applied to the umbilical cord stump from once to multiple times in the days following a home birth have evaluated this intervention compare...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329695
更新日期:2013-09-01 00:00:00