Klinika Neonatologii UM w Łodzi

Klinika Neonatologii UM w Łodzi

Oddział: 7 stanowisk intensywnej terapii 20 stanowisk terapii pośredniej 26 stanowisk rooming in 2013: 2500 porodów [47% CC ; 3% kleszczy] 502 pacjentów leczonych na intensywnej terapii i patologii noworodka 102 przyjętych z innych oddziałów 210 pacjentów zgłoszonych do VON 186 pacjentów zgłoszonych do PNWN - IF

Wdrożone praktyki: 2005 rok wprowadzenie standardów leczenia obecnie przygotowywana aktualizacja Przeszkolenie zespołu lekarskiego z zakresu USG szkolenie przeprowadzone dla całego zespołu przez dr Bokiniec, wyłoniona grupa 7 lekarzy - szkolenie w Roztoczańskiej Szkole USG Wszyscy lekarze po szkoleniu NLS i APLS Od 2005 roku wprowadzenie procedury InSuRe Od 2010 roku wprowadzenie na sali cięciowej stałej temperatury 24 stopnie C Od 2010 roku należymy do Programu Nieinwazyjnego Wspomagania Oddychania Noworodków Infant flow Od 2010 roku wprowadzenie procedury LISA/MIST Od 2013 roku przynależność do VON

Vermont Oxford Network nr 1095 Expanded Database Eligibility - zawiera ona w sobie VLBW Database Eligibility oraz noworodki urodzone z masą ciała powyżej 1500g urodzone w szpitalu lub przyjęte z zewnątrz wymagające wentylacji mechanicznej lub wsparcia oddechu własnego metodą CPAP. Baza wymaga wystandaryzowanych rozpoznań i odpowiedniego sposobu wypełniania ankiet. Każda jednostka chorobowa jest zdefiniowana

Wyniki za rok 2013 Noworodki w wieku ciążowym 22 do 29 HBD Porównany je z danymi 39510 z roku 2012

Infants GA 22 To 29 Weeks Center (2013) Network (2012) Admissions Number of Admissions 47 47 100.0% 39,51 100.0% 100.0% 100.0% Initial Disposition Status (All Infants) Home 7 47 14.9% 39,51 67.6% 52.0% 75.0% Transferred 32 47 68.1% 39,51 14.2% 5.3% 31.1% Died 8 47 17.0% 39,51 18.0% 10.0% 22.4% All 47 47 100.0% 39,51 100.0% 100.0% 100.0%

Birth Loca+on Inborn 33 47 70.2% 39,51 85.7% 83.3% 100.0% Infant Sex Male 22 47 46.8% 39,495 53.0% 47.4% 58.8% Maternal Race White 47 47 100.0% 38,934 48.9% 25.0% 77.8% OB Measures Prenatal Care 43 47 91.5% 39,317 95.1% 93.3% 100.0% Chorioamnioni+s 3 46 6.5% 38,89 17.1% 4.2% 22.8% Maternal Hypertension 7 44 15.9% 39,229 22.5% 13.3% 27.7% Antenatal Steroids, All Infants 34 46 73.9% 39,209 80.1% 69.2% 87.5% Antenatal Steroids, GA 24 to 33 33 45 73.3% 35,47 83.3% 72.7% 90.5% C- SecIon 38 47 80.9% 39,499 66.5% 58.7% 75.0% Antenatal Magnesium Sulfate 2 47 4.3% 38,454 45.8% 12.0% 60.5% Mul+ple Gesta+on Mul+ple Gesta+on 16 47 34.0% 39,505 25.6% 16.0% 32.0% SGA Small for GestaIonal Age 7 47 14.9% 39,483 8.4% 3.9% 11.1% Admission Temperature Admission Temp Measured 47 47 100.0% 37,19 96.8% 97.1% 100.0% < 32.0 0 47 0.0% 35,887 0.1% 0.0% 0.0% 32.0 to 35.9 17 47 36.2% 35,887 19.6% 5.4% 30.2% 36.0 to 36.4 15 47 31.9% 35,887 23.8% 15.4% 32.3% 36.5 to 37.5 14 47 29.8% 35,887 49.6% 34.2% 65.2% >37.5 1 47 2.1% 35,887 6.9% 0.0% 8.7%

APGAR Apgar 1 Minute < 4 14 47 29.8% 39,07 34.6% 23.4% 43.4% Apgar 5 Minutes < 4 4 46 8.7% 38,993 12.2% 5.3% 16.7% Delivery Room Deaths Died In DR 0 47 0.0% 39,51 4.6% 0.0% 7.1% Ini+al Resuscita+on DR Face Mask Ven+la+on 40 47 85.1% 39,373 69.3% 57.1% 84.6% DR Cardiac Compression 4 47 8.5% 39,398 8.0% 3.0% 13.0% DR Surfactant 22 47 46.8% 39,442 40.1% 9.1% 61.1% DR Epinephrine 2 47 4.3% 39,394 4.3% 0.0% 6.9% DR ETT VenIlaIon 26 46 56.5% 39,414 62.3% 47.7% 76.5% DR Oxygen 40 47 85.1% 39,382 89.5% 85.7% 97.7% DR CPAP 16 47 34.0% 39,321 30.0% 6.5% 46.0% None of the Above 4 47 8.5% 39,406 6.3% 0.0% 9.7%

Early Bacterial Sepsis Early Bacterial Sepsis 6 47 12.8% 37,624 2.9% 0.0% 3.9% Coagulase Nega+ve Staph Your Center 13 45 28.9% 35,516 8.3% 0.0% 11.3% Any Loca+on 14 45 31.1% 35,516 8.6% 0.0% 12.2% Fungal Infec+on Your Center 1 45 2.2% 35,518 1.4% 0.0% 1.6% Any Loca+on 1 45 2.2% 35,518 1.4% 0.0% 1.8% Any Late Infec+on Your Center 20 45 44.4% 35,522 17.2% 7.4% 22.9% Any Loca+on 21 45 46.7% 35,522 17.8% 7.7% 24.4%

Indomethacin for Any Reason Indomethacin for Any Reason 0 47 0.0% 37,559 27.2% 1.4% 38.8% Necro+zing Enterocoli+s Your Center 4 47 8.5% 37,65 6.4% 0.0% 8.7% Any Loca+on 5 47 10.6% 37,65 7.1% 0.0% 9.4% Patent Ductus Arteriosus Patent Ductus Arteriosus 19 47 40.4% 37,563 41.0% 24.4% 51.4% Ibuprofen for PDA Ibuprofen for PDA 15 47 31.9% 37,555 6.4% 0.0% 7.7% Probio+cs Probio+cs 30 47 63.8% 37,61 8.4% 0.0% 0.0%

Cranial Imaging Cranial Imaging 46 47 97.9% 37,658 93.7% 87.5% 98.5% Any PIH Your Center 26 46 56.5% 35,253 29.1% 17.6% 34.5% Any Loca+on 26 46 56.5% 35,285 31.0% 19.4% 37.8% Severe IVH Any LocaIon 8 46 17.4% 35,285 11.2% 4.9% 15.0% Grade of PIH PIH Grade 0 20 46 43.5% 35,285 69.0% 62.2% 80.6% PIH Grade 1 8 46 17.4% 35,285 11.7% 4.2% 14.6% PIH Grade 2 10 46 21.7% 35,285 8.1% 0.0% 10.5% PIH Grade 3 5 46 10.9% 35,285 4.7% 0.0% 7.1% PIH Grade 4 3 46 6.5% 35,285 6.5% 0.0% 9.1% Cys+c PVL CysIc PVL 2 45 4.4% 35,814 3.7% 0.0% 5.1%

All Infants Any Human Milk 21 47 44.7% 37,698 43.2% 27.8% 56.7% Human Milk Only 3 47 6.4% 37,698 9.3% 0.0% 14.5% Human Milk and ForIfier/Formula 18 47 38.3% 37,698 33.9% 16.7% 44.4% Formula Only 10 47 21.3% 37,698 40.6% 20.4% 48.8% No Enteral Feeding 16 47 34.0% 37,698 15.7% 10.3% 26.7% Unknown Enteral Feeding 0 47 0.0% 37,698 0.5% 0.0% 0.0%

Ven+la+on ConvenIonal 34 47 72.3% 37,67 75.8% 66.7% 87.5% Hifi 0 47 0.0% 37,659 30.3% 13.0% 38.9% Any Ven+la+on 34 47 72.3% 37,677 78.8% 70.4% 90.0% Other Respiratory Care Oxygen 46 47 97.9% 37,684 96.1% 94.7% 100.0% High Flow Nasal Cannula 4 47 8.5% 37,632 58.5% 18.8% 80.0% Nasal IMV/SIMV 33 47 70.2% 37,625 33.8% 1.5% 53.4% CPAP Nasal CPAP 37 47 78.7% 37,649 78.4% 64.5% 88.9% CPAP Before ETT Vent 19 39 48.7% 29,397 37.8% 19.6% 54.3% Vent A`er Early CPAP 7 19 36.8% 11,103 46.0% 27.3% 62.5% Surfactant Surfactant A`er 2 Hrs 8 35 22.9% 29,673 17.0% 4.0% 26.3% Surf > 2 Hr, Infants 501-1250 Gm 6 24 25.0% 24,602 15.9% 1.7% 25.0% Surfactant at Any Time 35 47 74.5% 39,468 76.2% 68.1% 88.9% Steroids for CLD Your Center 7 47 14.9% 37,611 12.4% 1.9% 16.7% Any Loca+on 7 47 14.9% 37,611 12.5% 2.1% 17.0% Inhaled Nitric Oxide Your Center 0 47 0.0% 37,654 6.8% 0.0% 7.3% Any Loca+on 0 47 0.0% 37,654 6.9% 0.0% 7.6% Oxygen at Discharge Home 4 11 36.4% 27,707 17.9% 0.0% 23.0% Transfer 22 28 78.6% 4,537 55.3% 48.4% 100.0%

Dura+on of Ven+la+on None 13 47 27.7% 15,226 20.5% 9.6% 31.3% < 4 Hours 3 47 6.4% 15,226 3.2% 0.0% 5.9% 4-24 Hours 4 47 8.5% 15,226 16.1% 7.7% 25.0% 2-3 Days 3 47 6.4% 15,226 12.4% 5.9% 16.7% 4-7 Days 3 47 6.4% 15,226 10.6% 4.6% 14.3% 8-14 Days 7 47 14.9% 15,226 9.0% 0.0% 11.8% 15-21 Days 4 47 8.5% 15,226 6.1% 0.0% 7.7% 22-28 Days 3 47 6.4% 15,226 4.9% 0.0% 6.5% > 28 Days 7 47 14.9% 15,226 17.1% 0.0% 19.8% Seizure Seizure 10 47 21.3% 15,259 2.2% 0.0% 2.5%

Re+nal Exam Re+nal Exam 22 47 46.8% 37,633 80.0% 66.7% 86.4% ROP None 12 22 54.5% 30,082 58.6% 48.7% 77.8% Any ROP (Stage 1 to 5) 10 22 45.5% 30,082 41.4% 22.2% 51.3% Severe ROP (Stage > 2) 6 22 27.3% 30,082 8.8% 0.0% 12.5% ROP Stage 1 3 22 13.6% 30,082 18.1% 5.0% 25.0% ROP Stage 2 1 22 4.5% 30,082 14.5% 2.6% 18.5% ROP Stage 3 6 22 27.3% 30,082 8.6% 0.0% 11.8% ROP Stage 4 0 22 0.0% 30,082 0.2% 0.0% 0.0% ROP Stage 5 0 22 0.0% 30,082 0.0% 0.0% 0.0%

Respiratory Distress Syndrome Respiratory Distress Syndrome 36 47 76.6% 37,661 86.3% 81.8% 98.1% Pneumothorax Your Center 1 47 2.1% 37,652 5.0% 0.0% 6.3% Any Loca+on 2 47 4.3% 37,653 5.3% 0.0% 6.7% Outcomes at 28 Days Oxygen 20 27 74.1% 31,947 61.1% 46.7% 72.2% Outcomes at 36 Weeks Oxygen 6 11 54.5% 25,349 40.5% 22.9% 50.0% Chronic Lung Disease 9 24 37.5% 29,534 35.4% 17.8% 44.6% CLD, Infants < 33 Weeks 9 24 37.5% 29,534 35.4% 17.8% 44.6%

Dr Anita Chudzik Dr Magdalena Kmiecik Dr Małgorzata Oziemska Dr Krzysztof Truszkowski Dr Maria Kwiatkowska Dr Dorota Jadczyk Dr Anna Piotrowska Dr Monika Wajchert Dr Joanna Parnowska Dr Barbara Strzałko-Głoskowska Dr Monika Górska Dr Katarzyna Więckowska Dr Ewa Welfel Dr Małgorzata Pokrzywnicka Dr Hanna Kowalska Dr Aleksandra Grzelińska Dr Marta Janowska

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