Implementation of Potentially Better Practices for the Prevention of Brain Hemorrhage and Ischemic Brain Injury in Very Low Birth Weight Infants

• DOI: 10.1542/peds.111.se1.e497
• Publication Date: 2021-12-10T22:14:31Z
• Authors: Debra McLendon; Jennifer Check; Patricia Carteaux; Laura Michael; Jim Moehring; Joel W. Secrest; Sue E. Clark; Howard Cohen; Sharon A. Klein; Diane Boyle; Jeffrey A. George; Susan Okuno-Jones; Debora S. Buchanan; Pam McKinley; Jonathan M. Whitf...
• Keywords: Brain hemorrhage

Using an evidence-based approach, a Vermont Oxford Network focus group whose goal was to reduce brain injury developed and implemented number of potentially better practices. Each center approached implementation the practices differently. Reducing incidence intraventricular hemorrhage periventricular leukomalacia are important for improving long-term outcomes low birth weight infants.Implementation approaches some but not all at various centers discussed. The reviewed include optimal peripartum management, such as resuscitation, avoidance hypothermia, surfactant delivery, early neonatal management by most experienced providers, measures minimize pain stress. Additional maintenance neutral head positioning, fluid volume therapy hypotension, indomethacin prophylaxis, ventilator routine suctioning, limiting use sodium bicarbonate postnatal dexamethasone.Approaches were specific, results vary. Although easier implement than others, communication, education, leadership critical process.The quality improvement multidisciplinary approach is useful tool finding ways leukomalacia.