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Characteristics of neonatal units that care for very preterm infants in Europe : results from the MOSAIC study
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Van Reempts, P., Gortner, L., Milligan, D., Cuttini, M., Petrou, Stavros, Agostino, R., Field, D., den Ouden, L., Borch, K., Mazela, J., Carrapato, M. and Zeitlin, J. (2007) Characteristics of neonatal units that care for very preterm infants in Europe : results from the MOSAIC study. Pediatrics, 120 (4). e815-e825. doi:10.1542/peds.2006-3122 ISSN 0031-4005.
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Official URL: http://dx.doi.org/10.1542/peds.2006-3122
Abstract
OBJECTIVES. We sought to compare guidelines for level III units in 10 European
regions and analyze the characteristics of neonatal units that care for very preterm
infants.
METHODS. The MOSAIC (Models of Organising Access to Intensive Care for Very
Preterm Births) project combined a prospective cohort study on all births between
22 and 31 completed weeks of gestation in 10 European regions and a survey of
neonatal unit characteristics. Units that admitted �5 infants at �32 weeks of
gestation were included in the analysis (N 111). Place of hospitalization of
infants who were admitted to neonatal care was analyzed by using the cohort data
(N 4947). National or regional guidelines for level III units were reviewed.
RESULTS. Six of 9 guidelines for level III units included minimum size criteria, based
on number of intensive care beds (6 guidelines), neonatal admissions (2), ventilated
patients (1), obstetric intensive care beds (1), and deliveries (2). The characteristics
of level III units varied, and many were small or unspecialized by
recommended criteria: 36% had fewer than 50 very preterm annual admissions,
22% ventilated fewer than 50 infants annually, and 28% had fewer than 6
intensive care beds. Level II units were less specialized, but some provided mechanical
ventilation (57%) or high-frequency ventilation (20%) or had neonatal
surgery facilities (17%). Sixty-nine percent of level III and 36% of level I or II units
had continuous medical coverage by a qualified pediatrician. Twenty-two percent
of infants who were �28 weeks of gestation were treated in units that admitted
fewer than 50 very preterm infants annually (range: 2%–54% across the study
regions).
CONCLUSIONS. No consensus exists in Europe about size or other criteria for NICUs. A
better understanding of the characteristics associated with high-quality neonatal
care is needed, given the high proportion of very preterm infants who are cared for
in units that are considered small or less specialized by many recommendations.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Pediatrics | ||||
Publisher: | American Academy of Pediatrics | ||||
ISSN: | 0031-4005 | ||||
Official Date: | 2007 | ||||
Dates: |
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Volume: | 120 | ||||
Number: | 4 | ||||
Page Range: | e815-e825 | ||||
DOI: | 10.1542/peds.2006-3122 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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