Evaluating the Impact of Eat, Sleep, Console in Neonatal Abstinence Syndrome Treatment for Infants Exposed to Substance Use In Utero.

Q2 Medicine
Shannon V McGrath, Allie Rivera, Christopher Kennie-Richardson, David Ehrmann, Julie Cline, Kaye Gable, Victoria Forrest
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Abstract

Objective: An increase in maternal use of licit or illicit substances, alcohol, and tobacco has resulted in an increased incidence of neonatal abstinence syndrome (NAS). In recent years, NAS management has shifted to initiating an Eat, Sleep, Console (ESC) approach prior to pharmacologic treatment. The objective of this study was to evaluate the impact of ESC in combination with pharmacologic treatment in the management of NAS for infants exposed to substance use in utero.

Methods: This single system, multisite, retrospective cohort study evaluated infants with known exposure to substance or polysubstance use in utero or those who had signs and symptoms of withdrawal with a positive toxicology screen. The primary outcome of rate of pharmacologic therapy initiated was evaluated pre and post implementation of ESC. Secondary outcomes included hospital length of stay, day of life that pharmacologic therapy was initiated, and an evaluation of the ESC guideline. A subgroup analysis with similar outcomes was also performed for patients with maternal polysubstance use.

Results: A total of 2843 patients were screened, and 50 patients were randomly selected for -inclusion in both pre- and post-groups. The rate of pharmacologic therapy initiated post implementation of ESC decreased from 58% to 30% (p < 0.01). In the post-group, there was a decrease in the number of -patients requiring scheduled morphine (33%, p < 0.01) and duration of pharmacologic therapy (14.6 days vs 6.47 days, p < 0.01).

Conclusions: Implementing an ESC guideline decreased the length of stay and rate of pharmacologic intervention needed for infants with NAS at our institution.

评估 "吃、睡、控制 "疗法在新生儿戒断综合征治疗中对胎儿接触药物婴儿的影响。
目的:产妇使用合法或非法药物、酒精和烟草的情况增多,导致新生儿禁欲综合征(NAS)的发病率上升。近年来,对新生儿禁欲综合征的管理已转向在药物治疗前采用 "吃、睡、控制"(ESC)方法。本研究的目的是评估ESC与药物治疗相结合对宫内接触药物的婴儿NAS管理的影响:这项单一系统、多地点、回顾性队列研究评估了已知在宫内接触过药物或使用过多种药物的婴儿,或有戒断症状和体征且毒理学筛查呈阳性的婴儿。评估的主要结果是ESC实施前后的药物治疗启动率。次要结果包括住院时间、开始药物治疗的天数以及对ESC指南的评估。此外,还对产妇使用多种药物的患者进行了分组分析,结果与此类似:共筛查了 2843 名患者,并随机抽取了 50 名患者,将其纳入前组和后组。实施 ESC 后,开始药物治疗的比例从 58% 降至 30%(p < 0.01)。在实施ESC后的组别中,需要按计划使用吗啡的患者人数(33%,p < 0.01)和药物治疗持续时间(14.6天 vs 6.47天,p < 0.01)均有所减少:在本院,ESC指南的实施缩短了NAS患儿的住院时间,降低了所需的药物干预率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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