The Second Golden Hour

Unterschiede in der Versorgung Frühgeborener in der zweiten Lebensstunde

The Second Golden Hour

Differences in the care of preterm infants in the second hour of life

by Frederike Vivien Hartmann
Doctoral thesis
Date of Examination:2021-04-13
Date of issue:2021-03-26
Advisor:Prof. Dr. Thomas Paul
Referee:PD Dr. Gerd-Johannes Bauerschmitz
Referee:Dr. Helmut Küster
Persistent Address: http://dx.doi.org/10.53846/goediss-8493

 

 

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Abstract

English

Objectives As quality of care in the delivery room has major impact on outcome of preterm infants, multiple guidelines have been established in recent years. There is, however, little evidence on how to proceed during postdelivery room care, the time of transfer and admission to the neonatal intensive care unit (NICU). The aim of this study was to identify processes taking place during this period with potential impact on outcome. Study design Prospective observational study. Setting Single-centre German tertiary NICU. Patients 40 inborn preterm infants undergoing postdelivery room care. Main outcome Prevalence of prolonged duration of postdelivery room care, disconnections from the ventilator and positioning of preterm infants. Results TotaldurationofpostdeliveryroomcareandNICU admission procedures were shorter in infants transferred in a transport incubator compared with using a NICU care station from birth. Extremely low birth weight (ELBW) infants spend 8% of the time in prone position in contrast to 39% in non-ELBW. Total duration of disconnection from the ventilator was 50 s and was ten times longer in infants who had nasal CPAP compared with infants intratracheally intubated. Infants with nCPAP had longer duration of disconnection from the ventilator if body weight was >1000 g or if they were transferred in a transport incubator. Conclusions Multiple parameters like birth weight or type of transport affect neonatal care during the postdelivery room period. Prospective studies are needed to identify and optimise parameters within this period that affect long-term outcome.
Keywords: Neonatology; preterm infant; postdelivery room care; Second Golden Hour
Schlagwörter: Neonatology; preterm infant; Second Golden Hour; postdelivery room care