To survey the current inclusion criteria used for retinopathy of prematurity (ROP) screening across tertiary level 3 neonatal intensive care units (NICUs) in Canada.
Clinical directors from 29 level 3 NICUs in Canada.
Survey of all 29 level 3 NICUs in Canada in September 2010. The survey inquired about the current ROP screening criteria in use in each centre including which neonates are enrolled in the screening program and the timing of when screening begins. The survey was sent via email to the clinical directors at each site. Nonrespondents were contacted by telephone.
In total, 23 centres replied, representing a 79% response rate with the survey. Seven different ROP screening inclusion criteria were found to be in use, although one of the centres did not have a clear inclusion protocol. The variation between centres was significant, with some using a combination of birth weight and gestational age and others using birth weight or gestational age alone as their criterion. There was also variation in the timing of initial eye examinations, with 8 different criteria currently in use. Discrepancies were also found among treatment patterns at the centres.
Despite the publication of updated Canadian guidelines in 2000, there continues to be significant variation in the actual inclusion criteria being used across the country. Therefore, a need exists for comprehensive, evidence-based Canadian guidelines to optimize the screening inclusion criteria for ROP.
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
Absence of guidelines on umbilical arterial catheter (UAC) and umbilical venous catheter (UVC) use and inability to predict the hospital course may sway the frontline staff to overuse umbilical catheters in preterm infants. Our objective was to evaluate the feasibility of implementing guidelines standardizing the use of umbilical catheters and its impact on the incidence of sepsis and resource use.