Evidence based care for preterm or sick newborn infants - Centre for Reviews and Dissemination, University of York

Evidence-based care for preterm or sick newborn infants and their families

Background

Although outcomes for preterm or sick newborn infants have improved substantially over the past 25 years, major morbidities associated with the need for prolonged intensive or invasive care have emerged. These include extra-uterine growth and developmental faltering secondary to nutritional deficiency, necrotising enterocolitis (NEC), and late-onset (hospital-acquired) invasive infection. Attributable mortality for NEC and severe infection is more than 20% and these are now the most common causes of death beyond the early neonatal period for very preterm infants. NEC, infection, and nutritonal insufficiency are also associated with increased rates of neuro-disability, longer durations of hospital stay, and higher (life-long) health service costs. Families and clinicians need to access high-quality evidence to guide care practices, highlight uncertainties, and inform priority setting for further research to prevent and treat these conditions.

Theme and Scope

Our research programme focuses on two related areas:

1. Nutrition, growth and development for very preterm infants:

(a) Different enteral feeds including use of expressed, donated breast milk, nutrient fortification options, and post hospital discharge support

(b) Methods of feeding including timing of introduction and rate of advancement of feeds, and indications for different feeding strategies in high-risk populations

2. Infection and NEC diagnosis, treatment and prevention:

(a) Identification (diagnostic test accuracy of clinical and bio-markers) and prevention and treatment of late-onset infection

(b) Risk avoidance management, with focus on central vascular catheter-associated infection

(c) Knowledge translation and quality improvement packages to prevent NEC, late-onset infection, growth failure and its consequences