十大正规博彩网站评级正规博彩平台卫生 Children’s helps identify a more effective way to care for newborns exposed to opioids 在 womb

一项开创性的多中心临床试验，儿科医生, 新生儿学专家, and nurse educators from 十大正规博彩网站评级正规博彩平台卫生’s Children’s Hospital at Dartmouth Hitchcock Medical Center (CHaD) and the Northern New England Perinatal Quality Improvement Network (NNEPQIN) played a key role has demonstrated an effective way to safely care for infants with Neonatal Opioid Withdrawal Syndrome (NOWS) that substantially reduces a newborn’s postnatal exposure to opioid medications and decreases their hospital length of stay. 

“新生儿阿片类药物戒断的饮食、睡眠和安慰” 最近出版的 在 新英格兰医学杂志 is the first large-scale multi-centered trial to compare the use of the Eat 睡眠 Console (ESC) Care Tool© with the traditional model of hospital care that uses a 21-item formal scoring method called the 芬尼根新生儿戒断评分系统. ESC护理工具是 由儿科医生邦尼·惠伦于2016年开发, MD和Kate 麦克米伦, MD, 乍得公共卫生硕士, 马修·格罗斯曼, 耶鲁-纽黑文儿童医院的医学博士, 苏珊Minear, 医学博士和新生儿学家Elisha Wachman说, 波士顿医疗中心的医学博士.

“这是一项关键的研究，表明使用饮食睡眠控制台方法, 包括ESC维护工具, 是否有一种安全有效的方法来护理产前阿片类药物暴露的婴儿,惠伦说. “This will help to transform the care of babies and their families 在 United States and internationally – encouraging and empowering parents to be their baby’s first-line treatment, caring for them with love and attention 在ir own room with medication given only if the babies need more help than this. 这种方法促进了联系和依恋, 已知的改善儿童神经发育和长期预后的因素. Limiting the total amount of opioids that babies are exposed to is also likely to lead to improved developmental outcomes.”

ESC维护工具是一个 结构化, 标准化, 以婴儿和家庭为中心的护理工具，基于创新的Eat, 睡眠, 由耶鲁大学的格罗斯曼开发的控制台方法, which focuses medical decision making on these three main newborn functions rather than the myriad of symptoms that a baby with opioid withdrawal may experience such as 颤抖、过度哭泣和易怒. The tool was developed to help support hospitals 在 formal assessment and 标准化 care of opioid-exposed newborns, while promoting parents as primary caregiver for their newborn and encouraging the use of non-pharmacologic care interventions such as skin-to-skin, 父母和婴儿同住一室, 持有, 用襁褓包裹, 母乳喂养, 并将平静的环境作为改善戒断症状的有效方法.

波士顿医疗中心首先试用了ESC护理工具 in 2016 and the Children’s Hospital at Dartmouth Hitchcock Medical Center was the next New England hospital to formally implement the ESC Care Tool into their clinical care of opioid-exposed newborns with improvements based on provider and family feedback. 到目前为止, more than 55 hospitals participating in a Northern New England formal quality improvement initiative, 包括新罕布什尔州所有17家分娩医院, have implemented the ESC Care Tool into their newborns’ care with providers and families sharing overall satisfaction with this new model of care.

利用这项初步工作, ESC-NOW试验的主要研究者Leslie Young, MD at the University of Vermont (UVM) Children’s Hospital and Lori Devlin DO at the University of Louisville, partnered with Whalen and 麦克米伦 in use of the ESC Care Tool 在ir clinical trial with the aim of investigating the clinical efficacy and safety of the ESC approach as compared with ‘usual’ hospital care across the country.   The trial was conducted by a partnership of the IDeA States Pediatric Clinical Trials Network (Dartmouth Hitchcock Medical Center is one of 18 participating sites) and the NICHD Neonatal 研究 Network.

Twenty-six US hospitals received formal training 在 use of the ESC Care Tool in a highly reliable manner by expert faculty, 包括瓦伦, 麦克米伦, 新生儿学专家 艾德丽安Pahl, 来自UVM的MD, and nurse educators/leaders Katie White RNC-LRN from Wentworth Douglass Hospital and Farrah 希恩, 十大正规博彩网站评级正规博彩平台大学盖泽尔医学院的MSN，注册护士，IBCLC.

在ESC-NOW临床试验中, 其中包括1300多名婴儿, investigators found that infants cared for with the ESC approach were medically ready for discharge approximately 6.7天前.2 vs 14.接受阿片类药物治疗的可能性降低63%(19.9天).5% vs 52%) compared to newborns cared for using the traditional Finnegan-based scoring approach.

A two-year follow-up study of a subset of infants is ongoing to monitor additional infant and family well-being measures including infant neurodevelopment, and will further inform the safety of the ESC care approach 在 care of opioid-exposed newborns here in Northern New England and nationally. The trial is funded by the Helping to End Addiction Long-term Initiative, or NIH HEAL Initiative^®—a trans-agency effort to speed scientific solutions to stem the national opioid crisis.