Abstract

A number of hospitals still exist with their neonatal ICU not within the vicinity of the delivery rooms. This means transporting compromised & unstable infants some distance to reach the ICU. At Hutzel Hosp. this problem was solved by the use of a NRRU in the delivery suite. This report evaluates our experience. The NRRU was designed as a miniature ICU & can accomodate 2 infants. High-risk infants with problems during delivery and those born with low APGAR scores were admitted to the NRRU for observation, stabilization of vital signs and/or further treatment. A nurse from the neonatal ICU was called to the NRRU if a patient was anticipated. The infants were transferred out of the NRRU only after vital signs had stabilized & skin temp. was at least 97 F.RESULTS: During a 10-month period, 54 newborns were admitted to the NRRU: (1) transfusion for severe Rh (9%), (2) tracheal lavage due to meconium aspiration (6%), (3) APGAR (1 min) less than 5 (67%) & (4) normal APGAR but high-risk newborn (18%). The mean 1 min. APGAR = 3.6 ± 2.7 with 89% requiring resuscitation. Mean birthweight = 2183 ± 954 g. Mean duration of stay = 48.3 min. 43% of those admitted subsequently died but this group had a significantly lower gestational age, weight & APGAR score compared to those who survived (P<0.005). It cannot be concluded whether the NRRU has improved survival but the 58% survival of infants with mean APGAR of 3.6 is encouraging. One factor for this might be the better temp. of the babies upon arrival at the ICU (97.1±0.9). In contrast, skin temp. on admission to the NRRU = 95.8 1.2F. It was also noted that working in the NRRU was more convenient because a pediatric nurse assisted & necessary equipment was on hand. The NRRU also prevented the holding up of a delivery room (mean = 48.3min.) because of an infant. This allowed more time for the infant to stabilize completely before being transported. It is felt that a NRRU can be used for optimal care to infants.

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