Pre-discharge Cardiorespiratory Monitoring in Preterm Infants. the CORE Study

Francesco Cresi; Enrico Cocchi; Elena Maggiora; Alice Pirra; Federica Logrippo; Maria Chiara Ariotti; Chiara Peila; Enrico Bertino; Alessandra Coscia

doi:10.3389/fped.2020.00234

Pre-discharge Cardiorespiratory Monitoring in Preterm Infants. the CORE Study

Front Pediatr. 2020 Jun 5:8:234. doi: 10.3389/fped.2020.00234. eCollection 2020.

Authors

Francesco Cresi¹, Enrico Cocchi¹, Elena Maggiora¹, Alice Pirra¹, Federica Logrippo¹, Maria Chiara Ariotti¹, Chiara Peila¹, Enrico Bertino¹, Alessandra Coscia¹

Affiliation

¹ Neonatal Intensive Care Unit, City of Health and Science-University of Turin, Turin, Italy.

Abstract

Objective: Ensuring cardiorespiratory (CR) stability is essential for a safe discharge. The aim of this study was to assess the impact of a new pre-discharge protocol named CORE on the risk of hospital readmission (RHR). Methods: Preterm infants admitted in our NICU between 2015 and 2018 were randomly assigned to CORE (exposed) or to standard (not-exposed) discharge protocol. CORE included 24 h-clinical observation, followed by 24 h-instrumental CR monitoring only for high-risk infants. RHR 12 months after discharge and length of stay represent the primary and secondary outcomes, respectively. Results: Three hundred and twenty three preterm infants were enrolled. Exposed infants had a lower RHR (log-rank p < 0.05). The difference was especially marked 3 months after discharge (9.09 vs. 21.6%; p = 0.004). The hospital length of stay in exposed and not-exposed infants was 39(26-58) and 43(26-68) days, respectively (p = 0.16). Conclusions: The CORE protocol could help neonatologists to define the best timing for discharge reducing RHR without lengthening hospital stay.

Keywords: NICU discharge; cardiorespiratory stability; hospital readmission; length of stay; safe discharge.