1Department of Pediatrics, Division of Neonatology, University of Virginia, Charlottesville, VA2Medical Predictive Science Corporation, Charlottesville, VA3Department of Statistics, University of Virginia, Charlottesville, VA4Department of Pediatrics, Division of Neonatology, University of Virginia, Birmingham, AL5Department of Pediatrics, Division of Neonatology, Oregon Health Sciences University, Portland, OR6Department of Pediatrics, Division of Neonatology, Wake Forest University, Winston-Salem, NC7Department of Pediatrics, Division of Neonatology, University of Miami, Miami, FL8Department of Pediatrics, Albert Einstein College of Medicine, The Children's Hospital at Montefiore Medical Center, New York City, NY9Division of Neonatology, Winnie Palmer Children's Hospital, Orlando, FL10Department of Pediatrics, Division of Neonatology, University of North Carolina, Chapel Hill, NC11Department of Pediatrics, The University of South Carolina School of Medicine-Greenville, Greenville, SC
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ObjectiveTo examine the effect of heart rate characteristics (HRC) monitoring on length of stay among very low birth weight (VLBW; <1500 g birth weight) neonates in the HeRO randomized controlled trial (RCT).Study designWe performed a retrospective analysis of length of stay metrics among 3 subpopulations (all patients, all survivors, and survivors with positive blood or urine cultures) enrolled in a multicenter, RCT of HRC monitoring.ResultsAmong all patients in the RCT, infants randomized to receive HRC monitoring were more likely than controls to be discharged alive and prior to day 120 (83.6% vs 80.1%, P = .014). The postmenstrual age at discharge for survivors with positive blood or urine cultures was 3.2 days lower among infants randomized to receive HRC monitoring when compared with controls (P = .026). Although there were trends in other metrics toward reduced length of stay in HRC-monitored patients, none reached statistical significance.ConclusionsHRC monitoring is associated with reduced mortality in VLBW patients and a reduction in length of stay among infected surviving VLBW infants.Trial registrationClinicalTrials.gov: NCT00307333.