@article{304041a163ba4ae7b3c726b98127222e,
title = "Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial",
abstract = "Objective: To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. Study design: This trial was conducted in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing and bedcoverings were standardized. The primary outcome was length of hospital stay from birth to discharge; secondary outcomes included length of stay and growth velocity from weaning to discharge. Adverse events were monitored. Results: Of 1565 infants screened, 885 were eligible, and 366 enrolled—187 to the 1600-g and 179 to the 1800-g group. Maternal and neonatal characteristics did not differ among weight groups. Length of hospital stay was a median of 43 days in the lower and 41 days in the higher weight group (P =.12). Growth velocity from completion of weaning to discharge was higher in the lower weight group, 13.7 g/kg/day vs 12.8 g/kg/day (P =.005). Groups did not differ in adverse events. Conclusions: Among moderately preterm neonates, weaning from incubator to crib at a lower weight did not decrease length of stay, but was safe and was accompanied by higher weight gain after weaning. Trial registration: ClinicalTrials.gov: NCT02160002.",
keywords = "incubator, moderately preterm infants, randomized controlled trial, temperature, weaning",
author = "{Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network} and Seetha Shankaran and Bell, {Edward F.} and Laptook, {Abbot R.} and Shampa Saha and Newman, {Nancy S.} and Kazzi, {S. Nadya J.} and John Barks and Stoll, {Barbara J.} and Rebecca Bara and Jenna Gabrio and Kirsten Childs and Abhik Das and Higgins, {Rosemary D.} and Carlo, {Waldemar A.} and S{\'a}nchez, {Pablo J.} and Carlton, {David P.} and Lara Pavageau and Malcolm, {William F.} and D'Angio, {Carl T.} and Ohls, {Robin K.} and Poindexter, {Brenda B.} and Sokol, {Gregory M.} and {Van Meurs}, {Krisa P.} and Colaizy, {Tarah T.} and Ayman Khmour and Puopolo, {Karen M.} and Meena Garg and Walsh, {Michele C.} and Polin, {Richard A.} and Martin Keszler and Hensman, {Angelita M.} and Elisa Vieira and Hibbs, {Anna Marie} and Siner, {Bonnie S.} and Truog, {William E.} and Pallotto, {Eugenia K.} and Kilbride, {Howard W.} and Cheri Gauldin and Anne Holmes and Kathy Johnson and Kurt Schibler and Kallapur, {Suhas G.} and Cathy Grisby and Barbara Alexander and Fischer, {Estelle E.} and Lenora Jackson and Kristin Kirker and Jennifer Jennings and Myra Wyckoff and Brion, {Luc P.}",
note = "Funding Information: The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network's Trial on Incubator Weaning of Moderately Preterm Infants (NCT02160002) through cooperative agreements. Although NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Participating NRN sites collected data and transmitted it to RTI International, the data coordinating center for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, A.D. (Data Coordinating Center Principal Investigator) and S.S. (Data Coordinating Center Statistician) had full access to all of the data in the study, and with the NRN Center Principal Investigators, take responsibility for the integrity of the data and accuracy of the data analysis. The authors declare no conflicts of interest. Funding Information: The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network's Trial on Incubator Weaning of Moderately Preterm Infants ( NCT02160002 ) through cooperative agreements. Although NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Participating NRN sites collected data and transmitted it to RTI International, the data coordinating center for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, A.D. (Data Coordinating Center Principal Investigator) and S.S. (Data Coordinating Center Statistician) had full access to all of the data in the study, and with the NRN Center Principal Investigators, take responsibility for the integrity of the data and accuracy of the data analysis. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",
year = "2019",
month = jan,
doi = "10.1016/j.jpeds.2018.08.079",
language = "English (US)",
volume = "204",
pages = "96--102.e4",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
}