Comparison of neonatal morbidity and mortality between single-room and open-bay care: a retrospective cohort study

Abstract

ObjectiveIn response to the increasing focus on family-centred care, neonatal intensive care unit (NICU) environments have gradually shifted towards the single-room design. However, the assumed benefits of this emerging design remain a subject of debate. Our goal was to evaluate the impact of single-room versus open-bay care on the risk of neonatal morbidity and mortality in preterm neonates.DesignRetrospective cohort study.SettingLevel III NICU.PatientsNeonates born <32 weeks’ gestation between 15 May 2015 and 15 May 2019.Main outcome measuresMortality and morbidities of a cohort of neonates admitted to a new, single-room unit (SRU) were compared with a historical cohort of neonates admitted to an open-bay unit (OBU). Group differences were evaluated and multivariable logistic regression analyses were performed.ResultsThree-hundred and fifty-six and 343 neonates were admitted to the SRU and OBU, respectively. No difference in neonatal morbidities and mortality were observed between cohorts (bronchopulmonary dysplasia: OR 1.08, 95% CI 0.73 to 1.58, p=0.44; retinopathy of the prematurity stage ≥2: OR 1.36, 95% CI 0.84 to 2.22, p=0.10; intraventricular haemorrhage: OR 0.89, 95% CI 0.59 to 1.34, p=0.86; mortality: OR 1.55, 95% CI 0.75 to 3.20, p=0.28). In adjusted regression models, single-room care was independently associated with a decreased risk of symptomatic patent ductus arteriosus (adjusted OR 0.54, 95% CI 0.31 to 0.95). No independent association between single-room care and any of the other investigated outcomes was observed.ConclusionsImplementation of single-rooms in our NICU did not lead to a significant reduction in neonatal morbidity and mortality outcomes.

Clinical outcomes of preterm infants while using automated controllers during standard care: comparison of cohorts with different automated titration strategies

“…Furthermore, respiratory support data were based on automatically stored data in our patient data management system, precluding human error. In 2017, our unit changed to single room care,28 and although there have been no other major changes in standard care besides type of ventilator, we cannot rule out that there are unmeasured changes that can influence results in either direction.…”