SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores

Richardson, Douglas K.; Corcoran, J D; Escobar, Gabriel J.; Lee, Shoo K.

doi:10.1067/mpd.2001.109608

Cited by 1,026 publications

(813 citation statements)

References 29 publications

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“…There were no significant differences between intervention and control groups in birth weight, gestational age, delivery room temperature, time from birth to NICU admission, or severity of illness as measured by modified SNAPPE II score 18 (Table 1).…”

Section: Resultsmentioning

confidence: 96%

Heat Loss Prevention for Preterm Infants in the Delivery Room

Wimmer²,

2005

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OBJECTIVE:Preterm infants are prone to hypothermia immediately following birth. Among other factors, excessive evaporative heat loss and the relatively cool ambient temperature of the delivery room may be important contributors. Most infants <29 weeks gestation had temperatures <36.41C on admission to our neonatal unit (NICU). Therefore we conducted a randomized, controlled trial to evaluate the effect of placing these infants in polyurethane bags in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the NICU. METHODS:After parental consent was obtained, infants expected to be <29 weeks gestation were randomized to intervention or control groups just prior to their birth. Infants randomized to the intervention group were placed in polyurethane bags up to their necks immediately after delivery before being dried. They were then resuscitated per NRP guidelines, covered with warm blankets, and transported to the NICU, where the bags were removed and rectal temperatures were recorded. Control infants were resuscitated, covered with warm blankets, and transported without being placed in polyurethane bags. Delivery room temperatures were recorded so this potentially confounding variable could be assessed. RESULTS:Intervention patients were less likely than control patients to have temperature < 36.41C on admission , 44 vs 70% ( p<0.01) and the intervention group had a higher mean admission temperature, 36.51C vs 36.01C ( p<0.003). This effect remained significant ( p<0.0001) when delivery room temperature was controlled in analysis. Warmer delivery room temperatures (Z261C) were associated with higher admission temperatures in both intervention and control infants, but only the subgroup of intervention patients born in warmer delivery rooms had a mean admission temperature >36.41C. CONCLUSIONS:Placing infants <29 weeks gestation in polyurethane bags in the delivery room reduced the occurrence of hypothermia and increased their NICU admission temperatures. Maintaining warmer delivery rooms helped but was insufficient in preventing hypothermia in most of these vulnerable patients without the adjunctive use of the polyurethane bags.

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Section: Resultsmentioning

confidence: 96%

Heat Loss Prevention for Preterm Infants in the Delivery Room

Wimmer²,

2005

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“…The score for neonatal acute physiology (SNAPPE-II), 24 an illness severity score developed to predict neonatal mortality, was calculated at 24 h of life. This score includes assessment of perinatal risk factors, including birth weight, small for gestational age versus appropriate for gestational age status, and 5 min Apgar score, as well as physiologic risk factors, including lowest mean arterial blood pressure, lowest temperature, lowest PaO 2 /FiO 2 ratio, lowest serum pH, urine output and presence of multiple seizures.…”

Section: Methodsmentioning

confidence: 99%

Fluid regimens in the first week of life may increase risk of patent ductus arteriosus in extremely low birth weight infants

et al. 2007

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Background: High fluid volumes may increase neonatal morbidity. However, evidence supporting fluid restriction is inconclusive and restricting fluids may restrict caloric intake.Objective: To determine if higher fluid intake was associated with increased risk of patent ductus arteriosus (PDA) or bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants.Study Design: A total of 204 ELBW (p32 weeks, p1250 g) infant survivors were grouped into low-, intermediate-and high-fluid groups. w 2 analyzed proportions of subjects with and without morbidities across groups. Logistic regression quantified increased risk of PDA or BPD associated with fluid intake while controlling for confounders. Analysis of variance compared differences in caloric intake across groups.Result: After controlling for gestational age, severity of illness and weight change, fluid intake on day 2 (odds ratio (OR) 1.014; confidence interval (CI) 1.001 to 1.028) and day 3 (OR 1.022; CI 1.004 to 1.040) was associated with increased risk of PDA.Conclusion: High fluid intake (>170 ml kg À1 day À1 ) in the first days of life is associated with increased risk of PDA.

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“…11 We also recorded lowest mean blood pressure, weight loss and highest daily fluid intake during the first 14 days of life, as well as the incidences of late-onset sepsis (LOS), survival, chronic lung disease (CLD, oxygen support at 36 weeks postmenstrual age), intracranial hemorrhage (IVH), surgical and pathological findings, initial day of feeding milk and milk at diagnosis of NEC/SIP. Infants were excluded from the analysis if they were admitted to the intensive care unit after 1 week of age, if they died within 48 h of admission or had an intestinal diagnosis other than NEC/SIP.…”

Section: Methodsmentioning

confidence: 99%

Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight

Huston¹,

Dietz²,

Campbell³

et al. 2006

J Perinatol

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Objective: To evaluate the relationship between enteral water infusion for hypernatremia and significant intestinal morbidity in infants p1000 grams.Study design: This is a retrospective study of 321 infants p1000 g birth weight. Infants were grouped by the highest serum sodium (mmol/l) during the first 14 days of life as follows: <150 (normal control), X150 (high sodium control), X150 and treated with sterile water (study group). Significant intestinal morbidity was defined as probable or proven necrotizing enterocolitis or spontaneous intestinal perforation. Statistical analysis included Student's t test for continuous variables and w 2 with Yeats correction for frequency variables. Multivariate logistic regression analysis was then performed to evaluate confounding variables among groups.Results: The incidence of intestinal morbidity was significantly higher in the high sodium-water treated group compared to each of the other groups (13/33 (38%) for high sodium-water versus 16/100 (16%) for high sodium control and 18/188 (10%) for normal sodium control, P<0.01 w 2 ). Logistic regression analysis indicated that enteral water and hydrocortisone were risk factors for significant intestinal morbidity.Conclusions: Enteral sterile water for hypernatremia appears to be associated with significant intestinal morbidity in infants p1000 g. Hydrocortisone is also a risk factor.

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SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores

Cited by 1,026 publications

References 29 publications

Heat Loss Prevention for Preterm Infants in the Delivery Room

Heat Loss Prevention for Preterm Infants in the Delivery Room

Fluid regimens in the first week of life may increase risk of patent ductus arteriosus in extremely low birth weight infants

Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight

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