Format

Send to

Choose Destination
Hosp Pediatr. 2018 Jan;8(1):1-6. doi: 10.1542/hpeds.2017-0128.

A Novel Approach to Assessing Infants With Neonatal Abstinence Syndrome.

Author information

1
Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut; and matthew.grossman@yale.edu.
2
Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut; and.
3
Department of Pediatrics, School of Medicine, University of Michigan, Ann Arbor, Michigan.

Abstract

OBJECTIVES:

Neonatal abstinence syndrome (NAS) is a growing problem and poses a significant burden on the health care system. The traditional Finnegan Neonatal Abstinence Scoring System (FNASS) assessment approach may lead to unnecessary opioid treatment of infants with NAS. We developed a novel assessment approach and describe its effect on the management of infants with NAS.

METHODS:

We retrospectively compared treatment decisions of 50 consecutive opioid-exposed infants managed on the inpatient unit at the Yale New Haven Children's Hospital. All infants had FNASS scores recorded every 2 to 6 hours but were managed by using the Eat, Sleep, Console (ESC) assessment approach. Actual treatment decisions made by using the ESC approach were compared with predicted treatment decisions based on recorded FNASS scores. The primary outcome was postnatal treatment with morphine.

RESULTS:

By using the ESC approach, 6 infants (12%) were treated with morphine compared with 31 infants (62%) predicted to be treated with morphine by using the FNASS approach (P < .001). The ESC approach started or increased morphine on 8 days (2.7%) compared with 76 days (25.7%) predicted by using the FNASS approach (P < .001). There were no readmissions or adverse events reported.

CONCLUSIONS:

Infants managed by using the ESC approach were treated with morphine significantly less frequently than they would have been by using the FNASS approach. The ESC approach is an effective method for the management of infants with NAS that limits pharmacologic treatment and may lead to substantial reductions in length of stay.

PMID:
29263121
DOI:
10.1542/hpeds.2017-0128

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center