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Title	Quality Improvement Bundle for Reducing Exposure to Mechanical Ventilation in Preterm Infants
Author	강수지, 배은송, 김미진, 양효주, 정영화, 최창원
작성자	최창원
Background	Exposure to mechanical ventilation (MV) is a well-known risk factor for bronchopulmonary dysplasia (BPD) in preterm infants.
Aim / Hypothesis	To reduce the incidence of BPD, we evaluated the impact of a quality improvement (QI) bundle aimed at minimizing exposure to mechanical ventilation in preterm infants with <32 weeks gestation or birth weight <1500g.
Inclusion Criteria	preterm infants with <32 weeks gestation or birth weight <1500g.
Exclusion Criteria	1. outborn 2. congenital anomalies 3. intubation was performed for specific examinations such as MRI or surgeries for conditions such as retinopathy of prematurity or inguinal hernia
Study Design Statistical methods	We compared the duration of exposure to mechanical ventilation between historical pre-QI (January 2019-December 2021) and prospective post-QI (January 2022–December 2023) cohorts of patients.
Primary Outcomes	Intubation rate (at DR or for instillation of surfactant) duration of inavsive mechanical ventilation
Secondary Outcomes and Definitions	Bronchopulmonary dysplasia other neonatal morbidities including ROP, sepsis, etc
Protocols	We introduced a QI bundle comprising 1) the avoidance of intubation during neonatal resuscitation in the delivery room (DR) 2) minimally invasive surfactant therapy (MIST) in the neonatal intensive care unit (NICU) 3) If a patient required intubation, we conducted daily assessments to determine the feasibility of extubation.
Funding

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