Is Length of Stay a Quality Indicator in Chronic Ventilated Neonate?

Is Length of Stay a Quality Indicator in Chronic Ventilated Neonate?Letter to the Editor As a fourth-year medical student going through my Newborn Intensive Care Unit (NICU) rotation, I am required to learn about systems-based practice.I found an interesting case of a preterm infant who suffered a traumatic birth at home.The gestational age was estimated to be 30-32 weeks by Ballard scoring.It was a precipitous breech delivery by a mother with a history of drug abuse.She was unaware of the pregnancy and received no prenatal care.At the scene, the infant was resuscitated by Emergency Medical Services (EMS) and brought to the emergency room (ER).Per EMS, the patient received 45 minutes of resuscitation, including cardiac compression, intubation, intraosseous line placement in the femur, and multiple doses of epinephrine.At the ER, the infant was re-intubated and umbilical lines were placed.Initial blood gas at ~ 75 minutes of life was pH 6.9/ pCO 2 30/PO 2 145/HCO 3 8/ Base access -22.4,lactate 20.The infant was then admitted to the NICU for further directed care and later placed on a ventilator.Throughout this infant's prolonged stay in the NICU, the following problems were addressed: Hypoxic-Ischemic encephalopathy, severe metabolic acidosis, seizures, decreased cardiac function, respiratory failure, transaminitis, and suspected lower extremities vascular injury.