|
Data Entry Form Name |
Field Name |
Type |
Length |
Limits |
Definition |
|
Resuscitation |
RESUSCIT |
Alpha |
1 |
N, O,
I, M, U |
“N”=none; “O”=Oxygen; “I”=IPPV; “M”=Code meds; “U”=Unknown |
|
Meconium in Trachea |
MECTRACH |
Alpha |
1 |
Y, N |
"Y" = Endotracheal suctioning at birth with meconium in
trachea. |
|
Asphyx |
ASPHYX |
Alpha |
1 |
Y, N |
"Y" = cord pH <7.00 |
|
Apgar 1 min |
APGAR1MN |
# |
2 |
0 to
10, 99 |
Unknown = “99”
|
|
Apgar 5 min |
APGAR5MN |
# |
2 |
0 to
10, 99 |
Unknown = “99” |
|
Surfactant (any # of doses) |
SURFACT |
Alpha |
1 |
Y, N,
U |
“Y” = Infant received any number of surfactant doses; "U" =
Unknown |
|
UAC |
UAC |
Alpha |
1 |
Y, N |
“Y” = UAC present for any length of time |
|
UVC |
UVC |
Alpha |
1 |
Y, N |
“Y” = UVC present for any length of time |
Respiratory Support
|
Data Entry Form Name |
Field Name |
Type |
Length |
Limits |
Definition |
|
Caffeine or Apnea Drug |
CAFFEINE |
Alpha |
1 |
Y, N |
“Y” = Infant received caffeine or other drug for apnea |
|
Recurrent Apnea |
RECAPNEA |
Alpha |
1 |
Y, N |
“Y” = Infant had recurrent episodes of apnea |
|
O2 |
O2 |
Alpha |
1 |
Y, N |
“Y” = infant received any oxygen after resuscitation |
|
Duration for O2 |
DURO2 |
# |
1 |
1,2,3,4 |
1: <1 wk; 2: <28d; 3: <3 mo; 4: >3mo |
|
O2AT36 |
Alpha |
1 |
Y, N |
“Y” = On chronic oxygen at 36 wks GA and
>= 28 days old;
Use “N” if infant was older than 32 weeks
at birth
|
|
|
CPAP Only |
CPAPONLY |
Alpha |
1 |
Y, N,
U |
"Y" = infant with mechanical ventilation only for
administration of surfactant.
"U" = Unknown |
|
IPPV |
IPPV |
Alpha |
1 |
Y, N |
“Y” = infant received any IPPV after resuscitation except for
surfactant dosing |
|
Duration for IPPV |
DURIPPV |
# |
1 |
1,2,3,4 |
1: <1 wk; 2: <28d; 3: <3 mo; 4: >3mo |
|
IPPV @ 36 wks CGA if >= 28 days old |
IPPVAT36 |
Alpha |
1 |
Y, N |
“Y” = On IPPV at 36 wks GA and >= 28
days old;
Use “N” if infant was older than 32 weeks
at birth
|
|
ECMO |
ECMO |
Alpha |
1 |
Y, N |
“Y” = Infant received ECMO |
|
Nitric Oxide |
NITROX |
Alpha |
1 |
Y, N |
“Y” = Infant received Nitric Oxide |
Baylor College of Medicine - Neonatology Section
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modified: 6/26/03