Evidence map›Paper›PMID 41498060›Full record

ArticleJournal of pediatrics. Clinical practice2025

A Roadmap to Improved Quality Outcomes in Neonates Exposed to Illegally Manufactured Fentanyl.

Cristiane G Lin, Christine Wade, Becky Micetic, Pooja Rangan, Natalie Wade, Vrinda Arora

Abstract read
In one paragraph

Article in Journal of pediatrics. Clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cristiane G LinArizona Neonatology, Pediatrix Medical Group, Phoenix, AZ.
Christine WadeArizona Neonatology, Pediatrix Medical Group, Phoenix, AZ.
Becky MiceticArizona Neonatology, Pediatrix Medical Group, Phoenix, AZ.
Pooja RanganDepartment of Pediatrics, Banner - University Medical Center Phoenix, Phoenix, AZ.
Natalie WadeArizona Neonatology, Pediatrix Medical Group, Phoenix, AZ.
Vrinda AroraArizona Neonatology, Pediatrix Medical Group, Phoenix, AZ.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The incidence of neonatal opioid withdrawal syndrome (NOWS) has dramatically increased, and illegally manufactured fentanyl may be a significant contributor. The optimal treatment approach for an infant experiencing severe withdrawal from fentanyl is unknown. Our aim was to decrease the mean length of stay (LOS) by 20% over 19 months for infants with NOWS by implementing a transitional phase before establishing our modified Eat, Sleep, Console (ESC) model of care. Study design: A multidisciplinary team used quality improvement methodology to improve treatment of NOWS in 2 phases, each adapted to fentanyl's complex pharmacology. Beginning May 2023, a hybrid Finnegan/ESC protocol was implemented to address hospital barriers for a year before initiating full ESC management. Data were collected on infants >35 weeks of gestational age admitted to a level III neonatal intensive care unit. Primary metrics included LOS and total days/doses of morphine. Rates of apnea and naloxone were used as balancing measures. The LOS was plotted on a statistical process control chart and the data were summarized with descriptive statistics. Results: Outcomes were analyzed for 217 infants. The aim was exceeded with a mean LOS reduction of 29% (hybrid) and 49% (ESC). On average, decreased morphine days (22.5, 11.2, 6.9, Conclusions: This quality improvement project provides a successful fentanyl-adapted ESC model that may be adopted to decrease postnatal morphine usage and LOS.

Indexed as

intensive care unitslength of staymorphineneonatalnewbornopioid

Identifiers

PMID41498060
PMCPMC12766099

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.