新生児の継続的な負圧換気後の結果:フォローアップ評価
Katherine Telford1, Lorraine Waters1, Harish Vyas2
1School of Human Development, University of Nottingham, Nottingham, UK.
Lancet (London, England)
|April 4, 2006
まとめ
継続的な陰性胸外圧 (CNEP) で治療された乳児の長期追跡調査では,死亡または障害のリスクの増加は認められなかった. CNEPを投与された子どもたちは,幼児期後半にIQと神経心理学的スコアでパフォーマンスを向上させました.
科学分野:
- 新生児医学 新生児医学
- 小児神経学について
- 呼吸器生理学 呼吸器生理学について
背景:
- 新生児呼吸器障害症候群の継続的な負の胸外圧 (CNEP) の以前の試験は懸念を提起しました.
- 標準治療に対するCNEPの長期的な続変は,調査が必要である.
研究 の 目的:
- 新生児としてCNEPで治療された子供の長期的な神経学的結果,認知機能,障害を評価する.
- CNEPが,幼児期の末期の悪影響と関連しているかどうかを判断する.
主な方法:
- 当初のランダム化試験の生存者133人 (9~15歳) の診察室での評価.
- 小児科医と心理学者によって実施される標準化された神経学的,認知的,および障害テスト.
- 65の完全なペアとペア化されていないデータを分析し,主な結果は死亡または重度の障害でした.
主要な成果:
- CNEPと標準治療群の主要なアウトカム (死亡または重度の障害) には有意な差異はありません.
- フルIQスコアも同様でしたが,CNEPグループはパフォーマンスのIQが著しく高かった (平均差は6.8ポイント).
- 神経心理学的テストは,CNEPグループの言語生産と視覚空間スキルの点で著しく高いスコアを明らかにしました.
結論:
- 新生児のCNEPは,幼児期の末期におけるより悪い長期的な結果と関連していません.
- 新生児における有害なアウトカムにおける小さな差異は,長期的な不利な結果にはつながらなかった.
- 新生児の介入に関する将来の研究は,長期的な成果評価を優先すべきである.
関連する概念動画
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Critical Guidelines for Assessing Ventilation:
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Critical Guidelines for Assessing Ventilation:
01:23Assessment of Respiration
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01:19Respiratory Assessment: Purpose and Indications
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01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
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Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:17Pulmonary Cycle: Exhalation
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01:29Suctioning the Nasopharyngeal Airway
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Equipment Required
Equipment Required