新生児における肺胸炎: 3つのNICUでのコホート研究
Mohsen A A Farghaly1, Mahmoud A M Ali2, Ceyda Acun1
1Neonatology Division, Cleveland Clinic Children's, Cleveland, OH, USA.
まとめ
新生児肺胸は早産児に多く見られる. インチューブやCPAPなどの出産室での介入は,肺胸症ではなく,NICUでのバブル連続正気圧 (b-CPAP) の使用に関連しています.
科学分野:
- 新生児科
- 小児呼吸器医学
- 緊急 治療
背景:
- 肺胸は新生児の重要な呼吸器合併症です
- 妊娠年齢 (GA) は新生児の呼吸器疾患の危険因子として知られています.
- 肺胸の発症におけるバブル連続正気圧 (b-CPAP) のような介入の役割は明らかにする必要があります.
研究 の 目的:
- 新生児の妊娠年齢の異なるカテゴリーで肺胸炎の流行を決定する.
- 新生児における肺胸症に関連した変数を特定する.
- 肺胸炎率に対するバブルCPAP (b-CPAP) 実施の影響を評価する.
主な方法:
- 3つの病院で6年間に渡って 58,706人の新生児を対象とした遡及コホート研究です.
- 胎児は妊娠年齢によって分類された: ≥35週,29〜34週,および ≤28週.
- 肺胸炎の症例は対照群と一致し,b-CPAPの導入前と後の流行を比較した.
主要な成果:
- 肺胸疾患の総発生率は0. 53%で,低GA群ではより高い割合で発生しました (29~34週間で4. 0%, ≤28週間で4. 6%).
- 出産室での介入 (CPAP,挿管) は早産児において重要なものであり,男性性および膜炎は≥35週間で観察された.
- 挿管されていない乳児の肺胸炎の罹患率は,b- CPAPの導入後に変わらなかった.
結論:
- 新生児肺胸は妊娠年齢と出産室での介入と強く関連しています
- 新生児集中治療室でのバブルCPAP (b- CPAP) の導入は,インチューブされていない乳児の肺胸発症率に有意な変化をもたらさなかった.
- 新生児肺胸を減らすには 出産室の管理を最適化することに 焦点を当てることが重要です
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