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针对较高或较低的动脉氧和度对极度早产婴儿死亡或残疾的影响:一项随机临床试验
Barbara Schmidt1, Robin K Whyte, Elizabeth V Asztalos
1Division of Neonatology, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Philadelphia, PA, USA. barbara.schmidt@uphs.upenn.edu
针对极度早产婴儿的较低的动脉氧和度 (85-89%) 与较高的目标 (91-95%) 相比,没有显著增加死亡或残疾率. 这一发现有助于确定脆弱新生儿的最佳氧和水平.
科学领域:
- 新生儿科学 新生儿科学
- 儿科重症监护 儿科重症监护
- 呼吸系统医学 呼吸系统医学
背景情况:
- 氧气治疗对于早产婴儿至关重要,但会带来毒性和氧化应激的风险.
- 在极度早产的婴儿中,最佳的动脉氧和目标以平衡益处和风险仍然不确定.
研究的目的:
- 为了比较较低与较高的动脉氧和目标对极度早产婴儿死亡或残疾率的影响.
- 调查不同氧和范围对主要新生儿结局的影响.
主要方法:
- 一项随机双盲试验,涉及多个国家的1201名极度早产婴儿 (23-27周妊娠年龄).
- 婴儿被分配到目标氧和范围为85-89%或91-95%,并使用调整的脉冲氧计进行监测.
- 主要结局是18个月校正年龄时死亡或残疾的复合结果.
主要成果:
- 在较低 (51.6%) 和较高 (49.7%) 氧和目标群体之间,18个月后死亡或残疾的综合结果没有显著差异.
- 个体死亡率在两组之间也没有显著差异 (16.6%对15.3%).
- 针对较低和度的目标导致氧气治疗的持续时间缩短 (平均差异为-0.8周).
结论:
- 针对极度早产婴儿的较低的动脉氧和度 (85-89%) 与较高的目标 (91-95%) 相比,不增加死亡或残疾率.
- 这些发现有助于为极度早产新生儿制定更安全,更有效的氧气管理策略.
- 进一步的研究可能会完善最佳的氧和范围,以尽量减少长期的疾病.
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