谁需要第二剂外源表面活性剂?
Lucia Lanciotti1, Matteo Pasqualini2, Alessio Correani1
1Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche, Ancona, AN, Italy; Division of Neonatology, Mother and Child Department, G. Salesi University Hospital, Ospedali Riuniti, Ancona, AN, Italy.
The Journal of pediatrics
|June 4, 2023
概括
孕妇高血压或对于妊娠年龄 (SGA) 较小的婴儿需要更频繁地重新注射表面活性剂. 这增加了支气管肺功能障碍的风险和早产婴儿的死亡率.
科学领域:
- 新生儿医学 新生儿医学
- 周围生理学 周围生理学
- 儿科呼吸系统医学 儿科呼吸系统医学
背景情况:
- 表面活性剂替代疗法对于管理早产婴儿的呼吸应急综合征 (RDS) 是至关重要的.
- 了解影响表面活性剂再剂量的因素对于优化治疗和改善结果至关重要.
研究的目的:
- 确定与早产婴儿需要表面活性剂再剂量的相关的产前和产后风险因素.
- 分析重新剂量对新生儿结局的影响.
主要方法:
- 对怀孕24至31周之间出生的婴儿进行了回顾性研究.
- 后勤回归分析以确定与表面活性剂减少剂量相关的临床因素.
- 数据来自意大利马尔克地区的单一III级区域NICU.
主要成果:
- 662名婴儿中有200名 (30%) 接受了一剂以上的表面活性剂.
- 怀孕期间的高血压 (OR 3.95) 和对于妊娠年龄来说的小血压 (SGA) (OR 3.93) 显著增加了再给药的风险.
- 较低的表面活性剂初始剂量 (100 mg/kg) 也增加了再剂量风险 (OR 4.56/4.61).
- 较大的妊娠年龄,延迟施用和较轻的RDS降低了再剂量风险.
结论:
- 妊娠高血压和SGA状态是表面活性剂再剂量的重要预测因素.
- 多重表面活性剂剂量与更高的支气管肺功能失调率,死亡率和长时间的呼吸辅助相关.
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