在非常早产的婴儿中,在不那么侵入性地施用表面活性剂时对舒适度的评估:一个多中心研究
Karin Pichler1, Benjamin Kuehne2, Janneke Dekker3
1Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria, karin.a.pichler@meduniwien.ac.at.
Neonatology
|June 13, 2023
概括
在较少侵入性表面活性剂 (LISA) 管理期间,非药物止痛疗法为61%的非常早产婴儿 (VPI) 提供了舒适. 需要进一步的研究来优化在此过程中所有VPI的舒适性.
科学领域:
- 新生儿医学 新生儿医学
- 儿科麻醉学 儿科麻醉学
- 新生儿疼痛管理 新生儿疼痛管理
背景情况:
- 较少侵入性表面活性剂 (LISA) 管理是非常早产婴儿 (VPI) 呼吸困扰综合征的关键程序.
- 在新生儿手术过程中评估和管理婴儿疼痛和不适对于最佳结果至关重要.
研究的目的:
- 调查非药物止痛药在LISA期间为VPI提供舒适性的有效性.
- 为了确定在这个过程中非药理方法在多大程度上足够.
主要方法:
- 在IV级NICU进行前性,非随机化,多中心观察性研究.
- 包括需要表面活性剂的VPI (22 0/731 6/7周妊娠年龄)
- 在LISA期间评估COMFORTneo分数,在第一次尝试失败时允许额外的analgosedation.
主要成果:
- 在LISA期间,在113个VPI中的61%中,非药物止痛药提供了足够的舒适性.
- 在喉腔镜检查期间,COMFORTneo得分达到峰值.
- 较低妊娠年龄的婴儿 (2226周) 在喉腔镜检查期间表现出更好的舒适度 (74.4%) 与较高妊娠年龄的婴儿 (2732周) (51.6%) 相比 (p=0.016).
结论:
- 在LISA期间,非药物镇痛在大多数VPI中是有效的.
- 需要策略来识别高风险的VPI不适,并定制疼痛治疗.
- 进一步的研究应侧重于针对患者的药物选择和剂量.
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