在怀孕34周以下的早产婴儿出生后立即维持正常热量:系统性审查和元分析
V V Ramaswamy1, J A Dawson2, M F de Almeida3
1Ankura Hospital for Women and Children, Hyderabad, India.
Resuscitation
|August 19, 2023
概括
产房干预可以帮助预防早产婴儿的低温症. 建议保持至少23°C的室温,使用塑料袋或包裹,并仔细监测过热.
科学领域:
- 新生儿医学 新生儿医学
- 围产期护理 围产期护理
- 热调节 热调节 热调节
背景情况:
- 在分娩室 (DR) 中,低温是早产新生儿 (<34周妊娠期) 的重大风险.
- 有效的DR干预对于预防低温和改善新生儿结果至关重要.
研究的目的:
- 评估各种分娩室干预措施在预防低温方面的有效性.
- 评估这些干预措施对早产婴儿结果的影响.
主要方法:
- 在Medline,Embase,CINAHL和CENTRAL数据库中进行全面的文献搜索.
- 包括随机对照试验,非随机对照试验和质量改进研究.
- 随机效应的元分析和GRADE准则,以确定证据的评估.
主要成果:
- DR温度≥23°C改善了温度结果,而没有增加过热风险 (低确定性).
- 塑料袋或塑料包装 (PBW) 使用改善了正常热量 (低确定性),但增加了高温症风险 (中等确定性).
- 加热加湿气体 (HHG) 降低了中度低温和严重的腹腔内出血风险 (非常低至低确定性).
结论:
- 推的DR干预措施包括温度≥23°C,手动模式的辐射加热器,PBW和早产婴儿的头罩.
- 在高发病率环境中,HHG和热床 (TM) 可以被视为PBW的辅助.
- 密切监测是预防高温症的必要条件.
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