在自发呼吸建立之前,是否可以避免吸气?
T H Nesterenko1, S Pocevic2, M Elgendy1
1Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
Journal of neonatal-perinatal medicine
|October 2, 2023
概括
延迟气道吸气,直到新生儿自己呼吸,避免深吸是可行的. 这种做法可以减少新生儿复苏期间的氧气使用.
科学领域:
- 新生儿复苏新生儿的复苏
- 儿科气道管理 儿童气道管理
- 提高医疗保健的质量 改善医疗保健的质量
背景情况:
- 新生儿的复苏包括立即的后喉吸入,可以触发阴道反应,导致胸或呼吸暂停.
- 在新生儿复苏期间延迟气道吸气并避免深吸的可行性尚未被调查.
研究的目的:
- 用两个准则评估新生儿复苏的可行性:延迟吸入直到自发呼吸,避免深层导管吸入.
- 测试这些修改复苏实践是安全和有效的假设.
主要方法:
- 实施了一项质量改进项目,包括对新指南的新生儿工作人员进行培训.
- 婴儿的嘴巴用干布清洁;只有自发呼吸开始后才开始吸.
- 用于口腔和鼻腔分泌物进行球泡吸,避免深吸;禁止导管吸.
主要成果:
- 对999名婴儿进行比较 (前501名,后498名) 显示,两组之间没有显著差异.
- 在自发呼吸之前吸气的发生率下降.
- 随着新的指导方针,人们观察到氧气使用的显著减少 (12.4%与4.4%,P < 0.001).
结论:
- 在新生儿复苏中,避免自发前的呼吸吸入和深层导管吸入是可行的.
- 这些修改后的做法与分娩室的氧气需求减少有关.
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