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在极度早产婴儿中,积极和宽容的血压管理之间的临床结果的比较
Narendra Aladangady1,2, Ajay Sinha2,3, Jayanta Banerjee4,5
1Department of Neonatology, Homerton University Hospital, Homerton Healthcare NHS Foundation Trust, London, E9 6SR, UK.
NIHR open research
|October 26, 2023
概括
在极度早产的婴儿中,积极的血压 (BP) 支持并没有增加死亡率或心室内出血 (IVH) 率. 然而,活跃的血压支持可能会减少死性肠球炎 (NEC) 的发生率.
科学领域:
- 新生儿医学 新生儿医学
- 儿童心脏病学 儿童心脏病学
- 临床护理 儿科 临床护理 儿科
背景情况:
- 对于极度早产婴儿的正常血压 (BP) 定义和低血压治疗值存在不确定性.
- 在生命的关键的前72小时内讨论最佳的血压管理策略.
研究的目的:
- 为了比较极度早产婴儿的短期结果,使用积极与宽容的BP支持方案进行管理.
- 评估不同高血压管理策略对死亡率,腹腔内出血 (IVH) 和死性肠球炎 (NEC) 的影响.
主要方法:
- 对出生于23 0/7至28 6/7周妊娠年龄之间的婴儿的医疗记录的回顾性审查.
- 接受主动血压支持 (维持平均动脉血压>30 mmHg) 与允许的血压支持 (仅用于低血压症状的药物) 的婴儿的比较.
主要成果:
- 在活跃和宽容的BP支持组之间,在离院前死亡或严重的IVH (等级>2) 中没有显著差异.
- 活跃高血压支持组中的婴儿的平均动脉血压和缩血压持续较高.
- 2或更高阶段的死性肠球炎 (NEC) 在宽容的BP支持组中明显更频繁.
结论:
- 与容许性支持相比,积极的BP支持并没有增加死亡率或IVH率.
- 积极的血压支持可能与极度早产婴儿中NEC的发病率降低有关.
- 建议进行前性多中心随机试验,以证实这些发现.
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