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预防性口表面活性剂用于早产新生儿出生时:一个随机临床试验
Madeleine C Murphy1,2,3, Jan Miletin4, Claus Klingenberg5,6
1National Maternity Hospital, Dublin, Ireland.
JAMA pediatrics
|December 11, 2023
概括
预防性口表面活性剂并没有降低非常早产婴儿的输管率. 这种用连续正气道压力 (CPAP) 给出的方法不建议在新生儿中常规使用.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 临床试验 临床试验
背景情况:
- 持续的正气道压力 (CPAP) 支持早产婴儿患有呼吸困扰综合征 (RDS) 的风险.
- 用于表面活性剂的输入管是常见的,但存在风险.
- 口腔大表面活性剂正在作为输管替代品进行探索.
研究的目的:
- 评估出生时的预防性口表面活性剂是否会减少早产婴儿呼吸衰竭的输管治疗.
- 评估这种替代表面活性剂输送方法的安全性和有效性.
主要方法:
- 一个未盲目的随机临床试验 (POPART) 涉及251名早产婴儿 (<29周怀孕).
- 婴儿接受了口腔大表面活性剂加CPAP或单独CPAP.
- 主要结局:在120小时内输入管道以治疗呼吸衰竭,心肌梗塞或呼吸暂停.
主要成果:
- 在口腔大表面活性剂组 (63.5%) 和对照组 (64.8%) 之间,输管率没有显著差异.
- 与对照组 (6.4%) 相比,口表面活性剂组 (16.6%) 的肺胸部发病率更高.
结论:
- 预防性口表面活性剂的使用并没有降低早产婴儿的输管率.
- 这些研究结果不支持在出生后立即使用口腔大表面活性剂和CPAP的常规使用.
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