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过渡期间的电心脏计量以及在非常早产婴儿的短期结果:一项前性观察性研究
C E Schwarz1,2,3, J M O'Toole4,5, D B Healy4
1Department of Paediatrics & Child Health, University College Cork, Cork, Ireland. christoph.schwarz@med.uni-heidelberg.de.
European journal of pediatrics
|January 8, 2024
概括
在非常早产婴儿的电心仪 (EC) 衍生心脏输出 (CO) 与两周内死亡或脑损伤等整体不良结果无关. 然而,随着时间的推移,CO变化与严重脑出血 (ICH级≥2) 有关.
科学领域:
- 新生儿生理学和重症监护
- 在婴儿的心血管监测.
- 神经保护策略的神经保护策略
背景情况:
- 以前的研究将生物反应性衍生的心脏输出 (CO) 与早产婴儿的不良结果联系起来.
- 了解早期的血液动力学变化对于管理非常早产婴儿至关重要.
- 电心计 (EC) 提供了一种非侵入性的CO评估方法.
研究的目的:
- 评估EC衍生CO及其在产后48小时内的变化与非常早产婴儿 (<32周妊娠年龄) 的短期不良结果之间的关联.
- 将不良结果定义为死亡率或头骨超声检查异常 (头骨内出血或周周结核白血病) 在生命的前两周内.
- 分析EC衍生CO的时间轨迹与这些结果相关.
主要方法:
- 一项前性观察性研究,包括53名非常早产婴儿.
- 电心仪 (EC) 用于测量在前48小时内按体重 (CO) 索引的心脏输出.
- 后勤回归和混合效应模型分析了CO中位数,CO轨迹和不良结果之间的关联.
主要成果:
- 经过对妊娠年龄进行调整后,EC衍生CO与联合不良结果 (死亡率或任何级别的脑损伤) 并没有独立相关.
- 在正常和不良结果的婴儿之间,CO的时间轨迹没有显著差异.
- 后期分析表明,CO时间轨迹与严重的内出血 (ICH ≥ 2 级) 之间存在关联.
结论:
- 在48小时内EC衍生的CO测量不能独立预测非常早产婴儿在前14天的整体脑损伤或死亡率.
- EC衍生的CO的时间变化可能与特定的严重脑损伤有关,例如显著的内出血.
- 过渡期内EC衍生的CO值可能与生物反应性衍生的值不同,并且在极度早产婴儿中随着时间的推移而增加.
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