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在通风早产新生儿中产后系统性皮质类固醇的结果:随机对照试验的系统性审查
Giovanni Boscarino1, Viviana Cardilli1, Maria Giulia Conti1
1Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Frontiers in pediatrics
|February 29, 2024
概括
系统性皮质类固醇可以改善呼吸结果,并减少早产婴儿的输出时间,但长期的神经发育影响尚不清楚. 德克萨米他比皮激素更有效,但存在风险.
科学领域:
- 新生儿科学 新生儿科学
- 儿科肺病学 儿科肺病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在早产新生儿中长期使用机械通风会增加支气管肺功能失调 (BPD) 的风险.
- 系统性皮质类固醇越来越多地用于BPD预防和治疗.
- 这些治疗方法的长期结果需要彻底评估.
研究的目的:
- 系统地审查早产婴儿系统性皮质类固醇的随机对照试验 (RCT).
- 评估与长期神经发育,生长,出率和不良影响的关联.
- 为了比较不同的皮质类固醇的疗效和安全性.
主要方法:
- 在2023年6月之前发表的39个RCT的系统审查.
- 在Medline,Scopus和PubMed中进行电子搜索.
- 包括系统性皮质类固醇的研究,不包括吸入形式.
主要成果:
- 系统性皮质类固醇可以改善呼吸系统的结果,并减少输出管的时间.
- 德克萨米他显示出比皮更大的疗效,但高血压和高血糖增加.
- 长期的生长和神经结果在很大程度上是未知的;在大多数研究中,不良影响是相似的.
结论:
- 新生儿系统性皮质类固醇,特别是甲,改善呼吸系统的结果,但需要谨慎使用.
- 目前的证据对于系统性类固醇在早产婴儿的长期神经发育影响是不确定的.
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