在早产婴儿中中等与高氧和目标:国家队列研究
Richard S Taylor1, Balpreet Singh2, Amit Mukerji3
1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Neonatology
|August 5, 2024
概括
对于极度早产的婴儿,目标是中等氧和水平 (88-93%) 与较高的目标 (90-95%) 相比,改善了没有重大疾病的生存率. 这一发现支持优化新生儿重症监护中的氧气管理.
科学领域:
- 新生儿科学 新生儿科学
- 儿科重症监护 儿科重症监护
- 呼吸系统医学 呼吸系统医学
背景情况:
- 对极度早产婴儿的最佳氧和目标仍然是新生儿护理中一个关键的不确定性领域.
- 目前的做法各不相同,需要研究以建立基于证据的指导方针.
研究的目的:
- 为了比较极度早产婴儿 (<29周怀孕) 的结果,使用中等和高氧和目标进行管理.
- 确定不同氧和目标与没有主要发病率,死亡率和特定新生儿发病率的生存率之间的关联.
主要方法:
- 来自加拿大新生儿网络 (CNN) 数据库的2011-2018年间接受的早产婴儿 (妊娠29周以下) 的队列分析.
- 根据现场调查问卷,中心被分为中等 (88-93%) 或高 (90-95%) 和目标群体.
- 用通用估计方程来调整人口统计差异和地点实践,主要结果是没有重大发病率的生存.
主要成果:
- 该研究包括高目标组的2,739名婴儿和中间目标组的6,813名婴儿.
- 在中间目标组中,没有重大发病的存活率显著更高 (aOR 1.59; 95% CI: 1.04, 2.45).
- 在死亡率,死性肠球炎 (NEC),早产治疗视网膜病变或脑损伤方面没有观察到显著差异. 亚组分析表明,支气管肺功能失调 (BPD) 的发病率较低,目标为中等水平.
结论:
- 在怀孕29周之前出生的新生儿中,准中等氧和水平 (88-93%) 与较高的目标 (90-95%) 相比,与没有重大发病率的生存率提高有关.
- 这些发现表明,更保守的氧和范围可能对极度早产婴儿有益,可能降低BPD率.
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