[怀孕年龄<32周的婴儿出生体重非常低的初始非侵入性通风衰竭的危险因素:多中心回顾性研究]
Wen-Wen Wu1, Hui Rong1, Rui Cheng1
1Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics
|September 13, 2024
概括
在32周前出生的早产婴儿的初始非侵入性通风 (NIV) 失败与更小的妊娠年龄,呼吸困扰综合征 (RDS) 和更高的氧气需求有关. 失败会增加并发症和更长时间住院的风险.
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:
- 过早出生的婴儿,特别是那些妊娠年龄小于32周的婴儿,通常需要呼吸辅助.
- 非侵入性通风 (NIV) 是这些婴儿的常见呼吸辅助方法.
- 了解导致NIV失败的因素对于改善结果至关重要.
研究的目的:
- 确定怀孕年龄<32周的非常低出生体重婴儿 (VLBWI) 初始NIV失败的风险因素.
- 在这个脆弱人群中调查初始NIV失败和不良预后之间的关联.
主要方法:
- 从28家三级医院收集了817名早产婴儿的回顾性数据 (2019年1月至2021年12月).
- 根据最初的结果,婴儿被分为成功的NIV和失败的NIV组.
- 统计分析以确定NIV失败和相关不良结果的风险因素.
主要成果:
- 在17.0%的婴儿中出现了NIV衰竭.
- 与NIV失败相关的因素包括较低的妊娠年龄,较低的出生体重,较低的Apgar分数,呼吸困难综合征 (RDS) 诊断,较高的阳性末尾呼吸压力,以及增加吸入氧气 (FiO2) 需求的比例 (≥30%).
- 尼维失败与肺部感染,肺胸炎,早产视网膜病变,支气管肺功能失调,严重腹腔内出血,更长时间住院和成本增加的更高发病率有关.
结论:
- 较小的妊娠年龄,RDS诊断,以及在初始NIV期间需要FiO2≥30%是NIV在早产婴儿 (<32周) 失败的重大风险因素.
- 最初的NIV失败是不良临床结果的强有力的预测因素,并且在这个人群中增加了医疗保健资源利用率.
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