新生儿晚期心肺复苏的最佳氧气使用 - - 文献综述
Deepika Sankaran1, Munmun Rawat2, Satyan Lakshminrusimha1
1Division of Neonatology, Department of Pediatrics, University of California, Davis, Sacramento, CA, USA.
Pediatric medicine (Hong Kong, China)
|October 4, 2024
概括
新生儿心肺复苏 (CPR) 期间的最佳启发氧度尚不清楚. 研究表明,在胸部压缩期间100%的氧气可以改善大脑的氧气供应,而ROSC后的突然断奶可能会减少氧化应激.
科学领域:
- 新生儿医学 新生儿医学
- 儿科重症监护 儿科重症监护
- 心肺生理学 心肺生理学
背景情况:
- 在新生儿心肺复苏 (CPR) 期间使用氧气 (O2) 是有争议的.
- 为了加速自发循环 (ROSC) 的恢复,确保足够的氧气供应,并改善生存,没有建立最佳的启发氧度 (FiO2).
- 将缺氧预防与避免高氧的平衡对神经发育结果至关重要.
研究的目的:
- 审查新生儿心肺复苏中使用氧气的演变.
- 检查动物和临床研究中关于在CPR期间和之后给予氧气的证据.
- 讨论与新生儿CPR氧化策略相关的生理学和结果.
主要方法:
- 来自PubMed和谷歌学者的英语文学叙事评论.
- 文献搜索跨越了35年 (1985年1月1日 - 2021年5月1日).
主要成果:
- 在CPR期间比较21%和100%O2的动物研究显示,即使在18%O2.2,也没有短期结果差异.
- 羔羊模型表明,在心肺复苏期间100%的O2增强了大脑的氧气供应,而21%的O2.
- 在ROSC后,突然断奶到21%的O2,并定位到85-95%的SpO2,与从100%的O2中慢慢断奶相比,最大限度地降低了氧过量和氧化应激.
结论:
- 进一步的临床研究对于确定新生儿心肺复苏期间最佳的氧化策略至关重要.
- 证据支持氧气评估和FiO2选择的具体方法,以改善生存和结果.
- 综述综合了当前关于在晚期新生儿心肺复苏和后ROSC期间使用氧气的文献.
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