关于早产新生儿低血压管理实践的调查:印度的观点
Rupam Das1, Rema Nagpal1, Sujata Deshpande1
1Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital, and Research Centre, Pune, India.
Frontiers in pediatrics
|November 5, 2024
概括
新生儿低血压管理在印度NICU医生之间有很大的差异,诊断标准和治疗方案不一致. 建议提高心声回声学的利用率和遵守指南,以标准化对早产婴儿的护理.
科学领域:
- 新生儿科学 新生儿科学
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 低血压在新生儿重症监护室 (NICU) 的早产婴儿中普遍存在 (24%-50%),特别是那些出生体重低 (<1,500g) 的婴儿.
- 及时诊断和管理对于预防末端器官损伤至关重要,特别是在大脑中.
- 目前的做法严重依赖于血压,定义,诊断工具和治疗策略有很大的差异.
研究的目的:
- 在印度NICU的医生中调查新生儿低血压的当前管理实践.
- 为了评估诊断标准的变化,使用心声回声学和治疗干预措施.
主要方法:
- 在印度NICU的320名医生中使用在线工具进行了横截面调查.
- 调查问卷涵盖了诊断标准,心声回声学实用性和管理策略,包括液体复苏,异能药物和类固醇.
主要成果:
- 很大一部分新生儿重症监护室 (78%) 实行延迟带紧.
- 只有44%的人有机构的低血压管理方案,诊断标准差异很大 (52%的人使用平均血压低于妊娠年龄).
- 85%的医生使用心声扫描,但只有73%的医生在低血压新生儿中使用心声扫描;通常采用"体积-诺托普-回声-类固醇"的方法,其中多巴胺是首选的第一线内诺托普.
结论:
- 在印度,新生儿低血压管理的实践显示出相当大的差异.
- 建议加强对床边心声回声仪的使用,以准确诊断和血液动力学监测.
- 通过指南传播来标准化临床实践对于改善护理至关重要.
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