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在早产新生儿的分娩室稳定开始的最佳氧气度:一个随机对照试验
Sonu Kumar1, Mayank Priyadarshi1, Poonam Singh1
1Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Resuscitation
|November 25, 2024
概括
在分娩室 (DR) 稳定早产新生儿,使用60%的初始吸入氧 (FiO2) 分数,在5分钟内显著改善氧和水平,而在30%的FiO2. 这种更高的FiO2也导致更好的分钟特定氧和趋势,而不会增加不良事件.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 临床试验 临床试验
背景情况:
- 在分娩室 (DR) 中稳定早产新生儿的灵感氧气 (FiO2) 的最佳初始分量仍然不清楚.
- 有效的DR稳定对于改善早产婴儿的结果至关重要.
研究的目的:
- 在早产新生儿 (<34周妊娠期) 中,以60%的FiO2对比30%的FiO2进行DR稳定启动的疗效.
- 评估初始FiO2对实现目标周边氧和 (SpO2) 和其他临床结果的影响.
主要方法:
- 一个开放的,随机对照试验,涉及150名需要呼吸辅助的早产新生儿.
- 婴儿被指派接受60%或30%的FiO2用于初始DR稳定,随后对SpO2目标进行定位.
- 主要结局是新生儿在5分钟的生命中达到≥80%的SpO2的比例.
主要成果:
- 在60%的FiO2组中的新生儿中,显著更高的比例在5分钟内达到≥80%的SpO2目标 (73.3%对50.7%,p<0.001).
- 在60%的FiO2组中,分钟特定的SpO2和FiO2趋势显著更高,而心率趋势是可比的.
- 在区域大脑氧化,需要呼吸辅助,表面活性剂,咖啡因,不良事件,死亡率或住院时间方面没有发现显著差异.
结论:
- 以60%的FiO2进行初始稳定,更有效地帮助早产新生儿 (<34周) 在DR中在5分钟内达到目标SpO2水平.
- 较高的初始FiO2 (60%) 表明氧和趋势有所改善,而不会影响这个脆弱人群的安全.
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