咖啡因治疗早产性呼吸暂停:对剂量实践和感知有效性的单中心研究
Kelly K Storm1, Robert B Flint1,2, Wes Onland3,4
1Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.
Neonatology
|December 16, 2024
概括
新生儿重症监护室 (NICU) 经常使用高于早产性呼吸暂停记录的咖啡因剂量. 这些现实数据表明,由于持续的治疗失败,需要个性化剂量策略.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
背景情况:
- 咖啡因是早产性呼吸暂停的标准药物治疗方法.
- 随机对照试验的证据支持其在新生儿重症监护室 (NICU) 的使用.
- 这项研究调查了现实世界的咖啡因使用模式.
研究的目的:
- 描述咖啡因在早产儿的临床使用情况.
- 为了确定咖啡因剂量实际上是否与已注册的方案有所不同.
- 确定接受高于登记平均每日剂量的婴儿比例.
主要方法:
- 从2018年到2021年,对怀孕30周前出生并入住新生儿集中治疗室的婴儿进行了回顾性分析.
- 排除标准包括晚入院,不使用咖啡因和数据不足.
- 主要结局:平均咖啡因剂量超过注册标签剂量的患者比例.
主要成果:
- 其中451名婴儿中有89%的婴儿每天平均摄入咖啡因剂量高于注册剂量.
- 维护剂量的中位数为5.3 mg/kg/天.
- 71%的人需要额外的治疗,如迷你负载,多克萨普拉姆或输管.
结论:
- 临床实践经常涉及高于注册的咖啡因剂量.
- 尽管高剂量和额外的疗法,很大一部分婴儿仍然需要进一步的干预.
- 对于早产性呼吸暂停,需要个性化剂量或替代疗法.
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