在早产新生儿中输出管失败的预测因素和结果:系统性审查
Lisiane Hoff Calegari1, Medha Goyal1, Sourabh Dutta2
1Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Pediatrics
|January 15, 2025
概括
在早产新生儿中,输出失败与较低的妊娠年龄和增加的呼吸支持有关. 这种情况显著增加了死亡率和支气管肺功能障碍的风险.
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:
- 输出失败 (EF) 是早产新生儿的常见并发症,通常与较差的健康结果有关.
- 识别预测因素和了解EF的结果对于改善这种脆弱人群的护理至关重要.
研究的目的:
- 系统地审查和分析现有关于预测因素和早产新生儿输出失败的结果的文献.
- 评估EF与死亡率和支气管肺功能障碍 (BPD) 的相关性.
主要方法:
- 从1995年开始,在多个数据库 (MEDLINE,Embase,CINAHL,Cochrane图书馆) 进行了全面的文献搜索.
- 包括的研究是实验性或观察性,重点是早产新生儿 (<37周),并报告EF预测因素 (机器学习,肺部超声波) 或结果.
- 使用RevMan Web进行了元分析,以汇集EF预测因素和结果的数据,包括死亡率和BPD.
主要成果:
- 较低的妊娠年龄,出生体重,月经后年龄和输出体重与更高的EF风险有关.
- 增加了输出前呼吸支 (以较低的pH值,较高的平均气道压力,FiO2和Pco2表示) 与EF相关.
- 输出失败与死亡率和/或BPD (OR 4.7) 的增加相关,包括单独的死亡率 (OR 3.87) 和BPD (OR 3.27).
结论:
- 较低的妊娠年龄和时间年龄,以及更高水平的预输出呼吸支,与早产新生儿的输出失败有关.
- 机器学习模型和肺部超声波显示出作为预测者的潜力,但需要进一步验证.
- 在这个人群中,输出失败是死亡率和支气管肺功能失调的重要危险因素.
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