在早产婴儿的NICU入院期间暴露于临床压力因素
Naomi J Meesters1, Gerbrich E van den Bosch1, Maria Luisa Tataranno2
1Division of Neonatology, Department of Neonatal and Pediatric Intensive Care, Erasmus MC -Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
European journal of pediatrics
|February 13, 2025
概括
新生儿重症监护室 (NICU) 的早产婴儿经历了相当大的压力,特别是那些妊娠年龄较低的婴儿. 减少压力的干预措施对于改善这些脆弱婴儿的结果至关重要.
科学领域:
- 新生儿医学 新生儿医学
- 儿科重症监护室的重症监护室
- 围产期研究 围产期研究
背景情况:
- 进入新生儿重症监护室 (NICU) 对早产婴儿来说是一个非常紧张的事件.
- 婴儿时期的高压力暴露与不利的长期发育结果有关.
研究的目的:
- 为了量化早产婴儿在NICU入院期间的压力暴露.
- 为了确定与该人口中高压力水平相关的风险因素.
主要方法:
- 一项涉及早产婴儿 (妊娠年龄<29周) 的全国性队列研究,这些婴儿被接收到荷兰10个NICU.
- 在新生儿重症监护室入院后的前期28天的随访情况.
- 利用NeO压力评分,一个验证的工具评估38个临床压力因素,量化每天的压力暴露.
- 采用线性混合建模来分析婴儿特征和产后年龄对压力评分的影响.
主要成果:
- 每天NeO压力评分的中位数为61,在入院当天达到峰值 (中位数为74).
- 鼻/口吸 (37%) 和内吸 (14%) 是导致压力的主要原因.
- 较低的妊娠年龄,不使用产前皮质类固醇和较低的5分钟Apgar分数与较高的每日NeO-压力分数有显著的关联.
- 该模型预测最年轻的婴儿随着时间的推移会增加NeO压力得分.
结论:
- 进入新生儿重症监护室的早产婴儿的压力暴露是动态的,受到各种因素的影响.
- 怀孕年龄最低的婴儿在整个新生儿重症监护室逗留期间面临持续高压力水平的风险最高.
- 这些发现强调了压力减轻策略的必要性,并突出了新生儿护理中有针对性的干预机会.
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