较少的侵入性表面活性剂管理与输管-表面活性剂-输管:与极度早产婴儿的机械通风减少有关
C Heiring1,2, S S Hedegaard3, E M Carlsen1,2
1Department of Neonatal and Pediatric Intensive Care, Copenhagen University Hospital, Copenhagen, Denmark.
Acta paediatrica (Oslo, Norway : 1992)
|February 26, 2025
概括
与输管-表面活性剂-输出管 (INSURE) 方法相比,在早产婴儿中,较少侵入性表面活性剂的使用 (LISA) 减少了机械通风 (MV) 的需要. 这一发现即使在没有针对LISA实施的专业预先培训的情况下也是如此.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统护理 呼吸系统护理
- 儿科手术 儿科手术
背景情况:
- 表面活性剂替代疗法对于管理早产婴儿的呼吸应急综合征至关重要.
- 较少侵入性表面活性剂 (LISA) 和输管-表面活性剂-输出管 (INSURE) 是两种常见的表面活性剂输送方法.
- 对比这些方法的疗效和结果对于优化新生儿呼吸系统护理至关重要.
研究的目的:
- 为了比较少侵入性表面活性剂 (LISA) 与输入管-表面活性剂-输出管 (INSURE) 在妊娠28周之前出生的婴儿的有效性.
- 确定这些表面活性剂的施用方法对机械通风 (MV) 的要求的影响.
主要方法:
- 在2017年7月至2021年7月期间,对怀孕28周之前出生的婴儿的医疗记录进行了回顾性审查.
- 婴儿接受了LISA或INSURE治疗,LISA在没有正式的先前培训的情况下被引入治疗.
- 使用后勤回归分析了主要结果 (需要在72小时内获得MV) 和二次结果,并调整了混因素.
主要成果:
- 总共有108名婴儿进行了分析 (51名LISA,57名INSURE).
- LISA与在72小时内 (aOR:0.40) 和入院期间 (aOR:0.199) 显著减少机械通风的需求有关.
- 没有观察到MV持续时间,整体呼吸支持续时间,首次通过成功率或其他新生儿发病率的显著差异.
结论:
- 与INSURE方法相比,较少侵入性表面活性剂 (LISA) 的使用与极度早产婴儿的机械通风需求减少有关.
- 在减少机械通风需求方面,即使在没有广泛的先前正式培训的情况下实施LISA,也可以实现LISA的好处.
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