全球对新生儿疼痛静坐的横截面调查:通过潜伏类分析揭示全球趋势和挑战
Cristina Arribas1, Giacomo Cavallaro2, Nunzia Decembrino3
1Neonatal Intensive Care Unit, Clínica Universidad de Navarra, Madrid, Spain.
European journal of pediatrics
|March 12, 2025
概括
全球新生儿疼痛治疗实践因地区和社会经济因素而异. 对新生儿镇静和疼痛管理的基于证据的指导方针的遵守仍然不一致,需要标准化的护理协议.
科学领域:
- 新生儿重症监护中心
- 药理学 药理学是指药理学的学科.
- 全球健康 全球健康
背景情况:
- 全球新生儿疼痛治疗处方模式存在显著差异,受人口结构和社会经济因素的影响.
- 尽管存在潜在的神经发育风险,但米达佐拉姆经常被使用,特别是在早产婴儿中.
- 目前关于新生儿止痛和镇静的指导方针尚未得到普遍实施,尤其是在社会人口统计指数较低的地区.
研究的目的:
- 在四个重症监护场景中分析新生儿疼痛治疗的全球处方模式.
- 探索处方模式,地理区域和社会人口统计指数 (SDI) 之间的关联.
- 评估在新生儿镇静中遵守基于证据的做法.
主要方法:
- 来自924个回复的2024年全球调查数据的分析.
- 隐性类别分析 (LCA) 用于将新生儿重症监护室 (NICU) 的处方分为不同的模式.
- 奇平方测试用于比较人口变量,包括地理区域和SDI,与处方模式.
主要成果:
- 确定了三种不同的处方模式用于输管前期治疗,新生儿镇静和围产期窒息管理.
- 欧洲和北美主要使用符合指导方针的模式 (芬太尼,氨酸,肌肉松剂) 进行输管.
- 高SDI的NICU更喜欢芬太尼用于新生儿镇静,而低SDI的NICU更喜欢米达佐或吗啡;芬太尼在周围窒息病例中很常见.
结论:
- 新生儿疼痛位存在实质性的区域差异,受SDI和地理因素的影响.
- 新生儿镇静指南的基于证据的实施中存在差距.
- 需要对新生儿护理协议进行全球标准化,并进一步研究米达佐拉姆和德克斯米德托米丁的长期安全性.
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