在出生时启动胸部压缩的胸部压缩的门:叙述性审查
Mathijs Binkhorst1, Elroy van Elsäcker2, René P Matthijsse2
1Division of Neonatology, Department of Pediatrics, Radboud University Medical Center, Radboud Institute for Health Sciences (RIHS), Amalia Children's Hospital, Nijmegen, the Netherlands. mathijs.binkhorst@radboudumc.nl.
概括
目前关于新生儿复苏的指导方针建议,如果新生儿开始进行胸部压缩 (CC),那么
科学领域:
- 新生儿医学 新生儿医学
- 儿童心脏病学 儿童心脏病学
- 复苏科学复苏科学 复苏科学
背景情况:
- 目前的新生儿复苏指南建议在呼吸30秒后,对于心率 (HR) 低于60拍/分钟的新生儿,启动胸部压缩 (CC).
- 本建议主要基于专家意见和有限的动物数据,缺乏强有力的临床证据.
研究的目的:
- 系统地评估现有证据,并评估当前有关心率值的见解,以启动在出生时新生儿胸肌梗塞期间的胸部压缩.
- 探索专家的意见,目前的门开始胸部压缩在新生儿经历心.
主要方法:
- 更新了之前的范围审查,通过系统的文献搜索 (MEDLINE,Embase,Cochrane) 更新到2024年3月,重点关注CC的HR门.
- 进行了病理生理学考虑,体外,动物和人类数据的叙述性审查,并补充了初步的数学建模结果.
- 向新生儿临床医生和研究人员传播了一项调查,以收集关于启动新生儿胸的CC的观点.
主要成果:
- 没有直接比较新生儿中CC开始的HR值的研究被确定.
- 大多数受访专业人士 (74.9%) 表示,如果HR在30-60bpm之间上升,他们愿意在启动AC之前等待30秒以上的辅助通风.
- 受访者优先考虑有效的通风,而不是在边界白心症中立即启动CC.
结论:
- 缺乏强有力的临床证据来支持目前的HR值,以启动新生儿复苏时的胸部压缩.
- 根据现有数据和专家的共识,重新考虑在新生儿胸中启动CC的门似乎是合理的.
- 人类婴儿的随机对照试验和适当的新生儿动物模型是建立基于证据的指导方针的必要条件.
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