常规36周扫描:预测长时间的新生儿重症监护室入院情况
A Arechvo1,2, E Demertzidou3, S Adjahou1
1Fetal Medicine Research Institute, King's College Hospital, London, UK.
概括
母亲因素,36周超声波扫描和分娩数据有助于预测新生儿重症监护室 (NICU) 长期入院的情况. 然而,超过40%的这些入院患者在出生前仍然无法预测.
科学领域:
- 孕产妇与胎儿的医学
- 新生儿重症监护室新生儿重症监护室
- 预测性诊断是一种预测性诊断.
背景情况:
- 预测新生儿重症监护室 (NICU) 长期入院对于资源配置和优化新生儿护理至关重要.
- 母亲的人口统计特征和病史是已知的风险因素,但它们对长期新生儿重症监护室停留的预测能力需要进一步调查.
- 第三个三个月的超声波发现和劳动/分娩数据对现有的预测模型的附加值尚未完全确定.
研究的目的:
- 评估母亲因素对长时间入院的NICU的预测性贡献.
- 评估36周超声波扫描结果在预测延长NICU入院的增加值.
- 确定母性特征,超声波数据和长时间NICU停留的劳动/分娩信息的综合预测性能.
主要方法:
- 一组107,762名单独怀孕的妇女接受了评估,包括病史,胎儿体重估计 (EFW) 和多普勒测量 (子宫动脉PI,动脉PI,胎儿中脑动脉PI) 在怀孕35-36周.
- 采用多变量后勤回归模型来分析母体因素,36周扫描结果和劳动/分娩数据对延长NICU入院的独立贡献.
- 检测率 (DRs) 和接收器运行特征曲线 (AUCs) 下的区域被计算出来,以比较不同模型的预测性能.
主要成果:
- 母亲因素如BMI,社会剥夺,试管婴儿受孕,慢性高血压,糖尿病和妊娠前明显预测了长时间的新生儿重症监护室入院 (AUC 0.606).
- 36周扫描结果,包括胎液指数和带/中脑动脉PI,改善了预测 (AUC0.637与母亲因素).
- 结合劳动和分娩数据 (分娩时的妊娠年龄,分娩方式,出生体重百分比) 进一步提高了预测 (AUC 0.709),达到 57.2% DR 在非产妇事件的10% FPR (AUC 0.790).
结论:
- 母亲因素,36周超声波结果,以及分娩数据独立地对预测长时间入院的NICU做出了贡献.
- 尽管有显著的预测性贡献,但超过40%的长期NICU入院在产前仍然无法预测.
- 这些发现凸显了NICU入院的多因素性质和产前预测的局限性.
相关概念视频
01:19Restorative Care
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:21Planning Nursing Care I
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
01:30Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
01:30Pneumonia V: Nursing management and Prevention
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.