在分娩室内少侵袭地施用表面活性剂:质量改进倡议
Jonathan R Burris1, Blair F Germain2, Patricia R Chess2
1Department of Pediatrics, Division of Neonatology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 651, Rochester, NY, 14642, USA. jonathan_burris@urmc.rochester.edu.
概括
在分娩室内进行少入侵的表面活性剂 (LISA) 管理是治疗呼吸系统应急综合征 (RDS) 的安全和有效方法. 这种方法显著减少了婴儿输管和机械通风的需要.
科学领域:
- 新生儿医学 新生儿医学
- 儿科呼吸系统护理 儿童呼吸系统护理
- 密集护理医学 密集护理医学
背景情况:
- 呼吸应急综合征 (RDS) 是早产婴儿常见的疾病.
- 输管和机械通风是RDS的标准但侵入性治疗方法.
- 较少侵入性表面活性剂管理 (LISA) 提供了一个潜在的较少负担的替代方案.
研究的目的:
- 评估LISA在分娩室 (DR) 的实施,作为新生儿稳定的一部分.
- 为了减少需要输管治疗RDS的婴儿数量.
- 增加从未需要输管治疗的婴儿比例.
主要方法:
- 制定了一个SMART目标,将LISA应用于超过30%的患有RDS的婴儿 (25.0-31.6周妊娠年龄) 中.
- 三个连续的计划-做-研究-行动周期被用于实施.
- 统计过程控制图表监控时间顺序的数据来跟踪进展.
主要成果:
- 在4年的时间里,184名患者接受了LISA治疗,112名患者接受了DR治疗.
- 发现LISA在98.9%的病例中是安全和成功的,包括DR管理.
- 产房输管率从65.5%下降到52.6%,而从未输管的婴儿从22.8%增加到38%.
结论:
- 在分娩室的LISA是管理RDS的安全有效策略.
- 实施LISA与减少输管和机械通风的需求有关.
- LISA的使用与支气管肺发育不良症 (BPD) 的减少相关.
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