持续的正气道压力与甲基丁对早产婴儿的呼吸暂停
Muhd Alwi Muhd Helmi1, Prema Subramaniam2, Jacqueline J Ho3
1Department of Paediatrics, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Malaysia.
关于持续正气道压力 (CPAP) 与神叶素在治疗早产婴儿的呼吸暂停症的有效性,证据非常不确定. 在现代新生儿护理中,这两种治疗方法在很大程度上被新方法所取代.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 复发性呼吸暂停是早产婴儿的常见和严重疾病,可能导致低氧化和胆心梗塞.
- 持续正气道压力 (CPAP) 和甲基丁是广泛用于管理早产性呼吸暂停的干预措施.
研究的目的:
- 评估和比较CPAP与甲基丁对于早产婴儿的呼吸暂停的益处和危害.
- 综合这些干预措施的疗效和安全性随机对照试验的证据.
主要方法:
- 在多个数据库 (CENTRAL,MEDLINE,Embase,CINAHL) 进行了系统的文献搜索,直到2024年8月.
- 包括一项小规模随机对照试验 (RCT),涉及32名早产婴儿,将CPAP与神叶素进行比较.
- 使用Cochrane偏差风险工具 (RoB 1) 评估偏差风险;合成遵循SWiM指南.
主要成果:
- 关于CPAP和神叶素在治疗失败 (RR 2.89,95% CI 1.12至7.47) 和死亡率 (RR 2.57,95% CI 0.97至6.82) 中的差异的证据非常不确定.
- 对于心动节拍 (RR 0.10,95% CI 0.01至1.60) 的证据也非常不确定;没有报告其他不良反应和长期结果.
- 包含的研究存在高偏差风险,原因是基线不平衡,缺乏盲目化和早期停止.
结论:
- 这项单一的,小规模的,过时的研究提供了非常不确定的证据,证明了CPAP和西奥菲林对早产性呼吸暂停的比较有效性.
- 在当前的新生儿实践中,这两种干预措施都已被鼻腔CPAP和咖啡因/氨基林在很大程度上取代.
- 未来的研究应该利用现代CPAP输送方法和咖啡因,特别是在低收入和中等收入国家,那里咖啡因的获取可能有限.
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