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呼吸护理方案的有效性,包括在35周或更长的妊娠期内少侵袭地表面活性剂的使用
Etze Chotzoglou1, Arun Prasath1, Riddhi Desai1
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
实施呼吸护理方案 (RCP) 增加了早产婴儿的表面活性剂使用,改善了氧化,但不是整体结果. 需要对35周以上妊娠年龄的婴儿进行更少侵入性的表面活性剂 (LISA) 管理进行进一步的研究.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统护理 呼吸系统护理
- 儿科肺病学 儿科肺病学
背景情况:
- 2018年10月,为持续正气道压力 (CPAP) 的早产婴儿引入了一项包含少侵入性表面活性剂 (LISA) 的呼吸护理协议 (RCP).
- 本研究评估了RCP实施后呼吸护理实践和结果的变化.
研究的目的:
- 为了比较呼吸护理实践和临床结果在婴儿≥35周妊娠年龄之前和之后引入一个RCP.
- 评估RCP对表面活性剂使用,氧气需求和呼吸系统严重性的影响.
主要方法:
- 一项回顾性队列研究比较了2016年1月至2018年9月 (RCP前) 和2018年10月至2021年12月 (RCP后) 的婴儿.
- 包括≥35周妊娠年龄的婴儿,需要CPAP<24小时且没有气吸收综合征.
- 分析了呼吸支,表面活性剂的使用,氧化和临床结果.
主要成果:
- 在RCP后的队列显示,与RCP前的队列相比,表面活性剂治疗使用量增加 (8%与22%,p<0.001).
- 在RCP后组的表面活性剂治疗与减少的FiO2需求和较低的呼吸系统严重性得分有关.
- 在这两组人群之间,在机械通风的需要,肺胸炎发病率或住院时间之间没有发现显著差异.
结论:
- 实施RCP导致表面活性剂的使用增加,并改善了≥35周GA的婴儿的氧化参数.
- 尽管氧化得到改善,但RCP并没有显著改变主要的临床结果.
- 需要进一步的研究来确定LISA在这个患者群体中的特定作用和疗效.
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