极度早产婴儿呼吸暂停的管理:欧洲调查
Anna Lavizzari1, G Jeroen Hutten2,3, Christian Heiring4
1Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Neonatology
|September 7, 2025
概括
在极度早产婴儿的呼吸暂停管理在欧洲各地有所不同,尽管咖啡因剂量一致. 需要进一步的研究来优化呼吸支策略和这些脆弱的婴儿的兴奋剂使用.
科学领域:
- 新生儿医学 新生儿医学
- 儿科肺病学 儿科肺病学
- 临床药房 临床药房
背景情况:
- 呼吸暂停是极度早产婴儿 (EPI) 的常见挑战,需要有效的管理策略.
- 目前的治疗包括咖啡因和呼吸辅助,但定义,监测和兴奋剂使用存在差异.
- 了解这些实践差异对于推进EPI中呼吸暂停治疗至关重要.
研究的目的:
- 调查目前欧洲新生儿重症监护室 (NICU) 监测和治疗EPI中呼吸暂停的做法.
- 为了识别咖啡因,多克萨普拉姆和非侵入性呼吸辅助的使用变异.
- 为未来的研究和临床指南提供信息,用于呼吸暂停管理.
主要方法:
- 在2024年3月至7月期间,向欧洲第三级NICU的主要顾问分发了一份基于网络的调查.
- 该调查收集了关于呼吸暂停的定义,监测技术 (心电图,脉冲氧计) 和治疗方法 (咖啡因,多克萨普拉姆,非侵入性通风) 的数据.
- 分析了来自24个欧洲国家的447个NICU的数据.
主要成果:
- 咖啡因酸盐是普遍使用的,23%的人在分娩室开始使用;剂量和断奶协议显示一致.
- 德克萨普拉姆的使用在地理位置上有所不同 (25%的NICU).
- 非侵入性呼吸辅助策略和自动闭环氧输送 (在25%的NICU中使用) 缺乏标准化的协议.
结论:
- 在欧洲早产婴儿的呼吸暂停治疗中存在显著的异质性,特别是在非侵入性支持方面.
- 需要对呼吸暂停的定义和监测实践进行标准化.
- 未来的研究应该优先考虑最佳的咖啡因时间/剂量,多克萨普拉姆的疗效和非侵入性呼吸辅助的优化.
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