早期流体状况和严重的腹腔内出血或极度早产婴儿的死亡
Lucinda J Weaver1, Samuel J Gentle1, Arie Nakhmani2
1Department of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Pediatric nephrology (Berlin, Germany)
|September 24, 2025
概括
极度早产婴儿的早期液体平衡与严重的腹腔内出血 (sIVH) 和死亡有关. 监测流体状态可以改善这些关键结果的预测模型.
科学领域:
- 新生儿科学 新生儿科学
- 儿科重症监护中心儿童重症监护中心
- 围产儿医学 围产儿医学
背景情况:
- 产后早期的液体平衡是严重腹腔内出血 (sIVH) 和极度早产婴儿死亡的潜在因素.
- 了解出生后第一周的流体动力学对于管理高风险新生儿至关重要.
研究的目的:
- 调查早期产后液体平衡测量与极度早产婴儿sIVH和/或死亡风险之间的关联.
- 评估液体平衡指标在识别患有sIVH和/或死亡风险的婴儿方面的预测性能.
主要方法:
- 从2014年到2021年,对932名婴儿进行了回顾性队列研究 (怀孕22至27周,出生体重≥400克).
- 纵向混合效应模型比较了有和没有sIVH/死亡的婴儿的每日液体平衡 (血清,体重变化,摄入量,输出量).
- 为了预测sIVH/死亡,开发了回归和机器学习模型,结合了液体平衡和临床变量.
主要成果:
- 较低的百分比体重变化,较高的液体摄入量,较高的水平和积极的早期液体平衡与sIVH和/或死亡有显著的关联.
- 结合液体平衡测量的模型显示,sIVH/死亡的预测得到了改善 (回归的AUC从0.75增加到0.80,机器学习的AUC从0.72增加到0.84).
结论:
- 早期产后液体状况是极度早产婴儿sIVH和/或死亡风险的重要指标.
- 结合流体平衡测量方法,可以大大提高sIVH和/或死亡预测模型的准确性.
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