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在早产婴儿接受血动力学显著的专利通道动脉的药物治疗的标准和限制液体的管理

Angela Paladini¹, Vito D'Andrea², Anthea Bottoni²

¹Dipartimento Universitario Scienze della Vita e Sanità Pubblica, UOC di Neonatologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy. angela.paladini@policlinicogemelli.it.

Pediatric research

|October 28, 2025

概括

在早产婴儿治疗专利动脉管 (PDA) 时,限制液体不会改善闭合率,但可能会损害生长. 建议进行个性化流体管理,以获得更好的新生儿结果.

科学领域:

新生儿医学新生儿医学
儿童心脏病学儿童心脏病学
关键护理医学关键护理医学

背景情况:

在专利导管动脉 (PDA) 治疗期间的液体管理是有争议的,传统的液体限制缺乏明确的结果效益.
流体限制对患有血液动力学显著PDA (hsPDA) 的早产新生儿的影响需要进一步调查.

研究的目的:

为了比较较高流体摄入方案与限制性流体方法对PDA关闭率,生长和早产新生儿并发症的影响.
评估在接受hsPDA药物治疗的婴儿中流体管理策略的临床意义.

主要方法:

一项追溯前性队列研究,比较两组接受药理PDA治疗的早产新生儿.
一个队列 (2021-2023) 接受了更高的液体摄入量 (80-100毫升/公斤/天),而另一个队列 (2018-2020) 遵循了限制性方案 (70毫升/公斤/天,限制为5-20%).
评估的结果包括PDA关闭率,生长参数 (体重z分数) 和新生儿并发症 (IVH,NEC,CLD).

主要成果:

在较高的液体摄入量和限制液体的组之间,hsPDA关闭率或新生儿重大并发症没有显著差异.
流体受限的新生儿经历了更多的中央导管日,并延迟了完全肠道养的时间.
在限制流体的组中观察到排放时较差的增长,由较低的体重z-score表明.

结论:

在药理PDA治疗期间的液体限制可能会对早产婴儿的生长和临床护理产生负面影响,但不会改善PDA关闭率.
建议采用个性化和平衡的流体管理策略,以潜在地提高新生儿的结果.
研究结果支持在hsPDA的管理中远离常规的液体限制,主张进一步研究最佳的水化策略.

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