在早产婴儿的辅助通风中延迟带紧期间的生理过渡: VentFirst试验的二次分析
Jennifer L Fang1, Karen D Fairchild2, Gina R Petroni3
1Division of Neonatal Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA network open
|November 24, 2025
概括
在延迟带紧 (DCC) 期间辅助通风减少了早产婴儿的输内管道,这些婴儿呼吸不好. 在DCC期间的这种干预可能会改善极早新生儿的复苏.
科学领域:
- 新生儿复苏新生儿的复苏
- 周产期生理学 周产期生理学
- 临床试验 临床试验
背景情况:
- 延迟带紧 (DCC) 可能会改善极度早产婴儿的生理过渡.
- 在DCC期间的辅助呼吸是一种潜在的干预措施,以增强新生儿复苏.
研究的目的:
- 评估120秒DCC的辅助通风是否减少了较高水平的复苏干预措施,而不是较短的DCC (30-60秒) 之后的复苏.
- 分析23至28周妊娠年龄 (GA) 之间出生的婴儿的结局.
主要方法:
- 对VentFirst随机临床试验 (NCT02742454) 的二次分析.
- 包括570名23至28周出生的婴儿"GA.
- 在120秒DCC期间接受辅助通风的婴儿与30-60秒DCC随后进行通风的婴儿之间的结果比较.
主要成果:
- 在DCC期间的辅助呼吸与婴儿在分娩室 (DR) 输入管的数量显著减少,婴儿在30秒内呼吸不好 (OR,0.52).
- 这种益处在26至28周的GA出生后的婴儿中最为明显,这些婴儿呼吸不好 (OR,0.32).
- 对于30秒后呼吸良好的婴儿或23-25周的GA之间的婴儿,没有观察到输管率的显著差异.
结论:
- 在DCC期间辅助通风似乎可以减少对极度早产婴儿的特定亚组在DR中输管的需要.
- 这些发现表明,在26-28周的GA出生后,需要复苏的婴儿可能会受益.
- 需要进一步的研究来证实这些发现,并指导临床实践在DCC期间对辅助通风进行指导.
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