新生儿科医生在新生儿重症监护室查和管理皮质类固醇诱导的上腺功能衰竭的实践-一个多中心研究
Sean Christopher Watson1, Parvesh Mohan Garg1, Cathrine Constantacos2
1Wake Forest University School of Medicine, Department of Neonatology, Winston-Salem, NC, USA.
概括
新生儿科医生在查和管理新生儿皮质类固醇诱导的上腺抑制 (AS) 方面表现出各种做法. 这种不一致凸显了需要标准化的临床指导方针,以确保在NICU中为婴儿提供最佳的护理.
科学领域:
- 新生儿医学 新生儿医学
- 儿科内分泌学 儿科内分泌学
- 临床实践的变性 临床实践的变性
背景情况:
- 皮质类固醇经常用于新生儿重症监护室 (NICU).
- 长时间使用皮质类固醇可以导致上腺抑制 (AS),这是一种潜在的严重疾病.
- 目前对新生儿AS的查和管理实践还没有得到很好的定义.
研究的目的:
- 调查新生儿科医生如何查和管理新生儿重症监护室内皮质类固醇诱导的上腺抑制 (AS) 的多样性.
- 识别AS的诊断工具和治疗方法的变化.
- 评估护理人员在离院时对AS的教育程度.
主要方法:
- 在儿童医院新生儿联盟中,向160名新生儿科医生分发了一项全国横截面调查.
- 用描述性统计数据分析了查方法,诊断测试,管理策略和出院计划的数据.
- 82名新生儿科医生完成了调查,为他们的临床实践提供了洞察力.
主要成果:
- 只有56.1%的新生儿科医生在长期暴露于全身皮质类固醇后对婴儿进行AS的查.
- 上皮质激素 (ACTH) 刺激测试被59.8%的受访者用于AS诊断.
- 吸入性皮质类固醇使用后对AS的查很少 (2.4%),这表明对其抑制作用的不确定性.
结论:
- 在全国范围内的查和对NICU婴儿上腺抑制的管理中存在显著的变化.
- 这种不一致表明缺乏标准化实践,并强调需要基于证据的临床指导方针.
- 制定明确的指导方针对于优化患AS风险的婴儿的护理和结果至关重要.
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