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新生儿复苏:澳大利亚和新西兰的通气设备综述与实践调查

Neonatal resuscitation: review of ventilation equipment and survey of practice in Australia and New Zealand.

作者信息

O'Donnell C P F, Davis P G, Morley C J

机构信息

Division of Neonatal Services, Royal Women's Hospital, Carlton, Victoria, Australia.

出版信息

J Paediatr Child Health. 2004 Apr;40(4):208-12. doi: 10.1111/j.1440-1754.2004.00339.x.

Abstract

OBJECTIVE

The equipment used to provide positive pressure ventilation at neonatal resuscitation varies between institutions. Available devices were reviewed and their use surveyed in a geographically defined region. The aim of this study was to establish which resuscitation equipment is used at neonatal intensive care units in Australia and New Zealand.

METHODS

A questionnaire was sent to a neonatologist at each of the 29 neonatal intensive care units in Australia and New Zealand, asking which resuscitation equipment they used. If it was not returned, follow up was by email and telephone.

RESULTS

Data was obtained from all units. Round face masks are used at all centres. Anatomically shaped masks are infrequently used at two of the three centres (10%) that have them. Straight endotracheal tubes are used exclusively at 23 (79%) centres. Shouldered tubes are used infrequently at three of the six centres that have them. The Laerdal Infant Resuscitator self-inflating bag is used at 22 (76%) centres. Flow-inflating bags are used at 12 (41%) centres. The Neopuff Infant Resuscitator is used at 14 (48%) centres. Varying oxygen concentrations are provided at delivery at 6/25 (24%) centres.

CONCLUSIONS

There is a paucity of evidence for the efficacy of the equipment used currently to resuscitate newborn infants. This complete survey of the tertiary centres in a geographical region shows considerable variation in practice, reflecting this lack of evidence and consequent uncertainty among clinicians. Further research is necessary to determine which devices are preferable for this most important and common intervention.

摘要

目的

各机构用于新生儿复苏时提供正压通气的设备不尽相同。对现有设备进行了审查,并在一个地理区域内对其使用情况进行了调查。本研究的目的是确定澳大利亚和新西兰的新生儿重症监护病房使用哪些复苏设备。

方法

向澳大利亚和新西兰29家新生儿重症监护病房的每位新生儿科医生发送了一份问卷,询问他们使用哪些复苏设备。若未回复,则通过电子邮件和电话进行跟进。

结果

从所有单位获取了数据。所有中心均使用圆形面罩。在拥有解剖学形状面罩的三个中心中的两个(10%),此类面罩使用频率较低。23个(79%)中心仅使用直管式气管内导管。在拥有带肩气管内导管的六个中心中的三个,此类导管使用频率较低。22个(76%)中心使用Laerdal婴儿复苏自充气式气囊。12个(41%)中心使用气流充气式气囊。14个(48%)中心使用Neopuff婴儿复苏器。6/25(24%)个中心在分娩时提供不同的氧浓度。

结论

目前用于复苏新生儿的设备疗效证据不足。对一个地理区域内三级中心的这项全面调查显示,实际操作存在很大差异,这反映了证据的缺乏以及临床医生由此产生的不确定性。有必要进行进一步研究,以确定哪些设备更适合这种最重要且常见的干预措施。

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