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皮肤接触护理期间的心动过缓和血氧饱和度下降:与体温过高无关。

Bradycardia and desaturation during skin-to-skin care: no relationship to hyperthermia.

作者信息

Bohnhorst Bettina, Gill Diana, Dördelmann Michael, Peter Corinna S, Poets Christian F

机构信息

Department of Neonatology and Pediatric Pulmonology, Hannover Medical School, Hannover, Germany.

出版信息

J Pediatr. 2004 Oct;145(4):499-502. doi: 10.1016/j.jpeds.2004.06.019.

Abstract

OBJECTIVE

We recently found increased temperature and increased bradycardia and desaturation during skin-to-skin care (SSC). We wanted to determine if these effects were related.

STUDY DESIGN

Twenty-two infants (median gestational age at birth 28.5 weeks [range 24-31], median age at study 25.5 days [range 10-60 days], median birth weight 1025 g [range 550-1525 g], median weight at study 1320 g [range 900-2460 g]) underwent three 2-hour recordings of breathing movements, nasal airflow, heart rate, and pulse oximeter saturation (SpO 2 ): at thermoneutrality (TN) during incubator care, at TN during SSC, and at elevated temperature (ET) during incubator care. Core temperature was measured via a rectal probe. Recordings were analyzed for the summed rate of bradycardia and desaturation (heart rate <2/3 of baseline; SpO 2 <or=80%).

RESULTS

Rectal temperature remained unchanged during SSC and increased by 0.6 degrees C during ET ( P < .001). The summed rate of bradycardia and desaturation was increased during SSC but not during ET (TN: median 2.2/hour (range, 0-19), ET: median 1.7/hour (range, 0-13), SSC: 3.0/hour (0-25), P < .02 SSC vs ET).

CONCLUSION

Bradycardia and desaturation were increased during SSC, even at constant rectal temperature, whereas ET had no effect on these events. Moderate hyperthermia did not increase respiratory instability in preterm infants.

摘要

目的

我们最近发现,在皮肤接触护理(SSC)期间,体温升高,心动过缓和血氧饱和度下降。我们想确定这些影响是否相关。

研究设计

22名婴儿(出生时胎龄中位数为28.5周[范围24 - 31周],研究时年龄中位数为25.5天[范围10 - 60天],出生体重中位数为1025克[范围550 - 1525克],研究时体重中位数为1320克[范围900 - 2460克])接受了三次为期2小时的呼吸运动、鼻气流、心率和脉搏血氧饱和度(SpO₂)记录:在暖箱护理时处于中性温度(TN)、在SSC时处于TN以及在暖箱护理时处于高温(ET)。通过直肠探头测量核心温度。对心动过缓和血氧饱和度下降的总发生率(心率<基线的2/3;SpO₂≤80%)进行记录分析。

结果

在SSC期间直肠温度保持不变,在ET期间升高了0.6℃(P <.001)。心动过缓和血氧饱和度下降的总发生率在SSC期间增加,但在ET期间未增加(TN:中位数2.2次/小时(范围0 - 19),ET:中位数1.7次/小时(范围0 - 13),SSC:3.0次/小时(0 - 25),SSC与ET相比P <.02)。

结论

即使直肠温度恒定,在SSC期间心动过缓和血氧饱和度下降仍会增加,而ET对这些事件没有影响。中度体温过高不会增加早产儿的呼吸不稳定性。

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