Chabernaud J-L, Gicquel C, Ammar F, Jourdain G, Quentin P, Castel C, Boithias C, Dehan M
SMUR Pédiatrique des Hauts-de-Seine (SAMU 92) et Service de Pédiatrie et Réanimation Néonatales, Hôpital Antoine Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart Cedex.
J Gynecol Obstet Biol Reprod (Paris). 2005 Feb;34(1 Suppl):S25-32. doi: 10.1016/s0368-2315(05)82683-3.
Most of the contemporary guidelines on newborn resuscitation are based on experience but lack scientific evidence. The use of 100% oxygen is one of the more evident. Today, these practices are questioned, particularly for the resuscitation of moderately depressed full term or near term newborns. Results of recent meta-analysis of trials that compared ventilation with air versus pure oxygen at birth suggests current practices should be revisited. On the basis of these data, air can be the initial gas to use for these babies. Large scale trials, including preterm and cause and/or severity of initial asphyxia, must now be undertaken before the publication of new guidelines for these populations. Particularly severely asphyxiated infants might require supplemental oxygen with titration of oxygen delivery and continuous monitoring of oxygen saturation.
大多数当代新生儿复苏指南是基于经验制定的，但缺乏科学依据。使用100%氧气就是一个较为明显的例子。如今，这些做法受到了质疑，尤其是在对中度窒息的足月儿或近足月儿进行复苏时。近期对出生时空气通气与纯氧通气进行比较的试验的荟萃分析结果表明，当前的做法应该重新审视。基于这些数据，空气可以作为这些婴儿最初使用的气体。在为这些人群发布新指南之前，现在必须开展大规模试验，包括针对早产儿以及初始窒息的原因和/或严重程度的试验。特别是重度窒息婴儿可能需要补充氧气，并对氧气输送进行滴定以及持续监测血氧饱和度。
