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[国际复苏联络委员会关于早产儿和足月儿的新复苏指南:批判性讨论及实施建议]

[ILCOR's new resuscitation guidelines in preterm and term infants: critical discussion and suggestions for implementation].

作者信息

Hansmann G, Humpl T, Zimmermann A, Bührer C, Wauer R, Stannigel H, Hoehn T

机构信息

Institutsangaben sind am Ende des Beitrags gelistet.

出版信息

Klin Padiatr. 2007 Mar-Apr;219(2):50-7. doi: 10.1055/s-2007-970072. Epub 2007 Mar 20.

Abstract

Recommendations of the International Liaison Committee on Resuscitation (ILCOR) become updated every five years with changing evidence resulting in revised recommendations for clinical practice. New data exist concerning the adequate oxygen concentration to be used in the delivery room, the management of imminent meconium aspiration, ventilation strategies and the role of body temperature during and after resuscitation of preterm and term newborn infants. Only in some cases new evidence has led to clear-cut recommendations for or against specific interventions. Therefore the present publication cites the original ILCOR-recommendations and discusses these with regard to their practical implementation. The authors of the present work suggest to commence resuscitation independendly of gestational age with room air and adjust the inspiratory oxygen concentration thereafter on clinical grounds. The authors also advocate the retention of the presently performed intranatal suction procedure in cases of meconium-stained amniotic fluid and the use of therapeutic hypothermia following perinatal asphyxia in term newborns according to the protocol of one of the published randomized, controlled trials. Standard equipment for neonatal resuscitation should include pressure gauge for monitoring of inspiratory pressures, oxygen blender, and pulse oxymeter. The predominant majority of ILCOR-recommendations have only been cited and have been commented with respect to their practical implementation within the clinical context.

摘要

国际复苏联合委员会(ILCOR)的建议每五年更新一次,随着证据的变化,临床实践的建议也会修订。关于产房使用的适当氧浓度、即将发生的胎粪吸入的处理、通气策略以及早产和足月新生儿复苏期间及之后体温的作用,有了新的数据。只有在某些情况下,新证据才导致对特定干预措施明确的支持或反对建议。因此,本出版物引用了ILCOR的原始建议,并讨论了其实际应用。本研究的作者建议,无论胎龄如何,均应使用空气开始复苏,然后根据临床情况调整吸入氧浓度。作者还主张,对于羊水胎粪污染的情况,保留目前进行的产时吸引程序,并根据已发表的一项随机对照试验方案,对足月新生儿围产期窒息后使用治疗性低温。新生儿复苏的标准设备应包括用于监测吸气压力的压力计、氧气混合器和脉搏血氧仪。大多数ILCOR建议仅被引用,并就其在临床背景下的实际应用进行了评论。

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