Buckmaster Adam G, Arnolda Gaston Rb, Wright Ian Mr, Henderson-Smart David J
Northern Sydney Central Coast Area Health Service, Gosford Hospital, Gosford, NSW, Australia.
J Paediatr Child Health. 2007 May;43(5):376-82. doi: 10.1111/j.1440-1754.2007.01083.x.
This study sought to identify the number of special care nurseries (SCNs) already using CPAP in 2004, and the number considering its use in the following 2 years, and to describe the characteristics of those hospitals.
All Australian hospitals with >200 registered deliveries in the year 2002, a SCN and at least one paediatrician were eligible (n = 157). Separate questionnaires were sent to the nurse unit manager (NUM) and the paediatrician responsible for the SCN in late 2004.
Of 157 eligible SCNs, 143 (91%) responded. CPAP was being used in 24/143 (17%). Of those nurseries not already using CPAP a further 45/119 (38%) were considering doing so in 2005/2006. State/Territory, greater availability of junior medical staff, use of a helicopter/airplane for transferring infants to tertiary centres and number of paediatricians were significantly associated with use of CPAP (all P < 0.05). Consideration of use was significantly associated with greater availability of junior medical staff, larger numbers of births and time to nearest (tertiary) centre (all P < 0.05).
There is a strong predisposition for the use of CPAP in SCNs despite the lack of evidence for its benefits or risks there. Studies are urgently required on the clinical benefits and risks of CPAP in a non-tertiary centre before the widespread introduction of CPAP takes place.
本研究旨在确定2004年已在使用持续气道正压通气(CPAP)的特殊护理病房(SCN)数量,以及在接下来两年中考虑使用CPAP的数量,并描述这些医院的特征。
2002年登记分娩量超过200例、设有SCN且至少有一名儿科医生的所有澳大利亚医院均符合条件(n = 157)。2004年末,分别向护士单元经理(NUM)和负责SCN的儿科医生发送了单独的调查问卷。
在157个符合条件的SCN中,143个(91%)做出了回应。24/143(17%)的SCN正在使用CPAP。在尚未使用CPAP的托儿所中,另有45/119(38%)的托儿所考虑在2005/2006年使用。州/领地、初级医务人员的更多可获得性、使用直升机/飞机将婴儿转运至三级中心以及儿科医生数量与CPAP的使用显著相关(所有P < 0.05)。对使用的考虑与初级医务人员的更多可获得性、更高的分娩数量以及到最近(三级)中心的时间显著相关(所有P < 0.05)。
尽管缺乏关于CPAP在SCN中的益处或风险的证据,但在SCN中使用CPAP的倾向很强。在广泛引入CPAP之前,迫切需要对非三级中心中CPAP的临床益处和风险进行研究。