Mosca F, Colnaghi M
UO di Neonatologia e Terapia Intensiva Neonatale, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano.
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):15-6.
Over the most recent 10 years there have been no significant further improvements in survival or morbidity rates of preterm infants, mostly the extremely-low-gestational-age-neonates (ELGANs, defined as less than or equal to 28 weeks' gestation).The incidence of some of the major morbidities associated with extreme prematurity, such as BPD, could potentially be affected by management in the first minutes of life; it may be necessary to apply the principles of care that occur in the neonatal intensive care unit in the delivery room to achieve a further improvements in short and long-term outcome of these neonates. Up to now, the care of the smallest preterm infants in the delivery room has received little attention: few resuscitation protocols addressed to these newborns, not advanced equipment used and subjective monitoring based on clinical examination. Therefore, it may be useful to incorporate an intensive care environment into the delivery room to enhance survival rates and reduce morbidity of the extremely preterm infants. New approaches in the first minutes of life using more gentle parameters of intervention are being studied but further evidence is needed to improve resuscitation procedures in these newborns.
在过去的10年里,早产儿尤其是极早早产儿(定义为胎龄小于或等于28周的新生儿)的生存率和发病率没有显著进一步改善。一些与极早早产相关的主要疾病的发病率,如支气管肺发育不良(BPD),可能会受到出生后最初几分钟管理措施的影响;可能有必要在产房应用新生儿重症监护病房的护理原则,以进一步改善这些新生儿的短期和长期预后。到目前为止,产房里最小的早产儿护理很少受到关注:针对这些新生儿的复苏方案很少,没有使用先进设备,且基于临床检查的监测主观性强。因此,在产房引入重症监护环境可能有助于提高极早早产儿的生存率并降低其发病率。目前正在研究在出生最初几分钟采用更温和干预参数的新方法,但还需要更多证据来改进这些新生儿的复苏程序。