University of Alabama, Birmingham, AL, USA.
J Pediatr. 2012 May;160(5):781-5.e1. doi: 10.1016/j.jpeds.2011.10.007. Epub 2011 Nov 17.
To determine whether resuscitation of infants who failed to develop effective breathing at birth increases survivors with neurodevelopmental impairment.
Infants unresponsive to stimulation who received bag and mask ventilation at birth in a resuscitation trial and infants who did not require any resuscitation were randomized to early neurodevelopmental intervention or control groups. Infants were examined by trained neurodevelopmental evaluators masked to both their resuscitation history and intervention group. The 12-month neurodevelopmental outcome data for both resuscitated and non-resuscitated infants randomized to the control groups are reported.
The study provided no evidence of a difference between the resuscitated infants (n = 86) and the non-resuscitated infants (n = 115) in the percentage of infants at 12 months with a Mental Developmental Index <85 on the Bayley Scales of Infant Development-II (primary outcome; 18% versus 12%; P = .22) and in other neurodevelopmental outcomes.
Most infants who received resuscitation with bag and mask ventilation at birth have 12-month neurodevelopmental outcomes in the reference range. Longer follow-up is needed because of increased risk for neurodevelopmental impairments.
确定在出生时未能出现有效呼吸的婴儿进行复苏是否会增加神经发育受损的幸存者。
在一项复苏试验中,对出生时对刺激无反应且接受气囊面罩通气的婴儿以及无需任何复苏的婴儿进行随机分组,分别进入早期神经发育干预组或对照组。由经过培训的神经发育评估员对婴儿进行检查,评估员对婴儿的复苏史和干预组均不知情。报告了随机分配至对照组的接受复苏和未接受复苏的婴儿在 12 个月时的神经发育结局数据。
研究结果并未表明在 12 个月时,接受气囊面罩通气复苏的婴儿(n=86)与未接受复苏的婴儿(n=115)在贝利婴幼儿发展量表 II (Bayley Scales of Infant Development-II)的精神发育指数<85的婴儿比例(主要结局;18%比 12%;P=.22)和其他神经发育结局方面存在差异。
大多数接受气囊面罩通气复苏的出生婴儿在 12 个月时具有参考范围内的神经发育结局。由于神经发育受损的风险增加,需要进行更长时间的随访。