美国新生儿重症监护病房中治疗性低体温的认知和实践。
Perceptions and practices of therapeutic hypothermia in American neonatal intensive care units.
机构信息
Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
Division of Healthcare Policy and Research, Mayo Clinic, Rochester, Minnesota.
出版信息
Am J Perinatol. 2014 Jan;31(1):15-20. doi: 10.1055/s-0033-1334454. Epub 2013 Mar 1.
OBJECTIVE
In 2005, therapeutic hypothermia (TH) was used in few American neonatal intensive care units (NICUs) with great variability in practices. We hypothesized that TH would be used with greater frequency and uniformity today.
STUDY DESIGN
We surveyed directors of 797 NICUs queried in our prior study to determine attitudes toward and practices of TH.
RESULTS
Of the 781 participants with valid addresses, we received completed surveys from 330 (42.3%). There was an increase in the number of respondents who believed that TH is effective (85% versus 31%, p < 0.0001). More NICUs used TH (50% versus 6%, p < 0.0001) and nearly all not offering TH transferred eligible neonates to centers that did (97% versus 29%, p < 0.0001). There has been increased standardization of TH practices with regard to enrollment criteria, duration, and methods of monitoring.
CONCLUSION
TH has become standard of care for the treatment of HIE in the United States. Most NICUs that use TH adhere to protocols, but variation still exists in TH practices.
目的
2005 年，在美国少数新生儿重症监护病房（NICU）中使用了治疗性低体温（TH），且实践中存在很大的差异。我们假设，如今 TH 的使用频率和一致性会更高。
研究设计
我们调查了我们之前研究中询问的 797 家 NICU 的主任，以确定他们对 TH 的态度和实践。
结果
在 781 名有有效地址的参与者中，我们收到了 330 名（42.3%）的完整回复。相信 TH 有效的回答者数量有所增加（85%对 31%，p<0.0001）。更多的 NICU 使用 TH（50%对 6%，p<0.0001），几乎所有不提供 TH 的 NICU 都将符合条件的新生儿转至提供 TH 的中心（97%对 29%，p<0.0001）。TH 的实践在纳入标准、持续时间和监测方法方面已经更加标准化。
结论
TH 已成为美国治疗 HIE 的标准治疗方法。大多数使用 TH 的 NICU 都遵守方案，但 TH 的实践仍存在差异。
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