Baik Nariae, Urlesberger Berndt, Schwaberger Bernhard, Freidl Thomas, Schmölzer Georg M, Pichler Gerhard
Division of Neonatology, Medical University, Graz, Austria.
Neonatology. 2015;107(2):100-7. doi: 10.1159/000368042. Epub 2014 Nov 18.
The fetal-to-neonatal transition is a complex process that includes changes in cardiac and respiratory systems.
The aim of this study is to review the different methods of cardiocirculatory monitoring during the immediate neonatal transition period.
A systematic search of PubMed and Ovid Embase was performed using the following terms: infant, newborn, newborn infant, neonate, neonates, heart, cardiac, blood pressure, haemodynamic, hemodynamics, blood circulation, circulation, echocardiography, ultrasonography, sonography, electrocardiography, ECG, oximetry, pulse, pulse oximetry, monitoring, measurement, acclimatization, adaptation, transition, after birth and delivery room. Additional articles were identified by manual search of cited references. Only human studies describing cardiocirculatory monitoring during the first 15 min after birth were included.
Thirteen studies were identified that described heart rate (HR). Additional five studies were identified that measured blood pressure. Four studies performed functional echocardiography during neonatal transition; two in addition to blood pressure monitoring and three in addition to HR monitoring.
Routine HR monitoring using electrocardiography or pulse oximetry is used to evaluate adequate hemodynamic transition, and reference ranges have been established. Measuring blood pressure noninvasively though noncontinuously might be of some value in future, considering that the normative data have been established recently. Echocardiographic monitoring during the immediate transition period will improve the knowledge about cardiac function changes, but introduction in clinical routine remains questionable.
胎儿到新生儿的转变是一个复杂的过程,包括心脏和呼吸系统的变化。
本研究的目的是回顾新生儿过渡期即刻心脏循环监测的不同方法。
使用以下术语对PubMed和Ovid Embase进行系统检索:婴儿、新生儿、新生婴儿、新生儿、心脏、心脏的、血压、血流动力学、血液循环、循环、超声心动图、超声检查、超声成像、心电图、心电图、血氧测定法、脉搏、脉搏血氧测定法、监测、测量、适应、过渡、出生后和产房。通过人工检索引用文献确定其他文章。仅纳入描述出生后前15分钟心脏循环监测的人体研究。
确定了13项描述心率(HR)的研究。另外确定了5项测量血压的研究。4项研究在新生儿过渡期进行了功能超声心动图检查;2项除血压监测外,3项除心率监测外。
使用心电图或脉搏血氧测定法进行常规心率监测用于评估充分的血流动力学转变,并且已经建立了参考范围。考虑到最近已经建立了规范数据,虽然非连续地无创测量血压在未来可能具有一定价值。过渡期即刻的超声心动图监测将增进对心脏功能变化的了解,但在临床常规中的应用仍存在疑问。