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分娩期间及产后的新生儿与母体体温调节

Neonatal and Maternal Temperature Regulation During and After Delivery.

作者信息

Perlman Jeffrey, Kjaer Klaus

机构信息

From the Department of Pediatrics and the Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.

出版信息

Anesth Analg. 2016 Jul;123(1):168-72. doi: 10.1213/ANE.0000000000001256.

Abstract

An important goal of obstetric anesthesia is to provide for the safety and comfort of the mother as well as to optimize physiologic outcomes for the neonate. Markers of neonatal physiologic outcome include cord umbilical artery pH and Apgar scores. Neonatal temperature has often been overlooked by anesthesiologists as an important physiologic outcome measure, but it may be significantly affected by operating room conditions and obstetric anesthesia technique at cesarean delivery. There is a dose-dependent increase in mortality with decreasing body temperature as well as an increased likelihood for more severe early respiratory distress. Multiple neonate-focused strategies have been shown to decrease the incidence of neonatal hypothermia. Because fetal temperature is affected by maternal temperature, strategies to mitigate maternal hypothermia at the time of delivery may also be important in preventing neonatal hypothermia. This focused review will examine the importance of neonatal temperature and discuss its relationship to maternal temperature as well as strategies for maintaining neonatal normothermia after delivery.

摘要

产科麻醉的一个重要目标是确保母亲的安全与舒适,同时优化新生儿的生理结局。新生儿生理结局的指标包括脐动脉血pH值和阿氏评分。新生儿体温常被麻醉医生忽视,未将其视为重要的生理结局指标,但剖宫产时手术室环境和产科麻醉技术可能会对其产生显著影响。体温降低会导致死亡率呈剂量依赖性增加,同时出现更严重早期呼吸窘迫的可能性也会增加。已证实多种以新生儿为重点的策略可降低新生儿体温过低的发生率。由于胎儿体温受母体体温影响,分娩时减轻母体体温过低的策略对于预防新生儿体温过低可能也很重要。本综述将探讨新生儿体温的重要性,讨论其与母体体温的关系以及分娩后维持新生儿正常体温的策略。

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