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补充氧气研究:一项关于计划性剖宫产术中母体吸氧对脐血气影响的随机对照研究。

Supplemental Oxygen Study: A Randomized Controlled Study on the Effect of Maternal Oxygen Supplementation during Planned Cesarean Delivery on Umbilical Cord Gases.

作者信息

Simon Valeria B, Fong Alex, Nageotte Michael P

机构信息

Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California.

Department of Obstetrics and Gynecology, Miller Children's and Women's Hospital/Long Beach Memorial Medical Center, Long Beach, California.

出版信息

Am J Perinatol. 2018 Jan;35(1):84-89. doi: 10.1055/s-0037-1606184. Epub 2017 Aug 24.

Abstract

OBJECTIVE

The aim was to determine the fetal umbilical blood gas effects of supplemental maternal oxygenation compared with room air (RA) during term planned cesarean delivery.

METHODS

This is a prospective randomized controlled study of singleton planned cesarean deliveries randomized to receive supplemental oxygen (O) at 10 L per minute (L/min) via facemask or RA. Umbilical cord gases were collected. The primary outcome was umbilical arterial pH level. Secondary outcomes included umbilical cord values and maternal and neonatal outcomes. Data were expressed as median ± interquartile range (IQR).

RESULTS

Seventy subjects in total were enrolled, with 65 subjects available for analysis. The median umbilical arterial O was significantly increased in the supplemental O group (18 [13.5-20.5] mm Hg) versus RA group (16 [12-18] mm Hg),  = 0.04). The median umbilical venous O was significantly increased in the supplemental O group (32 [26.5-36.0] mm Hg) versus RA group (28.5 [22-34.3] mm Hg),  = 0.04). There were no significant differences with other umbilical blood gas values and composite maternal or neonatal complications.

CONCLUSION

Subjects with term singleton gestations receiving O at 10 L/min during cesarean delivery compared with RA demonstrated no significant change in umbilical cord pH values. There was a significant increase in umbilical cord arterial and venous O levels in those receiving O.

摘要

目的

旨在确定足月计划性剖宫产时,与吸入室内空气(RA)相比,产妇吸氧对胎儿脐血气的影响。

方法

这是一项前瞻性随机对照研究,纳入单胎计划性剖宫产孕妇,随机分为通过面罩每分钟吸入10升(L/min)氧气(O)组或吸入RA组。收集脐带血气体。主要结局是脐动脉pH值。次要结局包括脐带血指标以及产妇和新生儿结局。数据以中位数±四分位间距(IQR)表示。

结果

共纳入70名受试者,65名受试者可供分析。与RA组(16[12 - 18]mmHg)相比,吸氧组脐动脉氧分压中位数显著升高(18[13.5 - 20.5]mmHg),P = 0.04。与RA组(28.5[22 - 34.3]mmHg)相比,吸氧组脐静脉氧分压中位数显著升高(32[26.5 - 三十六.0]mmHg),P = 0.04。其他脐血气值以及产妇或新生儿综合并发症方面无显著差异。

结论

足月单胎妊娠产妇剖宫产时,与吸入RA相比,每分钟吸入10L氧气组脐带血pH值无显著变化。吸氧组脐带动脉和静脉氧水平显著升高。

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