Baik Nariae, O'Reilly Megan, Fray Caroline, van Os Sylvia, Cheung Po-Yin, Schmölzer Georg M
Department of Pediatrics, Medical University Graz, Graz, Austria.
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.
Front Pediatr. 2018 Feb 12;6:18. doi: 10.3389/fped.2018.00018. eCollection 2018.
Approximately, 10-20% of newborns require breathing assistance at birth, which remains the cornerstone of neonatal resuscitation. Fortunately, the need for chest compression (CC) or medications in the delivery room (DR) is rare. About 0.1% of term infants and up to 15% of preterm infants receive these interventions, this will result in approximately one million newborn deaths annually worldwide. In addition, CC or medications (epinephrine) are more frequent in the preterm population (~15%) due to birth asphyxia. A recent study reported that only 6 per 10,000 infants received epinephrine in the DR. Further, the study reported that infants receiving epinephrine during resuscitation had a high incidence of mortality (41%) and short-term neurologic morbidity (57% hypoxic-ischemic encephalopathy and seizures). A recent review of newborns who received prolonged CC and epinephrine but had no signs of life at 10 min following birth noted 83% mortality, with 93% of survivors suffering moderate-to-severe disability. The poor prognosis associated with receiving CC alone or with medications in the DR raises questions as to whether improved cardiopulmonary resuscitation methods specifically tailored to the newborn could improve outcomes.
大约10%-20%的新生儿在出生时需要呼吸辅助，这仍然是新生儿复苏的基石。幸运的是，在产房需要进行胸外按压（CC）或使用药物的情况很少见。约0.1%的足月儿和高达15%的早产儿会接受这些干预措施，这将导致全球每年约100万新生儿死亡。此外，由于出生窒息，CC或药物（肾上腺素）在早产儿群体中（约15%）更为常见。最近一项研究报告称，在产房每10000名婴儿中只有6名接受了肾上腺素治疗。此外，该研究报告称，在复苏过程中接受肾上腺素治疗的婴儿死亡率很高（41%），短期神经疾病发病率也很高（57%为缺氧缺血性脑病和癫痫）。最近一项对出生后10分钟接受长时间CC和肾上腺素治疗但无生命迹象的新生儿的综述指出，死亡率为83%，93%的幸存者患有中度至重度残疾。在产房单独接受CC或与药物联合使用所带来的不良预后引发了一个问题，即专门为新生儿量身定制的改进心肺复苏方法是否能改善结局。
