Van Laere David, Voeten Michiel, O' Toole John M, Dempsey Eugene
Department of Neonatal Intensive Care, Antwerp University Hospital, Antwerp, Belgium.
Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Front Pediatr. 2018 Mar 26;6:74. doi: 10.3389/fped.2018.00074. eCollection 2018.
Echocardiography and near-infrared spectroscopy have significantly changed our view on hemodynamic transition of the extreme preterm infant. Instead of focusing on maintaining an arbitrary target value of blood pressure, we aim for circulatory well-being by a comprehensive holistic assessment of markers of cardiovascular instability. Most of these clinical and biochemical indices are influenced by transition itself and remain poor discriminators to identify patients with a potential need for therapeutic intervention. At the same time, the evolution in data capturing and storage has led to a change in our approach to monitor vital parameters. Continuous trend monitoring has become more and more relevant. By using signal extraction methods, changes in trends over time can be quantified. In this review, we will discuss the impact of these innovations on the current monitoring practices and explore some of the potential benefits these techniques may have in improving real-time detection of extreme low birth weight infants at risk for morbidity related to impaired hemodynamic transition.
超声心动图和近红外光谱技术显著改变了我们对极早产儿血流动力学转变的看法。我们不再专注于维持任意设定的血压目标值，而是通过对心血管不稳定标志物进行全面的整体评估来实现循环系统的良好状态。这些临床和生化指标大多受到转变过程本身的影响，对于识别可能需要治疗干预的患者而言，其鉴别能力仍然较差。与此同时，数据采集和存储技术的发展促使我们监测生命参数的方式发生了变化。连续趋势监测变得越来越重要。通过使用信号提取方法，可以量化随时间变化的趋势。在本综述中，我们将讨论这些创新对当前监测实践的影响，并探讨这些技术在改善对有血流动力学转变受损相关发病风险的极低出生体重儿进行实时检测方面可能带来的一些潜在益处。
