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校正胎龄 36 周时 1005 例早产儿的氧饱和度/吸入氧浓度比值:胎龄和早期呼吸疾病模式的影响。

Oxygen saturation/FIO2 ratio at 36 weeks' PMA in 1005 preterm infants: Effect of gestational age and early respiratory disease patterns.

机构信息

Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy.

Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy.

出版信息

Pediatr Pulmonol. 2019 May;54(5):637-643. doi: 10.1002/ppul.24265. Epub 2019 Jan 27.

Abstract

OBJECTIVE

To assess oxygen diffusion at 36 weeks' post-menstrual age in preterm infants by means of the non-invasive oxygen saturation/fraction of inspired oxygen ratio (36w-SFR) and to identify factors associated with 36w-SFR - ie, gestational age (GA) and early respiratory disease patterns (ERP).

METHODS

Retrospective analysis of prospectively collected data.

SETTING

Neonatal Intensive Care Unit.

PATIENTS

1005 preterm infants born below 32 weeks' GA.

INTERVENTIONS

36w-SFR was the mean of SFR values over 24 h on the day infants reached 36 weeks' PMA.

MAIN OUTCOME MEASURES

36w-SFR.

STATISTICS

descriptive statistics, univariate, and multivariate analysis to study associations of 36w-SFR, including GA and ERP.

RESULTS

36w-SFR was significantly different between infants with and without bronchopulmonary dysplasia (BPD) (371 vs 467, P < 0.001), and according to ERP (LowFIO2 466, pulmonary improvement-PI 460, pulmonary deterioration-PD 405, early persistent pulmonary deterioration-EPPD 344, P < 0.001). Significant differences were found either in BPD and in non-BPD patients according to ERP (P < 0.001). Patients without BPD had significant differences in 36w-SFR according to GA (P < 0.001), while infants with BPD and increasing GA at birth had a non-significant trend for increased 36w-SFR (P = 0.621). Factors associated with 36w-SFR were GA, being small for GA, sepsis, human milk feeding, and ERP.

CONCLUSIONS

Preterm infants without BPD had a spectrum of oxygen diffusion impairment that was inversely associated with GA at birth. Infants with different patterns of ERP had significant differences in 36w-SFR.

摘要

目的

通过非侵入性氧饱和度/吸入氧分数比(36w-SFR)评估早产儿在 36 孕周后氧扩散情况,并确定与 36w-SFR 相关的因素,即胎龄(GA)和早期呼吸疾病模式(ERP)。

方法

回顾性分析前瞻性收集的数据。

地点

新生儿重症监护病房。

患者

1005 名胎龄低于 32 周的早产儿。

干预措施

36w-SFR 是婴儿达到 36 孕周 PMA 后 24 小时内 SFR 值的平均值。

主要观察指标

36w-SFR。

统计学

描述性统计、单变量和多变量分析,以研究 36w-SFR 的相关性,包括 GA 和 ERP。

结果

患有和不患有支气管肺发育不良(BPD)的婴儿之间的 36w-SFR 差异有统计学意义(371 比 467,P<0.001),且根据 ERP 也有差异(低 FiO2 466、肺改善-PI 460、肺恶化-PD 405、早发性持续性肺恶化-EPPD 405,P<0.001)。根据 ERP,在患有和不患有 BPD 的患者中均存在显著差异(P<0.001)。不患有 BPD 的患者 36w-SFR 根据 GA 有显著差异(P<0.001),而患有 BPD 且出生时 GA 增加的婴儿,36w-SFR 有增加的非显著趋势(P=0.621)。与 36w-SFR 相关的因素是 GA、GA 小、败血症、母乳喂养和 ERP。

结论

不患有 BPD 的早产儿存在氧扩散受损的范围,与出生时的 GA 呈负相关。具有不同 ERP 模式的婴儿 36w-SFR 有显著差异。

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