微创表面活性剂给药对早产儿脑氧合的影响。
The effect of less invasive surfactant administration on cerebral oxygenation in preterm infants.
作者信息
Hanke Kathrin, Rausch Tanja K, Paul Pia, Hellwig Isabel, Krämer Christina, Stichtenoth Guido, Herz Alexander, Wieg Christian, König Inke R, Göpel Wolfgang, Herting Egbert, Härtel Christoph
机构信息
Department of Pediatrics, University of Lübeck, Lübeck, Germany.
Institute for Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany.
出版信息
Acta Paediatr. 2020 Feb;109(2):291-299. doi: 10.1111/apa.14939. Epub 2019 Sep 5.
AIM
To determine the regional cerebral tissue oxygenation saturation (rcSO ) in a group of infants requiring less invasive surfactant administration (LISA) as compared to infants with continuous positive airway pressure (CPAP) only.
METHODS
In preterm infants with a gestational age 26 0/7-31 6/7 weeks, we conducted an observational study using near-infrared spectroscopy (NIRS) in the first 120 hours of life.
RESULTS
We analysed the data of 22 infants who never received surfactant (CPAP), 22 infants had LISA and CPAP (LISA) and 6 infants received surfactant via endotracheal tube (ETT). Four infants had both surfactant application modes including six LISA applications. In total, there were 32 successful LISA applications but 44 attempts; 13/44 (30%) of LISA attempts resulted in a 20% decrease of rcSO . During the first 120 hours of life, rcSO values of CPAP were similar to those of infants in the LISA group, that is median rcSO values 90% vs 85%, respectively (P = .126). Episodes with rcSO values <65% were 0.4% in the CPAP group as compared to 4.8% in the LISA group (P < .001).
CONCLUSION
Our observational data indicate that rcSO values of infants in the LISA group were similar to the CPAP group.
目的
与仅接受持续气道正压通气（CPAP）的婴儿相比，确定一组需要进行微创表面活性剂给药（LISA）的婴儿的局部脑组织氧饱和度（rcSO）。
方法
在孕周为26 0/7 - 31 6/7周的早产儿中，我们在其出生后的前120小时内使用近红外光谱（NIRS）进行了一项观察性研究。
结果
我们分析了22例从未接受过表面活性剂治疗（CPAP组）、22例接受LISA和CPAP治疗（LISA组）以及6例通过气管插管接受表面活性剂治疗（ETT组）的婴儿的数据。4例婴儿接受了两种表面活性剂应用模式，其中包括6次LISA应用。总共进行了32次成功的LISA应用，但尝试次数为44次；13/44（30%）的LISA尝试导致rcSO降低20%。在出生后的前120小时内，CPAP组的rcSO值与LISA组婴儿的rcSO值相似，即rcSO中位数分别为90%和85%（P = 0.126）。rcSO值<65%的发作在CPAP组为0.4%，而在LISA组为4.8%（P < 0.001）。
结论
我们的观察数据表明，LISA组婴儿的rcSO值与CPAP组相似。
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