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资源受限地区极低出生体重儿的最佳通气和表面活性剂治疗。

Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions.

机构信息

Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa,

Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.

出版信息

Neonatology. 2020;117(2):217-224. doi: 10.1159/000506987. Epub 2020 May 26.

Abstract

In resource-restricted regions, respiratory distress syndrome (RDS) data are often underreported, making the determination of effective interventions and their outcome difficult. The combination of oxygen, nasal continuous positive airway pressure (CPAP) and surfactant therapy has the potential to prevent 42% of RDS-related deaths in sub-Saharan Africa, despite the financial implications. This article provides a brief overview on the status of RDS management, mainly nasal CPAP and surfactant therapy in very-low-birth-weight infants, in resource-restricted regions of sub-Saharan Africa. Data from the public health sector, as compared to the private health sector, of the Western Cape province, South Africa, are used to illustrate what RDS management strategies are able to accomplish in a resource-restricted region. Upscaling of all components (antenatal care, antenatal corticosteroids, prevention of hypothermia and RDS management strategies) are required to decrease premature infant mortality rates in resource-restricted areas.

摘要

在资源有限的地区,呼吸窘迫综合征(RDS)的数据常常报道不足,这使得确定有效的干预措施及其结果变得困难。尽管存在财务影响,但联合使用氧气、鼻持续气道正压通气(CPAP)和表面活性剂治疗有可能预防撒哈拉以南非洲 42%的与 RDS 相关的死亡。本文简要概述了资源有限的撒哈拉以南非洲地区,RDS 管理(主要是鼻 CPAP 和表面活性剂治疗)在极低出生体重儿中的现状。南非西开普省公共卫生部门的数据与私立卫生部门的数据进行了比较,以说明 RDS 管理策略在资源有限的地区能够取得什么成果。需要扩大所有组成部分(产前护理、产前皮质激素、预防低体温和 RDS 管理策略)的规模,以降低资源有限地区的早产儿死亡率。

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