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个性化管理有经口喂养挑战的高危婴儿的护理:我们知道什么?我们能做什么?

To Individualize the Management Care of High-Risk Infants With Oral Feeding Challenges: What Do We Know? What Can We Do?

作者信息

Lau Chantal

机构信息

Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.

出版信息

Front Pediatr. 2020 Jun 9;8:296. doi: 10.3389/fped.2020.00296. eCollection 2020.

Abstract

The increase in preterm infants' survival over the last 30 years has shed light over their inability to feed by mouth safely and efficiently. With adverse events such as increased risks for oxygen desaturation, bradycardia, penetration/aspiration, infants' hospitalization in neonatal intensive care units (NICUs) are understandably prolonged. Unfortunately, this leads to delayed mother-infant reunion, maternal stress, breastfeeding obstacles, and increased medical costs. Such impediments have stimulated clinicians and researchers to better understand the underlying causes and develop evidence-based solutions to assist these infants. However, it is notable that the research-to-practice translation of this knowledge has been limited as there are still no validated guidelines or protocols as how to best diagnose and care for these infants. This report revisits the immature physiologic functions at the root of these infants' oral feeding difficulties, the current practices, and the recent availability of evidence-based efficacious tools and interventions. Taking advantage of the latter, it presents a renewed perspective of how management strategies can be tailored to the specific needs of individual patients.

摘要

在过去30年里,早产儿存活率的提高凸显了他们无法安全、有效地经口喂养的问题。由于存在诸如氧饱和度降低、心动过缓、误吸等不良事件,新生儿重症监护病房(NICU)里婴儿的住院时间理所当然地延长了。不幸的是,这导致母婴团聚延迟、母亲压力增大、母乳喂养受阻以及医疗成本增加。这些障碍促使临床医生和研究人员更好地理解潜在原因,并制定基于证据的解决方案来帮助这些婴儿。然而,值得注意的是,由于目前仍没有关于如何最佳诊断和护理这些婴儿的经过验证的指南或方案,这方面知识从研究到实践的转化一直很有限。本报告重新审视了这些婴儿经口喂养困难根源处的不成熟生理功能、当前的做法以及近期基于证据的有效工具和干预措施的可用性。利用后者,本报告提出了一个新的视角,即如何根据个体患者的特定需求来调整管理策略。

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