School of Medical Physics & Engineering, Durham University, United Kingdom; Division of Neonatology, Sidra Medicine, Doha, Qatar.
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI, USA.
Semin Fetal Neonatal Med. 2020 Oct;25(5):101144. doi: 10.1016/j.siny.2020.101144. Epub 2020 Aug 1.
Disorders of perfusion in newborn infants are frequently observed in neonatal intensive care units. The current assessment practices are primarily based on clinical signs. Significant technologic advances have opened new avenues for continuous assessment at the bedside. Combining these devices with functional echocardiography provides an in-depth understanding of perfusion and allows targeting therapy to the pathophysiology rather than monitoring and targeting blood pressure. This change in approach is guided by the fact that perfusion disorders can result from a number of causes and a single management approach might do more harm than good. This approach has the potential to improve long term outcomes but needs to be tested in well-designed trials.
新生儿灌注异常在新生儿重症监护病房中较为常见。目前的评估方法主要基于临床体征。重要的技术进步为床边连续评估开辟了新途径。将这些设备与功能超声心动图相结合,可以深入了解灌注情况,并根据病理生理学靶向治疗,而不是监测和靶向血压。这种方法的改变是基于以下事实:灌注异常可能由多种原因引起,单一的治疗方法可能弊大于利。这种方法有可能改善长期预后,但需要在精心设计的试验中进行检验。