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仰卧位中线抬高预防极低出生体重儿和超低出生体重儿脑室内出血的回顾性多中心研究。

Elevated supine midline head position for prevention of intraventricular hemorrhage in VLBW and ELBW infants: a retrospective multicenter study.

机构信息

Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

Pediatrics, Advocate Children's Hospital-Park Ridge, Park Ridge, IL, USA.

出版信息

J Perinatol. 2021 Feb;41(2):278-285. doi: 10.1038/s41372-020-00809-6. Epub 2020 Sep 8.

DOI:10.1038/s41372-020-00809-6
PMID:32901115
Abstract

OBJECTIVE

To evaluate the impact of elevated supine midline head position on intraventricular hemorrhage (IVH) in very-low-birth-weight (VLBW) infants.

STUDY DESIGN

We reviewed data from four Level III/IV units. Two of these units (mid-line group) cared for infants in midline position and the other two (routine care group) provided routine care. We compared incidence of any and severe IVH in two groups using multivariate logistic regression analyses.

RESULTS

Of 2201 VLBW infants, 1041 were extremely-low-birth-weight (ELBW). Odds of any IVH were not different either for VLBW or ELBW infants. Odds of severe IVH were higher for VLBW infants in mid-line group (OR 1.43, 95% CI 1.007-2.02; p value 0.046) but not for ELBW infants (OR 0.9, 95% CI 0.6-1.4; p value 0.73).

CONCLUSIONS

The incidence of any IVH was similar in the two groups but the incidence of severe IVH was higher in VLBW infants in mid-line group.

摘要

目的

评估仰卧位中线头部抬高对极低出生体重(VLBW)儿脑室内出血(IVH)的影响。

研究设计

我们回顾了四个 III/IV 级单位的数据。其中两个单位(中线组)采用中线位置照顾婴儿,另两个单位(常规护理组)提供常规护理。我们使用多变量逻辑回归分析比较了两组的任何 IVH 和严重 IVH 的发生率。

结果

在 2201 名 VLBW 婴儿中,有 1041 名极低出生体重儿(ELBW)。VLBW 或 ELBW 婴儿的任何 IVH 发生率均无差异。中线组的 VLBW 婴儿发生严重 IVH 的几率较高(OR 1.43,95%CI 1.007-2.02;p 值 0.046),但 ELBW 婴儿则无差异(OR 0.9,95%CI 0.6-1.4;p 值 0.73)。

结论

两组的任何 IVH 发生率相似,但中线组的 VLBW 婴儿发生严重 IVH 的几率较高。

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1
Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.保持头部中线位置以预防早产儿生发基质-脑室内出血的发生或扩展。
Cochrane Database Syst Rev. 2017 Jul 20;7(7):CD012362. doi: 10.1002/14651858.CD012362.pub2.
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Infant position in neonates receiving mechanical ventilation.接受机械通气的新生儿的婴儿体位。
Cochrane Database Syst Rev. 2016 Nov 7;11(11):CD003668. doi: 10.1002/14651858.CD003668.pub4.
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Head Position Change Is Not Associated with Acute Changes in Bilateral Cerebral Oxygenation in Stable Preterm Infants during the First 3 Days of Life.
头部位置改变与出生后3天内稳定的早产儿双侧脑氧合的急性变化无关。
Am J Perinatol. 2015 Jun;32(7):645-52. doi: 10.1055/s-0034-1390348. Epub 2014 Oct 5.
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Evaluation and development of potentially better practices for the prevention of brain hemorrhage and ischemic brain injury in very low birth weight infants.评估并开发可能更好的预防极低出生体重儿脑出血和缺血性脑损伤的实践方法。
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