《使用牛肺磷脂表面活性剂的最佳表面活性物质输送方案：一项质量改进研究》
"Optimal surfactant delivery protocol using the bovine lipid extract surfactant: a quality improvement study".
机构信息
McGill University, Montreal, QC, Canada.
Department of Pediatrics, Neonatal Division, Jewish General Hospital, McGill University Health Center, Montreal, QC, Canada.
出版信息
J Perinatol. 2021 Jan;41(1):17-23. doi: 10.1038/s41372-020-00846-1. Epub 2020 Oct 3.
IMPORTANCE
Episodes of severe airway obstruction (SAO) are reported during surfactant administration.
OBJECTIVE
To evaluate adherence to and impact of a surfactant protocol on adverse events.
METHODS
An evidence-based protocol for surfactant administration was developed (2011), implemented (2012) and re-implemented (2014), including three major steps: lung recruitment, manual bagging, and bolus instillation. Three epochs were evaluated: E (2010), E (2015) and E (2018). Adherence was defined as compliance with all steps. Adverse events such as hypoxia (<80%) and severe airway obstruction (SAO) were investigated.
RESULTS
197 infants (246 administrations) were included: E 81 (110), E 52 (63), and E 64 (73). Adherence improved from 49% (E) to 67% (E). Full adherence to protocol significantly decreased SAO from 26% to 1.25% (E; p < 0.005) and hypoxia/bradycardia events (5 to 0% E; p < 0.005), without any side effects.
CONCLUSIONS
Adherence to a surfactant administration protocol improved over time and significantly decreased important adverse events.
重要性
在表面活性剂给药期间会报告严重气道阻塞（SAO）发作。
目的
评估表面活性剂方案的依从性及其对不良事件的影响。
方法
制定了一项基于证据的表面活性剂给药方案（2011 年），并在 2012 年实施，然后在 2014 年重新实施，包括三个主要步骤：肺复张、手动通气和推注。评估了三个时期：E（2010 年）、E（2015 年）和 E（2018 年）。依从性定义为所有步骤的遵守情况。研究了缺氧（<80%）和严重气道阻塞（SAO）等不良事件。
结果
共纳入 197 名婴儿（246 次给药）：E 组 81 例（110 次），E 组 52 例（63 次），E 组 64 例（73 次）。依从性从 49%（E 组）提高到 67%（E 组）。完全遵守方案可显著降低 SAO 的发生率（从 26%降至 1.25%；E 组；p < 0.005）和缺氧/心动过缓事件的发生率（从 5%降至 0%；E 组；p < 0.005），没有任何副作用。
结论
随着时间的推移，表面活性剂给药方案的依从性提高，显著降低了重要的不良事件。
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