极早产儿生后第一周血管活性药物的应用。
Vasoactive medications in extremely low gestational age neonates during the first postnatal week.
机构信息
Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
J Perinatol. 2021 Sep;41(9):2330-2336. doi: 10.1038/s41372-021-01031-8. Epub 2021 Mar 23.
OBJECTIVE
The management of early hypotension in extremely low gestational age neonates (ELGANs) varies greatly between centers. The objective of this study was to provide updated data on the use of vasoactive medications in ELGANs during the first postnatal week.
STUDY DESIGN
We identified ELGANs (22-27 weeks gestational age) cared for at Pediatrix neonatal intensive care units from 2009 to 2018. We evaluated the frequency of exposure to vasoactive medications by gestational age, and compared use of vasoactive medications between two epochs (2009-2013 and 2014-2018).
RESULTS
A total of 10,070/34,234 (29%) ELGANs received ≥1 vasoactive medication. Dopamine was the most frequently used vasoactive medication. The majority (83%) of treated ELGANs initiated therapy on postnatal days 0-1. Overall use of vasoactive medications was slightly lower in 2014-2018 than 2009-2013 (28 vs 31%, p < 0.001).
CONCLUSION
A substantial proportion of ELGANs were exposed to vasoactive medications during the first postnatal week.
目的
极低胎龄儿（ELGANs）早期低血压的管理在各中心之间差异很大。本研究的目的是提供 ELGANs 在出生后第一周内使用血管活性药物的最新数据。
研究设计
我们确定了 2009 年至 2018 年在 Pediatrix 新生儿重症监护病房接受治疗的 ELGANs（22-27 周胎龄）。我们评估了血管活性药物在不同胎龄中的暴露频率，并比较了两个时期（2009-2013 年和 2014-2018 年）之间血管活性药物的使用情况。
结果
共有 10070/34234（29%）名 ELGANs 使用了至少一种血管活性药物。多巴胺是最常用的血管活性药物。大多数（83%）接受治疗的 ELGANs 在出生后第 0-1 天开始治疗。与 2009-2013 年相比，2014-2018 年血管活性药物的总体使用量略低（28%比 31%，p<0.001）。
结论
相当一部分 ELGANs 在出生后第一周内接触到血管活性药物。
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