加拿大马尼托巴省新生儿重症监护中目标性新生儿超声心动图服务。
Targeted neonatal echocardiography service in neonatal intensive care in Manitoba, Canada.
机构信息
Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Division of Pediatric Cardiology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
出版信息
J Perinatol. 2022 May;42(5):655-659. doi: 10.1038/s41372-021-01258-5. Epub 2021 Oct 29.
OBJECTIVE
To evaluate the impact of a targeted neonatal echocardiography (TNE) service on patient management in the neonatal intensive care units (NICU) in Winnipeg, Canada.
STUDY DESIGN
Retrospective cohort study of neonates who had TNEs from 2014 to 2019. The primary outcome was the change in clinical management based on TNE recommendation. Multivariate logistic regression analysis was used to identify predictors of the primary outcome.
RESULTS
A total of 747 echos were performed on 307 neonates. Patent ductus arteriosus assessment was the most common indication for TNE followed by evaluation of pulmonary hypertension and systemic hemodynamics. TNE led to a change in clinical management following 492 (66%) echos. Mechanical ventilation [Odds ratio (OR) 2.4, 95% CI: 1.7-3.4, P < 0.001) and receiving inhaled nitric oxide (1.9, 95% CI: 1.3-3.0, P = 0.003) were the predictors for the change in clinical management following TNE.
CONCLUSION
TNE has enhanced patient care by altering the management of patients in the NICU.
目的
评估加拿大温尼伯新生儿重症监护病房（NICU）中目标性新生儿超声心动图（TNE）服务对患者管理的影响。
研究设计
对 2014 年至 2019 年间进行 TNE 的新生儿进行回顾性队列研究。主要结局是根据 TNE 建议改变临床管理。采用多变量逻辑回归分析确定主要结局的预测因素。
结果
共对 307 名新生儿进行了 747 次超声心动图检查。动脉导管未闭评估是 TNE 最常见的适应证，其次是肺动脉高压和全身血液动力学评估。492 次（66%）超声心动图检查后 TNE 导致临床管理发生变化。机械通气[比值比（OR）2.4，95%可信区间：1.7-3.4，P<0.001]和吸入一氧化氮（1.9，95%可信区间：1.3-3.0，P=0.003）是 TNE 后临床管理改变的预测因素。
结论
TNE 通过改变 NICU 患者的管理，增强了患者的护理。
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