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“脑保护套餐”对孕周<30周早产儿严重脑室内出血的影响:一项回顾性单中心研究

Impact of a "Brain Protection Bundle" in Reducing Severe Intraventricular Hemorrhage in Preterm Infants <30 Weeks GA: A Retrospective Single Centre Study.

作者信息

Persad Nishkal, Kelly Edmond, Amaral Nely, Neish Angela, Cheng Courtney, Fan Chun-Po Steve, Runeckles Kyle, Shah Vibhuti

机构信息

Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada.

Department of Nursing, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada.

出版信息

Children (Basel). 2021 Oct 31;8(11):983. doi: 10.3390/children8110983.

Abstract

BACKGROUND

despite advances in perinatal care, periventricular/intraventricular hemorrhage (IVH) continues to remain high in neonatal intensive care units (NICUs) worldwide. Studies have demonstrated the benefits of implementing interventions during the antenatal period, stabilization after birth (golden hour management) and postnatally in the first 72 h to reduce the incidence of IVH.

OBJECTIVE

to compare the incidence of severe intraventricular hemorrhage (IVH ≥ Grade III) before and after implementation of a "brain protection bundle" in preterm infants <30 weeks GA.

STUDY DESIGN

a pre- and post-implementation retrospective cohort study to compare the incidence of severe IVH following execution of a "brain protection bundle for the first 72 h from 2015 to 2018. Demographics, management practices at birth and in the NICU, cranial ultrasound results and short-term morbidities were compared.

RESULTS

a total of 189 and 215 infants were included in the pre- and post-implementation phase, respectively. No difference in the incidence of severe IVH (6.9% vs. 9.8%, = 0.37) was observed on the first cranial scan performed after 72 h of age.

CONCLUSION

the implementation of a "brain protection bundle" was not effective in reducing the incidence of severe IVH within the first 72 h of life in our centre.

摘要

背景

尽管围产期护理有所进步,但全球新生儿重症监护病房(NICU)中脑室周围/脑室内出血(IVH)的发生率仍然很高。研究表明,在产前实施干预措施、出生后稳定病情(黄金小时管理)以及出生后72小时内进行产后干预,有助于降低IVH的发生率。

目的

比较在孕周<30周的早产儿中实施“脑保护综合措施”前后严重脑室内出血(IVH≥III级)的发生率。

研究设计

一项实施前后的回顾性队列研究,比较2015年至2018年实施“出生后首个72小时脑保护综合措施”后严重IVH的发生率。比较了人口统计学、出生时和NICU的管理措施、头颅超声结果和短期发病率。

结果

实施前和实施后阶段分别纳入了189例和215例婴儿。在72小时龄后进行的首次头颅扫描中,未观察到严重IVH发生率的差异(6.9%对9.8%,P = 0.37)。

结论

在我们中心,实施“脑保护综合措施”对降低出生后72小时内严重IVH的发生率无效。

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