Kim Jeongeun, Lee Jin Won, Kim Dong Yeon
Registered Nurse, Neonatal Intensive Care Unit, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Unit Manager, Hematology Intensive Care Unit, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Child Health Nurs Res. 2020 Oct;26(4):434-444. doi: 10.4094/chnr.2020.26.4.434. Epub 2020 Oct 31.
The aim of this retrospective study was to analyze the characteristics of peripheral arterial ischemia and tissue necrosis in premature babies, as well as the effects of nitroglycerin.
In total, 513 newborns were enrolled who were admitted to the neonatal intensive care unit with a gestational age of 34 weeks or younger. Data were collected on general personal and clinical information, peripheral arterial ischemia, and nitroglycerin patch application in the premature infants. The collected data were analyzed using the test, t-test, Mann-Whitney U test, logistic regression.
Thirty-six (7.0%) infants had peripheral arterial ischemia, while 477 (93.0%) infants did not. Lower gestational age ( =35.97, <.001), lower birth weight ( =29.40, <.001), lower blood pressure ( =23.10, <.001), and insertion of an umbilical artery catheter (<.001) were significantly associated with the occurrence of peripheral arterial ischemia. Among the preterm infants in whom nitroglycerin patches were applied, 30 (83.3%) premature infants without necrosis improved without complications, 4 (11.1%) showed hypotension, and 2 (5.6%) showed skin damage.
Based on a review of our experiences with nitroglycerin patches, we recommend closely observing skin color and using nitroglycerin patches on the skin to help improve flow in premature infants with peripheral arterial ischemia.
本回顾性研究旨在分析早产儿外周动脉缺血和组织坏死的特征以及硝酸甘油的作用。
共纳入513例胎龄34周及以下入住新生儿重症监护病房的新生儿。收集早产儿的一般个人和临床信息、外周动脉缺血及硝酸甘油贴片应用情况的数据。对收集到的数据进行卡方检验、t检验、曼-惠特尼U检验和逻辑回归分析。
36例(7.0%)婴儿发生外周动脉缺血,477例(93.0%)婴儿未发生。胎龄较低(=35.97,<.001)、出生体重较低(=29.40,<.001)、血压较低(=23.10,<.001)以及脐动脉导管插入(<.001)与外周动脉缺血的发生显著相关。在应用硝酸甘油贴片的早产儿中,30例(83.3%)无坏死的早产儿病情改善且无并发症,4例(11.1%)出现低血压,2例(5.6%)出现皮肤损伤。
基于我们使用硝酸甘油贴片的经验,我们建议密切观察皮肤颜色,并在皮肤上使用硝酸甘油贴片以帮助改善外周动脉缺血早产儿的血流。