Division of Neonatology and Paediatric Intensive Care Medicine, Department of Paediatrics, Medical Faculty, TU Dresden, Dresden, Germany.
Saxony Center for Feto-Neonatal Health, Medical Faculty, TU Dresden, Dresden, Germany.
Pediatr Res. 2024 Aug;96(3):616-624. doi: 10.1038/s41390-022-01945-9. Epub 2022 Feb 5.
In current resuscitation guidelines, tactile stimulation is recommended for infants with insufficient respiratory efforts after birth. No recommendations are made regarding duration, onset, and method of stimulation. Neither is mentioned how tactile stimulation should be applied in relation to the gestational age. The aim was to review the physiological mechanisms of respiratory drive after birth and to identify and structure the current evidence on tactile stimulation during neonatal resuscitation. A systematic review of available data was performed using PubMed, covering the literature up to April 2021. Two independent investigators screened the extracted references and assessed their methodological quality. Six studies were included. Tactile stimulation management, including the onset of stimulation, overall duration, and methods as well as the effect on vital parameters was analyzed and systematically presented. Tactile stimulation varies widely between, as well as within different centers and no consensus exists which stimulation method is most effective. Some evidence shows that repetitive stimulation within the first minutes of resuscitation improves oxygenation. Further studies are warranted to optimize strategies to support spontaneous breathing after birth, assessing the effect of stimulating various body parts respectively within different gestational age groups.
在当前的复苏指南中，建议对出生后呼吸努力不足的婴儿进行触觉刺激。对于刺激的持续时间、开始时间和方法，没有任何建议。也没有提到触觉刺激应该如何根据胎龄应用。目的是回顾出生后呼吸驱动的生理机制，并确定和构建新生儿复苏期间触觉刺激的现有证据。使用 PubMed 对现有数据进行了系统回顾，涵盖了截至 2021 年 4 月的文献。两名独立调查员筛选了提取的参考文献，并评估了它们的方法学质量。共纳入 6 项研究。分析并系统呈现了触觉刺激管理，包括刺激的开始、总持续时间和方法以及对生命参数的影响。触觉刺激在不同中心之间以及在同一中心内差异很大，没有共识认为哪种刺激方法最有效。一些证据表明，在复苏的最初几分钟内进行重复刺激可以改善氧合。需要进一步的研究来优化支持出生后自主呼吸的策略，分别评估在不同胎龄组刺激不同身体部位的效果。
