Division of Neonatal Medicine, Department of Pediatrics, Sidra Medicine, Doha, Qatar; Department of Engineering & Medical Physics, Durham University, United Kingdom.
Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, Michigan, USA.
Semin Fetal Neonatal Med. 2022 Jun;27(3):101329. doi: 10.1016/j.siny.2022.101329. Epub 2022 Mar 31.
Managing perfusion in the micropreemie is challenging and should be guided by the patho-physiology, gestational and postnatal age of the baby, perinatal history, and the persistence of fetal shunts. The assessment should incorporate bedside tools such as blood pressure, clinical perfusion markers, and functional echocardiography. The multimodal approach to diagnose and identify the cause of hemodynamic compromise paves the way to a targeted approach to treatment. Characterizing the predominant pathophysiologic cause of low cardiac output and impaired cellular metabolism enables a more accurate use of inotropes, vasopressors, and volume support to suit a particular pathophysiologic situation.
管理早产儿的灌注是具有挑战性的，应该根据婴儿的病理生理学、胎龄和出生后年龄、围产期病史以及胎儿分流的持续时间来指导治疗。评估应包括床边工具，如血压、临床灌注标志物和功能超声心动图。采用多模式方法诊断和确定血流动力学障碍的原因，为治疗提供针对性方法。描述低心输出量和细胞代谢受损的主要病理生理原因，能够更准确地使用正性肌力药、血管加压素和容量支持来适应特定的病理生理情况。
