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孕周超过32周的新生儿呼吸窘迫患者经鼻塞持续气道正压通气(nCPAP)体位调整后新生儿肺部超声评分降低

Lowering of the Neonatal Lung Ultrasonography Score after nCPAP Positioning in Neonates over 32 Weeks of Gestational Age with Neonatal Respiratory Distress.

作者信息

Perri Alessandro, Fattore Simona, D'Andrea Vito, Sbordone Annamaria, Patti Maria Letizia, Nobile Stefano, Tirone Chiara, Giordano Lucia, Tana Milena, Priolo Francesca, Serrao Francesca, Riccardi Riccardo, Prontera Giorgia, Vento Giovanni

机构信息

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

Neonatal Intensive Care Unit, "San Giovanni Calibita Fatebenefratelli" Hospital, Isola Tiberina, 00186 Rome, Italy.

出版信息

Diagnostics (Basel). 2022 Aug 7;12(8):1909. doi: 10.3390/diagnostics12081909.

Abstract

Respiratory distress (RD) is one of the most common causes of admission to the neonatal intensive care unit. Correct diagnosis and timely intervention are crucial. Lung ultrasonography (LU) is a useful diagnostic tool for the neonatologist in the diagnosis of RD; the neonatal lung ultrasonography score (nLUS) can be used in the diagnostic process, but some authors hypothesise that it is also useful for the management of some neonatal RD. The aim of this study is to analyse the changes in nLUS score before (T0) and after (T1) the start of respiratory support with nasal CPAP in neonates over 32 weeks of age with RD. Thirty-three newborns were enrolled in this retrospective study. LU was performed before and after the start of CPAP. The median nLUS scores at T0 and T1 were 9 (IQR 7−12) and 7 (IQR 4−10), respectively, and showed a significant difference (p < 0.001). The magnitude of reduction in nLUS score, expressed as a percentage, was inversely related to the need for subsequent administration of exogenous surfactant. The study suggests the usefulness of the nLUS score in assessing the response to CPAP in neonates over 32 weeks gestational age.

摘要

呼吸窘迫(RD)是新生儿重症监护病房收治的最常见原因之一。正确诊断和及时干预至关重要。肺部超声检查(LU)是新生儿科医生诊断RD的一种有用的诊断工具;新生儿肺部超声评分(nLUS)可用于诊断过程,但一些作者推测它对某些新生儿RD的管理也有用。本研究的目的是分析32周龄以上患有RD的新生儿在开始使用鼻持续气道正压通气(CPAP)进行呼吸支持之前(T0)和之后(T1)nLUS评分的变化。33例新生儿纳入了这项回顾性研究。在开始CPAP之前和之后进行了LU检查。T0和T1时的nLUS评分中位数分别为9(四分位间距7 - 12)和7(四分位间距4 - 10),且差异有统计学意义(p < 0.001)。以百分比表示的nLUS评分降低幅度与随后给予外源性表面活性剂的需求呈负相关。该研究表明nLUS评分在评估孕龄32周以上新生儿对CPAP的反应方面是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b353/9406690/42c0664aeb15/diagnostics-12-01909-g001.jpg

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