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极早产儿的触觉刺激及其无创呼吸支持需求

Tactile stimulation in very preterm infants and their needs of non-invasive respiratory support.

作者信息

Kaufmann Maxi, Seipolt Barbara, Rüdiger Mario, Mense Lars

机构信息

Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care Medicine, TU Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany.

Saxony Center for Feto-Neonatal Health, TU Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany.

出版信息

Front Pediatr. 2022 Nov 18;10:1041898. doi: 10.3389/fped.2022.1041898. eCollection 2022.

Abstract

AIM

Despite the lack of evidence, current resuscitation guidelines recommend tactile stimulation in apneic infants within the first minutes of life. The aim was to investigate whether timing, duration or intensity of tactile stimulation influences the extent of non-invasive respiratory support in extremely preterm infants during neonatal resuscitation.

METHODS

In an observational study, we analyzed 47 video recordings and physiological parameters during postnatal transition in preterm infants below 32 weeks of gestational age. Infants were divided into three groups according to the intensity of respiratory support.

RESULTS

All infants were stimulated at least once during neonatal resuscitation regardless of their respiratory support. Only 51% got stimulated within the first minute. Rubbing the feet was the preferred stimulation method and was followed by rubbing or touching the chest. Almost all very preterm infants were exposed to stimulation and manipulation most of the time within their first 15 min of life. Tactile stimulation lasted significantly longer but stimulation at multiple body areas started later in infants receiving prolonged non-invasive respiratory support.

CONCLUSION

This observational study demonstrated that stimulation of very preterm infants is a commonly used and easy applicable method to stimulate spontaneous breathing during neonatal resuscitation. The concomitant physical stimulation of different body parts and therefore larger surface areas might be beneficial.

摘要

目的

尽管缺乏证据,但当前的复苏指南仍建议在出生后的头几分钟内对呼吸暂停的婴儿进行触觉刺激。目的是研究触觉刺激的时机、持续时间或强度是否会影响极早产儿在新生儿复苏期间无创呼吸支持的程度。

方法

在一项观察性研究中,我们分析了32周以下胎龄早产儿出生后过渡期间的47段视频记录和生理参数。根据呼吸支持的强度将婴儿分为三组。

结果

所有婴儿在新生儿复苏期间至少受到一次刺激,无论其呼吸支持情况如何。只有51%的婴儿在第一分钟内受到刺激。搓脚是首选的刺激方法,其次是搓或触摸胸部。几乎所有极早产儿在出生后的前15分钟内大部分时间都受到刺激和操作。接受长时间无创呼吸支持的婴儿触觉刺激持续时间明显更长,但多部位刺激开始时间较晚。

结论

这项观察性研究表明,对极早产儿进行刺激是新生儿复苏期间刺激自主呼吸的常用且易于应用的方法。同时对不同身体部位进行物理刺激,从而扩大刺激表面积可能有益。

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