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进食、睡眠、安抚评估对新生儿阿片类药物戒断综合征的独立影响

Independent Impact of Eat, Sleep, Console Assessment on Neonatal Opioid Withdrawal Syndrome.

作者信息

Chyi Lisa J, Li Sherian, Lee Catherine, Walsh Eileen M, Kuzniewicz Michael W

机构信息

Division of Neonatology, Department of Pediatrics, Kaiser Permanente, Walnut Creek, CA, USA.

Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.

出版信息

Clin Pediatr (Phila). 2024 Sep;63(8):1097-1105. doi: 10.1177/00099228231204448. Epub 2023 Oct 5.

Abstract

Compared with the Finnegan Neonatal Abstinence Scoring System (FNASS), the Eat, Sleep, Console (ESC) approach reduces pharmacotherapy and length of stay (LOS) for neonatal opioid withdrawal syndrome (NOWS) infants. The independent outcome contribution of ESC is unknown as the approach combines ESC assessment with additional management changes. Our objective was to evaluate ESC assessment's independent impact on outcomes compared with FNASS. We conducted a retrospective cohort study of in utero opioid-exposed infants ≥35 weeks gestation managed with FNASS versus ESC. Outcomes included pharmacotherapy initiation, LOS, length of pharmacotherapy, and emergency department visit/readmissions. Among 151 FNASS and 100 ESC managed infants, pharmacotherapy initiation ( = .47), LOS for all infants ( = .49), and LOS for pharmacologically treated infants ( = .68) were similar. Length of pharmacotherapy did not differ ( = .84). Emergency department evaluation/NOWS readmission was equally rare ( = .65). Using equivalent models of care, comparison of ESC and FNASS assessment tools showed no difference in NOWS outcomes.

摘要

与芬尼根新生儿戒断评分系统(FNASS)相比,“进食、睡眠、安抚”(ESC)方法可减少新生儿阿片类药物戒断综合征(NOWS)婴儿的药物治疗及住院时间(LOS)。由于ESC方法将ESC评估与其他管理变化相结合,其对结局的独立影响尚不清楚。我们的目的是评估与FNASS相比,ESC评估对结局的独立影响。我们对孕周≥35周的宫内阿片类药物暴露婴儿进行了一项回顾性队列研究,这些婴儿分别采用FNASS和ESC进行管理。结局包括药物治疗开始情况、住院时间、药物治疗时长以及急诊就诊/再入院情况。在151例采用FNASS管理的婴儿和100例采用ESC管理的婴儿中,药物治疗开始情况(P = 0.47)、所有婴儿的住院时间(P = 0.49)以及接受药物治疗婴儿的住院时间(P = 0.68)相似。药物治疗时长无差异(P = 0.84)。急诊评估/NOWS再入院同样罕见(P = 0.65)。使用等效的护理模式,ESC和FNASS评估工具的比较显示NOWS结局无差异。

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