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生理基础脐带夹闭可稳定极低出生体重儿的心肺参数。

Physiological-based cord clamping stabilised cardiorespiratory parameters in very low birth weight infants.

机构信息

Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

出版信息

Acta Paediatr. 2024 May;113(5):931-938. doi: 10.1111/apa.17135. Epub 2024 Jan 31.

Abstract

AIM

We investigated the influence of physiological-based cord clamping (PBCC) on cardiorespiratory stability in very low birth weight (VLBW) infants during the first 72 h of life.

METHODS

This retrospective study comprised VLBW infants born at <32 + 0 weeks of gestation and admitted to the neonatal intensive care unit of the Medical University of Graz, Austria, from December 2014 to April 2021. VLBW infants delivered with PBCC were matched by gestational age and birth weight to delayed cord clamping controls. The PBCC group was stabilised after birth with an intact cord. Routine monitoring parameters were compared between the groups.

RESULTS

We included 54 VLBW infants. The mean gestational ages of the PBCC group and controls were 27.4 ± 1.9 versus 27.4 ± 1.8 weeks (p = 0.87), and the mean birth weights were 912 ± 288 versus 915 ± 285 g (p = 0.96), respectively. The mean cord clamping time was 191 ± 78 s in the PBCC group. Heart rate was lower in the PBCC group during the first 3 days after birth, reaching significance by 10 h. Other monitoring parameters did not reveal any differences between the two groups.

CONCLUSION

PBCC stabilised cardiorespiratory parameters in VLBW infants. The lower heart rate in the PBCC group suggested higher blood volume following intact cord resuscitation.

摘要

目的

我们研究了生理基础脐带夹闭(PBCC)对极低出生体重(VLBW)婴儿生命最初 72 小时内心肺稳定性的影响。

方法

这是一项回顾性研究,纳入了 2014 年 12 月至 2021 年 4 月在奥地利格拉茨医科大学新生儿重症监护病房出生且胎龄<32+0 周的 VLBW 婴儿。通过胎龄和出生体重与延迟脐带夹闭对照组相匹配的方式,选取接受 PBCC 的 VLBW 婴儿。PBCC 组在出生后通过保持脐带完整来稳定。比较两组常规监测参数。

结果

我们纳入了 54 名 VLBW 婴儿。PBCC 组和对照组的平均胎龄分别为 27.4±1.9 周和 27.4±1.8 周(p=0.87),平均出生体重分别为 912±288 克和 915±285 克(p=0.96)。PBCC 组的平均脐带夹闭时间为 191±78 秒。PBCC 组在出生后前 3 天的心率较低,在 10 小时时达到显著水平。两组其他监测参数无差异。

结论

PBCC 稳定了 VLBW 婴儿的心肺参数。PBCC 组的心率较低提示完整脐带复苏后血容量较高。

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