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三级新生儿重症监护病房产房内的新生儿复苏计划(NRP)指南及主要复苏事件的时机:理解偏差

Neonatal resuscitation program (NRP) guidelines and timing of major resuscitation events in delivery rooms at a level III NICU: Understanding deviations.

作者信息

Boddu Praveen Kumar, Velumula Pradeep Kumar, Jani Sanket, Fernandes Nithi, Lua Jorge, Natarajan Girija, Bajaj Monika, Thomas Ronald, Chawla Sanjay

机构信息

Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

MercyOne Waterloo Medical Center, Waterloo, IA, USA.

出版信息

Resusc Plus. 2024 Feb 20;17:100571. doi: 10.1016/j.resplu.2024.100571. eCollection 2024 Mar.

Abstract

OBJECTIVE

To describe the timing of major resuscitation events in the Delivery room.

METHODS

A retrospective study of neonates born at a level III birthing hospital who received chest compressions in the delivery room was conducted. The timing of the resuscitation events i.e., intubation, UVC, endotracheal (ETT), epinephrine and intravenous (IV) epinephrine were described. The timing of these events were compared for deliveries with the presence of neonatology team.

RESULTS

51 neonates were included. The primary outcome occurred in 28 (65%) of deliveries. An alternate airway was secured at 4.24 ± 5.9 minutes. Endotracheal epinephrine and IV epinephrine were administered at a mean time of 3.98 ± 3 minutes and 10.87± 5.18 minutes after the initiation of chest compressions respectively.

CONCLUSION

Data from real-life cases on the timeline of events suggest that major resuscitation events as suggested by Neonatal Resuscitation Program Guidelines, are often significantly delayed.

摘要

目的

描述产房内主要复苏事件的发生时间。

方法

对一家三级分娩医院出生且在产房接受胸外按压的新生儿进行回顾性研究。描述了复苏事件的发生时间,即插管、脐静脉置管(UVC)、气管内(ETT)、肾上腺素和静脉注射肾上腺素的时间。比较了有新生儿科团队在场的分娩中这些事件的发生时间。

结果

纳入51例新生儿。28例(65%)分娩出现主要结局。在4.24±5.9分钟时建立了替代气道。气管内肾上腺素和静脉注射肾上腺素分别在开始胸外按压后平均3.98±3分钟和10.87±5.18分钟给予。

结论

来自实际病例中事件时间线的数据表明,新生儿复苏计划指南所建议的主要复苏事件常常显著延迟。

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Timing and documentation of key events in neonatal resuscitation.新生儿复苏中关键事件的时机和记录。
Eur J Pediatr. 2018 Jul;177(7):1053-1056. doi: 10.1007/s00431-018-3160-8. Epub 2018 Apr 30.
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Time Perception during Neonatal Resuscitation.新生儿复苏过程中的时间感知
J Pediatr. 2016 Oct;177:103-107. doi: 10.1016/j.jpeds.2016.07.003. Epub 2016 Aug 4.

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