规范新生儿缺氧缺血性脑病评估和文件记录实践。
Standardizing neonatal hypoxic ischemic encephalopathy evaluation and documentation practices.
机构信息
Division of Neonatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
出版信息
J Perinatol. 2024 Aug;44(8):1216-1221. doi: 10.1038/s41372-024-01916-4. Epub 2024 Feb 29.
BACKGROUND
Infants at risk for hypoxic ischemic encephalopathy (HIE) require a time sensitive evaluation and decision-making regarding treatment with therapeutic hypothermia (TH). Prior to this project, there was no standardized approach to evaluating these infants locally.
METHODS
Included infants were "at risk for HIE," defined as meeting the "patient characteristics" and "biochemical criteria" per the institutional HIE pathway. Our primary outcome was documentation of an HIE therapeutic hypothermia evaluation (HIETHE) within the first six hours of life which included: (1) recognition of at-risk status, (2) an encephalopathy exam, and (3) a decision regarding TH. Plan-Do-Study-Act cycles included novel clinical decision support.
RESULTS
From October 2020 to May 2023, among infants at-risk for HIE, the average percentage with an HIETHE documented improved from 47% to 82%.
CONCLUSIONS
We standardized the approach to infants at risk for HIE and improved the presence of a complete and timely evaluation regarding TH eligibility.
背景
患有缺氧缺血性脑病（HIE）风险的婴儿需要进行及时的评估，并就治疗性低温（TH）的治疗做出决策。在此之前，当地没有评估这些婴儿的标准化方法。
方法
纳入的婴儿被定义为“有 HIE 风险”，符合机构 HIE 途径的“患者特征”和“生化标准”。我们的主要结果是在生命的头 6 小时内记录 HIE 治疗性低温评估（HIETHE），包括：（1）识别高危状态，（2）进行脑病检查，以及（3）决定是否进行 TH。计划-执行-研究-行动循环包括新的临床决策支持。
结果
从 2020 年 10 月到 2023 年 5 月，有 HIE 风险的婴儿中，记录 HIETHE 的婴儿比例从 47%提高到 82%。
结论
我们对有 HIE 风险的婴儿进行了标准化评估，并改进了关于 TH 资格的完整和及时评估的存在。
Zotero 插件