早发性低体循环超声筛查与早产儿脑室周围出血的相关性：一项多中心队列研究。
Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study.
机构信息
Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain.
Pediatric Intensive Care Unit and Pediatric Cardiology Unit, Complejo Asistencial Universitario de León, León, Spain.
出版信息
J Perinatol. 2024 Oct;44(10):1496-1503. doi: 10.1038/s41372-024-01968-6. Epub 2024 Apr 25.
OBJECTIVE
To determine whether early echocardiography screening of low systemic blood flow reduces intraventricular hemorrhage in preterm infants.
STUDY DESIGN
Prospective multicenter study in preterm infants below 33 weeks of gestational age at nine neonatal units. Five units performed early echocardiography screening for low systemic blood flow and guided clinical management (exposure group) and 4 units did not (control group). Our main outcome was ≥grade II intraventricular hemorrhage or death within the first 7 days of life. The main analysis used the inverse probability of treatment weighting.
RESULTS
Three hundred and thirty-two preterm infants (131 in the exposure group and 201 in the control group) were included. Exposure to early echocardiography screening was associated with a significant reduction in ≥grade II intraventricular hemorrhage or early death [odds ratio 0.285 (95% CI: 0.133-0.611); p = 0.001].
CONCLUSIONS
Early echocardiography screening for low systemic blood flow may reduce the incidence of intraventricular hemorrhage in preterm infants.
目的
确定早期超声心动图筛查低体循环血流量是否能降低早产儿的脑室内出血发生率。
研究设计
在九个新生儿病房中，对胎龄小于 33 周的早产儿进行前瞻性多中心研究。五个单位进行早期超声心动图筛查低体循环血流量，并指导临床管理（暴露组），4 个单位不进行（对照组）。我们的主要结局是出生后 7 天内发生≥Ⅱ级脑室内出血或死亡。主要分析采用逆概率治疗加权法。
结果
共纳入 332 例早产儿（暴露组 131 例，对照组 201 例）。早期超声心动图筛查与≥Ⅱ级脑室内出血或早期死亡显著降低相关[比值比 0.285（95%可信区间：0.133-0.611）；p=0.001]。
结论
早期超声心动图筛查低体循环血流量可能降低早产儿脑室内出血的发生率。
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