Rickart Alexander J, Sikdar Oishi, Jenkinson Allan, Greenough Anne
Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, UK.
Children (Basel). 2024 Sep 6;11(9):1094. doi: 10.3390/children11091094.
The results of a survey of twenty-four neonatal units in the United Kingdom and Ireland are presented. A structured ten-item questionnaire was used, and demonstrated the variation in how infants with RS are diagnosed and managed. Notably, the survey revealed that a minority of infants were diagnosed antenatally. There were significant discrepancies in diagnostic criteria used and 79% of the units referred the patients to tertiary services. A preference for minimally invasive approaches to managing upper airway obstruction, such as a trial of prone positioning before progressing to a nasopharyngeal airway, was reported by 96% of the centers. A narrative review was undertaken which discusses the current practices for diagnosis and early management of Robin sequence (RS). The challenges of antenatal diagnosis, strategies to enhance outcomes through early detection and controversies surrounding the management of neonatal upper airway obstruction associated with RS are included. The results of the survey and our comprehensive review of the literature emphasize that there remains uncertainty regarding the best approach to treating Robin sequence.
本文展示了对英国和爱尔兰24个新生儿科的调查结果。采用了一份包含10个条目的结构化问卷，结果显示了患有罗宾序列征（RS）的婴儿在诊断和管理方式上的差异。值得注意的是，调查显示少数婴儿是在产前被诊断出的。在使用的诊断标准上存在显著差异，79%的科室将患者转诊至三级医疗机构。96%的中心报告称，在处理上呼吸道梗阻时倾向于采用微创方法，比如在使用鼻咽气道之前先尝试俯卧位。本文进行了一篇叙述性综述，讨论了罗宾序列征（RS）诊断和早期管理的当前做法。内容包括产前诊断的挑战、通过早期检测改善预后的策略以及与RS相关的新生儿上呼吸道梗阻管理方面的争议。调查结果以及我们对文献的全面综述强调，对于治疗罗宾序列征的最佳方法仍存在不确定性。
