孕32周以下早产儿过渡期脐带处理策略与氧合情况
Oxygenation associated with cord management strategies among preterm infants <32 weeks gestation during the transition period.
作者信息
Peterson Catherine, Ferrer Lucia, Sanjay Shashank, Poeltler Debra, Lakshminrusimha Satyan, Katheria Anup C
机构信息
Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USA.
Department of Pharmaceutical & Clinical Sciences, Campbell University, Buies Creek, NC, USA.
出版信息
J Perinatol. 2025 Jan;45(1):55-62. doi: 10.1038/s41372-024-02127-7. Epub 2024 Oct 11.
OBJECTIVE
Compare changes in SpO and FiO post-birth among preterm infants after delayed cord clamping (DCC), umbilical cord milking (UCM) or early cord clamping (ECC).
STUDY DESIGN
Retrospective study of infants <32 weeks gestation born between 2014 and 2021. ECC was clamping 0-59 s, DCC was clamping ≥60 s after delivery, UCM defined as milking the intact umbilical cord several times before clamping.
RESULTS
Of 463 infants; 257 received DCC, 168 received UCM, 38 received ECC. UCM infants had higher median SpO values at 4-(79% UCM vs 69% DCC, p = 0.027) and 5-(85% UCM vs 80% DCC, p = 0.023) minutes after-birth compared to DCC. DCC and UCM infants required lower FiO levels in the first 5-minutes compared to ECC infants (DCC 0.38 ± 0.17, UCM 0.40 ± 0.20 vs ECC 0.51 ± 0.27, p's <0.001).
CONCLUSION
The proportion of infants achieving SpO ≥ 80% by 5 min was similar in all groups, FiO needed to achieve this goal was higher in ECC infants.
目的
比较延迟脐带结扎（DCC）、脐带挤血（UCM）或早期脐带结扎（ECC）后早产儿出生后血氧饱和度（SpO）和吸入氧分数（FiO）的变化。
研究设计
对2014年至2021年间出生的孕周<32周的婴儿进行回顾性研究。ECC是在分娩后0 - 59秒结扎脐带，DCC是在分娩后≥60秒结扎脐带，UCM定义为在结扎前多次挤压完整的脐带。
结果
463名婴儿中，257名接受DCC，168名接受UCM，38名接受ECC。与DCC相比，UCM组婴儿出生后4分钟（UCM组为79%，DCC组为69%，p = 0.027）和5分钟（UCM组为85%，DCC组为80%，p = 0.023）时的SpO中位数更高。与ECC组婴儿相比，DCC组和UCM组婴儿在出生后前5分钟需要的FiO水平更低（DCC组0.38±0.17，UCM组0.40±0.20，ECC组0.51±0.27，p值均<0.001）。
结论
所有组中在5分钟时SpO≥80%的婴儿比例相似，ECC组婴儿达到这一目标所需的FiO更高。
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