视频喉镜辅助下微创表面活性剂给药的疗效、安全性及卫生经济学研究
Outcomes, safety and health economics of introduction of video laryngoscopy-assisted less invasive surfactant administration.
作者信息
Gupta Venkata, Weinberger Barry, Galanti Stephanie G, Patel Jimikumar, Kasniya Gangajal, Kurepa Dalibor
机构信息
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, USA.
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Ochsner Children's Hospital, Ochsner Health, New Orleans, LA, USA.
出版信息
J Perinatol. 2025 Apr;45(4):513-520. doi: 10.1038/s41372-024-02162-4. Epub 2024 Nov 22.
BACKGROUND
Less invasive surfactant administration (LISA) is associated with better outcomes than InSurE (Intubation-Surfactant administration-Extubation). Video-laryngoscopy (VL) facilitates intubation in neonates, however safety and cost-effectiveness of VL-assisted LISA have not been evaluated.
METHODS
We compared the outcomes of infants receiving VL-assisted LISA (n = 67) with a historical cohort of infants who received InSurE (n = 52). Secondary aims were to evaluate safety and cost-effectiveness.
RESULTS
VL-assisted LISA was associated with reduced duration of non-invasive ventilation (NIV), reduced duration of oxygen therapy, reduced composite days on NIV and mechanical ventilation (MV), and shorter NICU stay with lower hospital costs for infants ≥29 weeks GA, compared to InSurE. In the VL-assisted LISA group, 66% of the tracheal catheters were placed on the first attempt and 16% of infants displayed desaturation during placement.
CONCLUSION
In infants ≥29 weeks GA, VL-assisted LISA reduced exposure to NIV, oxygen, NIV and MV combined, length of stay, and cost of care compared to InSurE.
背景
与气管插管-肺表面活性物质给药-拔管（InSurE）相比，微创肺表面活性物质给药（LISA）具有更好的治疗效果。视频喉镜（VL）有助于新生儿插管，然而，VL辅助LISA的安全性和成本效益尚未得到评估。
方法
我们将接受VL辅助LISA的婴儿（n = 67）的治疗结果与接受InSurE的历史队列婴儿（n = 52）进行了比较。次要目的是评估安全性和成本效益。
结果
与InSurE相比，对于孕龄≥29周的婴儿，VL辅助LISA可缩短无创通气（NIV）持续时间、减少氧疗持续时间、减少NIV和机械通气（MV）的综合天数，并缩短新生儿重症监护病房（NICU）住院时间，降低住院费用。在VL辅助LISA组中，66%的气管导管首次尝试放置成功，16%的婴儿在放置过程中出现血氧饱和度下降。
结论
对于孕龄≥29周的婴儿，与InSurE相比，VL辅助LISA减少了NIV、氧气、NIV和MV联合使用的暴露时间、住院时间和护理成本。
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