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产房内持续气道正压通气用于极早产儿:一项中国单中心回顾性研究

Continuous positive airway pressure in delivery room in extremely preterm infants: A single-center retrospective study in China.

作者信息

Zhang Xiaoting, Chen Long, Zhong Xiaoyun, Ou Jiangfeng, Shi Yuan

机构信息

Department of Neonatology Children's Hospital of Chongqing Medical University National Clinical Research Center for Child Health and Disorders Ministry of Education Key Laboratory of Child Development and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders Chongqing Key Laboratory of Pediatrics Chongqing China.

Department of Pediatrics Women and Children's Hospital of Chongqing Medical University Chongqing China.

出版信息

Pediatr Discov. 2024 Oct 25;3(2):e2507. doi: 10.1002/pdi3.2507. eCollection 2025 Jun.

Abstract

To assess the beneficial effects of delivery room continuous positive airway pressure (DRCPAP) in extremely preterm infants, a single-center retrospective study was performed at the Women and Children's Hospital of Chongqing Medical University in China. Infants born between January 2016 and December 2018 were regarded as the control group, and those born between January 2019 and August 2022 were considered as the observation group (DRCPAP group). The primary outcome was tracheal intubation within 72 h after birth. Six hundred and seven patients were included in the study (control: 232; DRCPAP: 375). Compared with the control group, DRCPAP reduced the intubation rate (56.8% vs. 62.9%, OR 0.57, 95% CI 0.34-0.96,  0.035), including <28 weeks gestational age (GA) subgroup (61.5% vs. 84.7%, OR 0.12, 95% CI 0.02-0.78,  0.027). One-to-one propensity score matching (195:195) was used to match the baseline characteristics of patients in DRCPAP and control group. After matching, no significant differences were observed in intubation rate within 72 h between the two groups (20.5% [40 of 195] vs. 22.1% [43 of 195];  = 0.711). Whether DRCPAP can reduce intubation rate within 72 h requires further investigation.

摘要

为评估产房持续气道正压通气(DRCPAP)对极早产儿的有益效果,在中国重庆医科大学附属妇女儿童医院开展了一项单中心回顾性研究。将2016年1月至2018年12月出生的婴儿作为对照组,将2019年1月至2022年8月出生的婴儿作为观察组(DRCPAP组)。主要结局为出生后72小时内气管插管。该研究共纳入607例患者(对照组:232例;DRCPAP组:375例)。与对照组相比,DRCPAP降低了插管率(56.8%对62.9%,OR 0.57,95%CI 0.34 - 0.96,P = 0.035),包括孕周<28周(GA)亚组(61.5%对84.7%,OR 0.12,95%CI 0.02 - 0.78,P = 0.027)。采用一对一倾向评分匹配法(195:195)对DRCPAP组和对照组患者的基线特征进行匹配。匹配后,两组在72小时内的插管率无显著差异(20.5%[195例中的40例]对22.1%[195例中的43例];P = 0.711)。DRCPAP是否能降低72小时内的插管率尚需进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9808/12258101/dd081c9bb30d/PDI3-3-e2507-g002.jpg

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