Riegel K, Hohenauer L, Lemburg P, von Loewenich V
Monatsschr Kinderheilkd (1902). 1979 Jan;127(1):1-13.
This report contains three sections: A general definition of aims and tasks of neonatal intensive care is followed by the description of four regions and four neonatal units of different structure with some relevant statistics. According to this inquiry about 1.5 cots for maximum neonatal care and 4 cots for intermediate care per 1000 live births are needed. Considering efficiency and effectivity the smallest independent intensive care unit should "cover an area" of 4000 deliveries per year; it should be closely connected to a least one obstetrical unit. Where and how this neonatal unit may be integrated into a childrens hospital can be derived from the four examples given. It should be recognized that 1) high quality intensive care depends on the availability of additional pediatric services, 2) comprehensive care of newborn infants necessitates regional organization including a newborn ambulance system. Thus, close contacts with obstetrical, but also with pediatric units offering better facilities should be established. In yearly intervals results are to be self-controlled by statistical means. The following incidences of normal survival of infants referred to childrens hospitals can be gained currently [2]: Birth weights below 1000 g: above 20%; 1000--1499 g: above 85%; above 1500 g: better than 95%. Less favorable figures call for analyses of reasons and measures to abolish them.
首先是新生儿重症监护目标与任务的总体定义,接着描述了四个不同结构的地区和四个新生儿单元,并给出了一些相关统计数据。根据此项调查,每1000例活产儿大约需要1.5张用于最高级新生儿护理的床位以及4张用于中级护理的床位。考虑到效率和有效性,最小的独立重症监护单元每年应“覆盖”4000例分娩;它应与至少一个产科单元紧密相连。从所给出的四个例子中可以得出该新生儿单元可在何处以及如何整合到儿童医院中。应当认识到:1)高质量的重症监护依赖于额外儿科服务的可及性;2)新生儿的全面护理需要包括新生儿急救系统在内的区域组织。因此,应与产科单元建立紧密联系,同时也应与提供更好设施的儿科单元建立紧密联系。每年都要用统计方法进行自我控制。目前可获得以下转诊至儿童医院的婴儿正常存活发生率[2]:出生体重低于1000克:高于20%;1000 - 1499克:高于85%;高于1500克:优于95%。不太理想的数据需要分析原因并采取措施消除这些不利因素。