Abstract:
European Consensus Guidelines (ECG) on the management of respiratory distress syndrome (RDS) have been developed and updated twice since 2007 reflecting changes in practice as new evidence emerges. The aim of this study was to evaluate the progress in clinical outcome of babies after the implementation of the updated ECG in 2010. Forty-eight neonates born in 2002-2003 (Group 02/03; n = 15) and in 2012-2013 (Group 12/13; n = 33) at gestational age of 26.2 ± 1.7 weeks were included into this retrospective study. Resuscitation procedures, ventilation support, and postnatal administration of surfactant were assessed. In Group 12/13, compared with Group 02/03, there was a higher rate of maternal corticosteroid prophylactic treatment (33 % vs. 0 %, p < 0.001), more children received primary nasal continuous positive airway pressure (nCPAP) (54.5 % vs. 20 %, p < 0.01) and repeated doses of surfactant (33 % vs. 0 %, p < 0.001), and had a reduced rate of mortality, bronchopulmonary dysplasia, and necrotizing enterocolitis. We conclude that the management of extremely preterm newborns improved considerably over the decade resulting in a significant reduction of mortality and morbidity.
摘要:
自2007年以来,关于呼吸窘迫综合征(RDS)管理的欧洲共识指南(ECG)已经制定并更新了两次,反映了实践中的变化,因为新证据出现。这项研究的目的是评估2010年实施更新的ECG后婴儿临床结局的进展。这项回顾性研究纳入了2002-2003年(02/03组;n=15)和2012-2013年(12/13组;n=33)胎龄为26.2±1.7周的48例新生儿。复苏程序,通风支持,和出生后表面活性剂的给药进行评估。在12/13组中,与02/03组相比,母体皮质类固醇预防性治疗的比率更高(33%vs.0%,p<0.001),更多儿童接受原发性鼻塞持续气道正压通气(nCPAP)(54.5%vs.20%,p<0.01)和重复剂量的表面活性剂(33%vs.0%,p<0.001),死亡率降低了,支气管肺发育不良,和坏死性小肠结肠炎.我们得出的结论是,在过去的十年中,极早产新生儿的管理得到了显着改善,从而大大降低了死亡率和发病率。