Abstract:
Background: Premature birth affects millions of neonates each year, placing them at risk for respiratory disease due to prematurity. Bronchopulmonary dysplasia is the most common chronic lung disease of infancy, but recent data suggest that even premature infants who do not meet the strict definition of bronchopulmonary dysplasia can develop adverse pulmonary outcomes later in life. This post-prematurity respiratory disease (PPRD) manifests as chronic respiratory symptoms, including cough, recurrent wheezing, exercise limitation, and reduced pulmonary function. This document provides an evidence-based clinical practice guideline on the outpatient management of infants, children, and adolescents with PPRD. Methods: A multidisciplinary panel of experts posed questions regarding the outpatient management of PPRD. We conducted a systematic review of the relevant literature. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to rate the quality of evidence and the strength of the clinical recommendations. Results: The panel members considered the strength of each recommendation and evaluated the benefits and risks of applying the intervention. In formulating the recommendations, the panel considered patient and caregiver values, the cost of care, and feasibility. Recommendations were developed for or against three common medical therapies and four diagnostic evaluations in the context of the outpatient management of PPRD. Conclusions: The panel developed recommendations for the outpatient management of patients with PPRD on the basis of limited evidence and expert opinion. Important areas for future research were identified.
摘要:
背景:早产每年影响数百万新生儿,由于早产使他们面临呼吸道疾病的风险。支气管肺发育不良是婴儿期最常见的慢性肺部疾病,但最近的数据表明,即使不符合支气管肺发育不良严格定义的早产儿也会在以后的生活中出现不良的肺部结局。这种早产后呼吸道疾病(PPRD)表现为慢性呼吸道症状,包括咳嗽,反复喘息,运动限制,肺功能下降.本文件提供了关于婴儿门诊管理的循证临床实践指南,孩子们,和青少年PPRD。方法:一个多学科专家小组提出了有关PPRD门诊管理的问题。我们对相关文献进行了系统的回顾。建议的分级,评估,发展,采用评估方法对证据质量和临床建议的强度进行评分。结果:小组成员考虑了每个建议的强度,并评估了应用干预措施的收益和风险。在制定建议时,小组考虑了患者和护理人员的价值观,护理的费用,和可行性。在PPRD的门诊管理中,针对或针对三种常见的医学疗法和四种诊断评估提出了建议。结论:专家组根据有限的证据和专家意见,为PPRD患者的门诊管理提出了建议。确定了未来研究的重要领域。