背景:虽然不是普遍的,正在为出生时体重<500克的婴儿提供积极护理,称为适合胎龄的超低出生体重(ULBW)婴儿。这些婴儿死亡或发生重大疾病的风险最大。ULBW婴儿在生命的最初几天由于皮肤的极端解剖和生理不成熟而面临与流体和热量损失以及皮肤损伤相关的挑战。尽管有关于ULBW婴儿结局的新兴文献,缺乏证据为这一婴儿队列提供最佳护理的实践指南提供依据.
方法:使用PubMed和Embase数据库对文献进行了全面回顾。搜索关键词包括\"体温调节或体温调节\",\"培养箱湿度\",\"护肤\",\"婴儿,极低出生体重\"和\"超低出生体重婴儿\"。
结果:体温调节的证据,培养箱湿度,和护肤措施适用于出生时体重<1500g的早产儿,但不适用于ULBW婴儿。体温调节的研究,培养箱湿度,或皮肤护理实践的样本量较小,不包括ULBW婴儿的亚组分析.ULBW婴儿的当前实践建议是根据对极低和/或极低出生体重婴儿的研究而采用的。
结论:这篇叙述性综述侧重于体温调节方面的挑战,培养箱湿度,和ULBW婴儿的护肤实践,突出了当前的研究差距,并提出了为改善ULBW婴儿健康结果的实践提供信息的潜在发展。视频摘要(MP41,49,115kb)。
BACKGROUND: Although not universal, active care is being offered to infants weighing < 500 g at birth, referred to as ultra-low birth weight (ULBW) infants appropriate for gestational age. These infants have the greatest risk of dying or developing major morbidities. ULBW infants face challenges related to fluid and heat loss as well as skin injury in the initial days of life from extreme anatomical and physiological immaturity of the skin. Although there is an emerging literature on the outcomes of ULBW infants, there is a paucity of evidence to inform practice guidelines for delivering optimal care to this cohort of infants.
METHODS: A comprehensive review of the literature was performed using the PubMed and Embase databases. Searched keywords included \"thermoregulation or body temperature regulation\", \"incubator humidity\", \"skin care\", \"infant, extremely low birth weight\" and \"ultra-low birth weight infants\".
RESULTS: Evidences for thermoregulation, incubator humidity, and skincare practices are available for preterm infants weighing < 1500 g at birth but not specifically for ULBW infants. Studies on thermoregulation, incubator humidity, or skincare practices had a small sample size and did not include a sub-group analysis for ULBW infants. Current practice recommendations in ULBW infants are adopted from research in very and/or extremely low birth weight infants.
CONCLUSIONS: This narrative review focuses on challenges in thermoregulation, incubator humidity, and skincare practices in ULBW infants, highlights current research gaps and suggests potential developments for informing practices for improving health outcomes in ULBW infants. Video abstract (MP4 1,49,115 kb).