肺部超声特征可预测因剖腹产而出现短暂新生儿呼吸急促或呼吸窘迫综合征的婴儿进入新生儿重症监护病房。,European Journal of Pediatrics

当前位置： X-MOL 学术 › Eur. J. Pediatr. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

肺部超声特征可预测因剖腹产而出现短暂新生儿呼吸急促或呼吸窘迫综合征的婴儿进入新生儿重症监护病房。
European Journal of Pediatrics ( IF 3.0 ) Pub Date : 2020-09-19 , DOI: 10.1007/s00431-020-03789-z
Antonio Poerio ₁ , Silvia Galletti ₂ , Michelangelo Baldazzi ₁ , Silvia Martini ₂ , Alessandra Rollo ₂ , Sofia Spinedi ₂ , Francesco Raimondi ₃ , Maurizio Zompatori ₁ , Luigi Corvaglia ₂ , Arianna Aceti ₂

Affiliation

我们旨在评估肺部超声 (LU) 在预测因剖腹产 (CS) 出生的婴儿因暂时性新生儿呼吸急促或呼吸窘迫综合征而进入新生儿重症监护病房 (NICU) 的可靠性。在意大利博洛尼亚的 Sant'Orsola-Malpighi 医院的产房和新生儿重症监护室进行了一项前瞻性、观察性、单中心研究。包括由 CS 出生的足月和晚期早产儿。LU 在出生后 30' 和 4 小时进行。LU 外观根据先前验证的三点评分系统进行分级（3P-LUS：1 型，白肺；2 型，黑/白肺；3 型，正常肺）。还计算了完整的 LUS。招募了 100 名婴儿，其中 7 名被送入 NICU。5 例出生时双侧 1 型肺的婴儿均入住 NICU。患有 2 型和/或 3 型肺的婴儿不太可能入住 NICU。入住 NICU 的婴儿的平均全 LUS 为 17，未入住的婴儿的平均全 LUS 为 8。在两个独立的二元逻辑回归模型中，3P 和完整 LUS 均被证明与 NICU 入院独立相关（OR [95% CI] 0.001 [0.000-0.058]、P = .001 和 2.890 [1.472-5.672] , P = .002，分别）。3P-LUS 的 ROC 分析得出的 AUC 为 0.942（95% CI，0.876-0.979；P<.001），而完整 LUS 的 ROC 分析得出的 AUC 为 0.978（95%CI，0.926-0.997；P <.001）。两种 LU 评分的 AUC 没有显着差异 (p = .261)。结论：出生后 30 分钟执行的 3P-LUS 被证明是一种可靠的工具，可用于识别 CS 所生的足月和晚期早产儿，因暂时性新生儿呼吸急促或呼吸窘迫综合征需要入住 NICU 的人。已知情况 • 肺部超声 (LU) 已成为新生儿环境中极具吸引力的诊断工具，并且最近发布了新生儿重症监护病房 (NICU) 中的床旁 LU 指南。• LU 目前用于诊断多种新生儿呼吸系统疾病，也被提议用于预测进一步干预，例如 NICU 入住、早产儿需要表面活性剂治疗或机械通气。新增内容 • LU 在出生后 30 英尺进行，并通过简单的三分评分系统进行评估，这是一种可靠的工具，可用于识别剖腹产的足月和晚期早产儿，需要入住 NICU 的一过性新生儿呼吸急促或呼吸窘迫综合征患者。• 在新生儿期进行的 LU 证实了其在改善新生儿常规临床管理方面的潜在作用。

"点击查看英文标题和摘要"

Lung ultrasound features predict admission to the neonatal intensive care unit in infants with transient neonatal tachypnoea or respiratory distress syndrome born by caesarean section.

We aimed to evaluate the reliability of lung ultrasound (LU) to predict admission to the neonatal intensive care unit (NICU) for transient neonatal tachypnoea or respiratory distress syndrome in infants born by caesarean section (CS). A prospective, observational, single-centre study was performed in the delivery room and NICU of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Term and late-preterm infants born by CS were included. LU was performed at 30' and 4 h after birth. LU appearance was graded according to a previously validated three-point scoring system (3P-LUS: type-1, white lung; type-2, black/white lung; type-3, normal lung). Full LUS was also calculated. One hundred infants were enrolled, and seven were admitted to the NICU. The 5 infants with bilateral type-1 lung at birth were all admitted to the NICU. Infants with type-2 and/or type-3 lung were unlikely to be admitted to the NICU. Mean full-LUS was 17 in infants admitted to the NICU, and 8 in infants not admitted. In two separate binary logistic regression models, both the 3P- and the full LUS proved to be independently associated with NICU admission (OR [95% CI] 0.001 [0.000-0.058], P = .001, and 2.890 [1.472-5.672], P = .002, respectively). The ROC analysis for the 3P-LUS yielded an AUC of 0.942 (95%CI, 0.876-0.979; P<.001), while ROC analysis for the full LUS yielded an AUC of 0.978 (95%CI, 0.926-0.997; P<.001). The AUCs for the two LU scores were not significantly different (p = .261).Conclusion: the 3P-LUS performed 30 min after birth proved to be a reliable tool to identify, among term and late preterm infants born to CS, those who will require NICU admission for transient neonatal tachypnoea or respiratory distress syndrome. What is known • Lung ultrasound (LU) has become an attractive diagnostic tool in neonatal settings, and guidelines on point-of-care LU in the neonatal intensive care unit (NICU) have been recently issued. • LU is currently used for diagnosing several neonatal respiratory morbidities and has been also proposed for predicting further intervention, such as NICU admission, need for surfactant treatment or mechanical ventilation in preterm infants. What is new • LU performed 30' after birth and evaluated through a simple three-point scoring system represents a reliable tool to identify, among term and late preterm infants born to caesarean section, those with transient neonatal tachypnoea or respiratory distress syndrome who will require NICU admission. • LU performed in the neonatal period confirms its potential role in ameliorating routine neonatal clinical management.

更新日期：2020-09-19

点击分享查看原文

点击收藏

公开下载

阅读更多本刊新发论文本刊介绍/投稿指南