Skin-to-skin stabilisation and uninterrupted respiratory support for preterm infants after birth: feasibility of a new and simplified rPAP system.

IF 3.9 2区 医学 Q1 PEDIATRICS
Sonja Baldursdottir, Kolbrun Gunnarsdottir, Snorri Donaldsson, Baldvin Jonsson, Thomas Drevhammar
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引用次数: 0

Abstract

Background: The rPAP respiratory support system, used for delivery room stabilisation with nasal prongs, has been shown to reduce the need for intubation in extremely preterm infants. A simplified version of the system has been developed. The purpose of this study was to determine the feasibility of providing uninterrupted respiratory support with the simplified rPAP from birth up to 4 hours of life and to assess ease of use for skin-to skin stabilisation.

Methods: This was a non-randomised feasibility study conducted at Karolinska University Hospital, Sweden. Respiratory support with continuous positive airway pressure (CPAP) and positive pressure ventilation if needed was given with the simplified rPAP using heated humidified gases. Respiratory support was provided in the delivery room, during transportation and in the neonatal unit, for a maximum of 4 hours.

Results: 32 preterm infants with a mean (SD) gestational age of 33.4 weeks (±1.2) were included. Of 17 infants born vaginally, 13 were stabilised skin-to-skin. The remaining infants were stabilised on a resuscitation table. All infants received CPAP and nine received positive pressure ventilation. 31 infants received continued support during transport and after arrival in the neonatal unit. Minor interruptions in CPAP support occurred in all infants. The study did not reveal problems with usability of the system.

Conclusion: It is feasible to stabilise preterm infants with the simplified respiratory support system both skin-to-skin and on a resuscitation table, and to provide continued respiratory support with the same system during transportation and in the neonatal unit.

Trial registration number: NCT04244890.

早产儿出生后的皮肤接触稳定和不间断呼吸支持:新型简化 rPAP 系统的可行性。
背景:rPAP 呼吸支持系统用于在产房使用鼻插管稳定呼吸,已被证明可减少极早产儿的插管需求。该系统的简化版已经开发出来。本研究的目的是确定从出生到出生后 4 小时内使用简化版 rPAP 提供不间断呼吸支持的可行性,并评估皮肤对皮肤稳定的易用性:这是一项在瑞典卡罗林斯卡大学医院进行的非随机可行性研究。通过使用加热加湿气体的简化 rPAP,在需要时提供持续气道正压(CPAP)和正压通气的呼吸支持。呼吸支持在产房、转运途中和新生儿病房提供,最长时间为 4 小时:共纳入 32 名早产儿,平均(标清)胎龄为 33.4 周(±1.2)。17名经阴道分娩的婴儿中,13名接受了皮肤对皮肤的稳定护理。其余婴儿在复苏台上进行了稳定。所有婴儿都接受了 CPAP,9 名婴儿接受了正压通气。31 名婴儿在转运途中和抵达新生儿病房后接受了持续支持。所有婴儿的 CPAP 支持都有轻微中断。研究没有发现系统可用性方面的问题:结论:使用简化呼吸支持系统在皮肤接触和复苏台上稳定早产儿是可行的,在转运过程中和新生儿病房中使用同一系统持续提供呼吸支持也是可行的:NCT04244890.
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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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