新生儿低血压时皮质类固醇的使用:加拿大新生儿科医生调查

IF 2.3 4区 医学 Q2 PEDIATRICS
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引用次数: 0

摘要

评估使用皮质类固醇治疗新生儿低血压的处方做法和观点。对加拿大 30 个学术中心的三级新生儿重症监护病房的新生儿科医生(n = 206)进行横断面电子问卷调查。总回复率为 33%(72/206),完成率为 94%。大多数受访者(48/72,64%)所在的科室同时收治新生儿和非新生儿,53%(37/70)的受访者所在的科室每年收治的超低出生体重儿超过 100 名。在 72 位受访者中,39% 使用负荷剂量,其中大多数(57%)使用 2 毫克/千克。剂量范围不一,大多数人使用 0.5 毫克/千克或 1 毫克/千克,每 6 小时一次。56%(40/72)的新生儿科医生报告在开始使用氢化可的松前测量过皮质醇,其中开始使用氢化可的松的临界值从<100到<500 nmol/L不等,大多数医生(48%)使用<100 nmol/L。在 71 位受访者中,92%(65 位)表示需要进行随机对照试验,研究皮质类固醇在新生儿低血压中的应用,其中 52%(37 位)表示干预组应在使用一次血管加压素/肌注后再使用氢化可的松。这项调查有助于了解三级新生儿科医生在新生儿低血压时使用皮质类固醇的处方做法。虽然皮质类固醇经常被开具处方,但在皮质类固醇的使用指征、剂量和持续时间方面存在差异。这项调查的结果可用于进一步研究新生儿低血压的治疗方法,包括临床试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Corticosteroid use in neonatal hypotension: A survey of Canadian neonatologists

Objective

To assess prescribing practices and perspectives regarding the use of corticosteroids in the management of neonatal hypotension.

Methods

Cross-sectional questionnaire-based electronic survey of neonatologists (n = 206) practicing at tertiary neonatal intensive care units across 30 academic centres in Canada.

Results

The overall response rate was 33% (72/206), with a completion rate was 94%. Most (48/72, 64%) worked in a unit that covered both inborn and outborn infants, and 53% (37/70) worked in units with >100 very low birth weight infants admitted annually. Among the 72 respondents, 39% use a loading dose, of whom most (57%) use 2 mg/kg. Dosing ranges were variable, most using either 0.5 mg/kg or 1 mg/kg, q6h. Among the 56% (40/72) of neonatologists who reported measuring cortisol before initiation of hydrocortisone, cut-offs for initiation of hydrocortisone varied from <100 to <500 nmol/L, most of whom (48%) used <100 nmol/L. Of 71 respondents, 92% (65) indicated that a randomized control trial examining the use of corticosteroids in neonatal hypotension is needed, of whom 52% (37) indicated that the intervention group should receiving hydrocortisone after one vasopressor/inotrope.

Conclusions

This survey provides insight into the prescribing practices of tertiary neonatologists with regards to the use of corticosteroids in neonatal hypotension. While corticosteroids are frequently prescribed, there is variability in the indication, dosing, and duration of corticosteroid use. The findings from this survey can be used to inform further research, including a clinical trial, regarding the practice in the management of neonatal hypotension.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
170
审稿时长
48 days
期刊介绍: Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.
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