引入视频喉镜辅助微创表面活性给药的结果、安全性和卫生经济学。

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2024-11-22 DOI:10.1038/s41372-024-02162-4

Venkata Gupta, Barry Weinberger, Stephanie G Galanti, Jimikumar Patel, Gangajal Kasniya, Dalibor Kurepa

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引用次数: 0

摘要

背景：与 InSurE（插管-表面活性物质给药-拔管）相比，微创表面活性物质给药（LISA）能带来更好的治疗效果。视频喉镜（VL）有助于新生儿插管，但 VL 辅助 LISA 的安全性和成本效益尚未得到评估：我们比较了接受 VL 辅助 LISA 的婴儿（n = 67）与接受 InSurE 的历史婴儿队列（n = 52）的结果。次要目的是评估安全性和成本效益：与 InSurE 相比，VL 辅助 LISA 可缩短无创通气（NIV）持续时间，缩短氧疗持续时间，减少 NIV 和机械通气（MV）的复合天数，缩短新生儿重症监护室（NICU）的住院时间，降低住院费用。在 VL 辅助 LISA 组中，66% 的气管导管在第一次尝试时就已置入，16% 的婴儿在置入过程中出现不饱和：结论：与 InSurE 相比，对于体重≥29 周的婴儿，VL 辅助 LISA 可减少 NIV、氧气、NIV 和 MV 的使用量，缩短住院时间，降低护理成本。

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Outcomes, safety and health economics of introduction of video laryngoscopy-assisted less invasive surfactant administration.

Background: Less invasive surfactant administration (LISA) is associated with better outcomes than InSurE (Intubation-Surfactant administration-Extubation). Video-laryngoscopy (VL) facilitates intubation in neonates, however safety and cost-effectiveness of VL-assisted LISA have not been evaluated.

Methods: We compared the outcomes of infants receiving VL-assisted LISA (n = 67) with a historical cohort of infants who received InSurE (n = 52). Secondary aims were to evaluate safety and cost-effectiveness.

Results: VL-assisted LISA was associated with reduced duration of non-invasive ventilation (NIV), reduced duration of oxygen therapy, reduced composite days on NIV and mechanical ventilation (MV), and shorter NICU stay with lower hospital costs for infants ≥29 weeks GA, compared to InSurE. In the VL-assisted LISA group, 66% of the tracheal catheters were placed on the first attempt and 16% of infants displayed desaturation during placement.

Conclusion: In infants ≥29 weeks GA, VL-assisted LISA reduced exposure to NIV, oxygen, NIV and MV combined, length of stay, and cost of care compared to InSurE.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.