电阻抗断层扫描证实了足月新生儿分娩方式对早期肺通气的影响。

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Adomas Janulionis, Viktorija Sutova, Vita Langiene, Ernestas Virsilas, Violeta Drejeriene, Arunas Liubsys, Arunas Valiulis
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引用次数: 0

摘要

背景:由于医学和文化原因,通过剖宫产(CS)出生的婴儿数量在全球范围内不断增加。目的:本研究旨在利用电阻抗断层扫描(EIT)确定分娩方式对新生儿早期肺通气的影响。材料和方法:病例对照研究于2020年12月至2021年4月进行。它包括32例CS分娩的足月新生儿和20例正常阴道分娩(NVD)分娩的足月新生儿作为对照。电阻抗断层扫描检查采用带有NEO SensorBelt和32个集成电极的swisstorm BB2设备进行,频率为47.68 Hz。分别于出生后30min、60min和90min(平均时间分别为13min、62min和930min)进行3次数据记录。结果:剖宫产新生儿在第二次记录时,与NVD分娩的新生儿相比,重力依赖区无通气面积更大(p = 0.04)。与NVD组相比,CS组在第2次和第3次记录时肺拉伸变化较低(p = 0.022和p = 0.032)。在研究组中,与对照组相比,出生后1 h,最低拉伸区域(10-20%,20-30%和30-40%)的肺总容量增加(p = 0.024, p = 0.004和p = 0.044)。第1次和第3次EIT记录的测量结果显示,与NVD新生儿相比,CS新生儿右肺潮气量(TV)向中央区域分布更大,而NVD新生儿在出生后立即向右肺中央腹侧区域分布更多。结论:分娩方式对足月新生儿出生后早期肺通气有显著影响。剖宫产新生儿的特点是在重力依赖的肺区通气较差,而NVD新生儿表现出更大的肺拉伸变化和更强烈的组织扩张,可能导致更好的产后适应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Electrical impedance tomography confirmed the impact of the method of delivery of term neonates on early lung aeration.

Background: The number of infants born via cesarean section (CS) is increasing globally due to medical and cultural reasons.

Objectives: This study aimed to determine the effect of the mode of delivery on early lung aeration in newborns using electrical impedance tomography (EIT).

Material and methods: The case-control study was conducted from December 2020 to April 2021. It included 32 term neonates delivered by CS and 20 term neonates delivered by normal vaginal delivery (NVD) as controls. Electrical impedance tomography examinations were performed with a Swisstom BB2 device with NEO SensorBelt and 32 integrated electrodes at 47.68 Hz. Three data recordings were conducted within 30, 60 and 90 min (mean times: 13, 62 and 93 min, respectively) after the birth.

Results: Cesarean section neonates, compared to those delivered by NVD, had greater non-aerated areas in gravity-dependent lung regions at the 2nd recording (p = 0.04). The CS group showed lower changes in lung stretch at the 2nd and 3rd recording compared to the NVD group (p = 0.022 and p = 0.032, respectively). In the study group, lung regions with the lowest stretch (10-20%, 20-30% and 30-40%) corresponded with increased total lung capacities 1 h after birth compared to the control group (p = 0.024, p = 0.004 and p = 0.044, respectively). Measurements from the 1st and 3rd EIT recording showed a greater distribution of tidal volume (TV) in the right lung toward the central regions among CS neonates compared to NVD neonates, whereas NVD neonates showed increased distribution of TV toward the central-ventral regions of the right lung immediately after birth.

Conclusions: The mode of delivery significantly affects early postnatal lung aeration in term neonates assessed using EIT. Caesarean section neonates were characterized by poorer aeration in gravity-dependent lung regions, whereas NVD neonates demonstrated greater changes in lung stretch and more intense tissue expansion, potentially leading to better postnatal adaptation.

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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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