Survival of the very-low-birth-weight infants after cardiopulmonary resuscitation in neonatal intensive care unit.
Survival of the very-low-birth-weight infants after cardiopulmonary resuscitation in neonatal intensive care unit.
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DOI：
10.1038/sj.jp.7211054
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发表时间：
2004-05-01
期刊：
影响因子：
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通讯作者：
Dhanireddy, Ramasubbareddy
中科院分区：
文献类型：
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作者：
Kostelanetz, Anna S;Dhanireddy, Ramasubbareddy
目的：评估过去十年新生儿护理的进步是否改变了新生儿重症监护室（NICU）中心肺复苏（CPR）后极低出生体重（VLBW）婴儿的结局。所有极低出生体重婴儿的医疗记录（n=283，体重（BW）=1066+/-281 g，胎龄（GA）=28.3+/-2.9周）在1999年和2002年之间入住NICU。29例（10.25%）在NICU接受心肺复苏。只有一个婴儿幸存下来。校正GA后，与NICU中需要CPR显著相关的临床变量为（校正比值比; 95%CI）：肺出血（7.89; 3.06 - 20.28），肺漏气综合征（23.90; 7.58 - 75.4）和剖宫产分娩（0.26; 0.1 - 0.66）。结果是相似的，当数据进行重新分析匹配的28名婴儿在CPR组与28名婴儿相同的GA在non-CPR group.CONCLUSIONS：婴儿谁需要心肺复苏术在新生儿重症监护室的生存率仍然非常差。这种不良结局需要与父母讨论，选择“不复苏”（DNR）顺序可能适合这些婴儿，特别是对治疗无反应的多器官衰竭婴儿。
OBJECTIVE: To assess whether advances in neonatal care in the last decade have altered the outcome of very-low-birth-weight (VLBW) infants after cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU).STUDY DESIGN: Medical records of all VLBW infants (n=283, body weight (BW)=1066+/-281 g, gestational age (GA)=28.3+/-2.9 weeks) admitted to the NICU between 1999 and 2002 were reviewed.RESULTS: In all, 29 (10.25%) infants received CPR in the NICU. Only one of these infants survived. After adjusting for GA, the clinical variables significantly associated with the need for CPR in the NICU were (adjusted odds ratio; 95% CI): pulmonary hemorrhage (7.89; 3.06 to 20.28), pulmonary air leak syndrome (23.90; 7.58 to 75.4), and delivery by Cesarian section (0.26; 0.1 to 0.66). The results were similar when the data were reanalyzed matching the 28 infants in the CPR group with 28 infants of identical GA in the non-CPR group.CONCLUSIONS: Survival rate for the infants who require CPR in the NICU remains extremely poor. This poor outcome needs to be discussed with parents and the option of the "do not resuscitate" (DNR) order may be appropriate for these infants, especially for those infants with multiple organ failure unresponsive to therapy.