Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia.
Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia.
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DOI：
10.1055/s-0035-1547326
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发表时间：
2015-08
影响因子：
2
通讯作者：
Collaco JM
中科院分区：
文献类型：
--
作者：
Guaman MC;Gien J;Baker CD;Zhang H;Austin ED;Collaco JM
尽管早产儿的存活率有所提高，但支气管肺发育不良（BPD）仍然是一种持续的发病率。严重BPD（sBPD）的发生率、临床病程和目前的治疗仍有待确定。为了解决这些知识差距，形成了一个多中心协作，以改善该人群的结局。我们于2013年12月17日在8个新生儿重症监护病房（NICU）进行了“快照”。每一个出生在< 32周的住院病人的标准化临床数据表都被完成并集中整理用于分析。sBPD定义为经后36周时接受≥ 30%的辅助供氧和/或正压通气。在710名住院患者中，351名婴儿出生时< 32周，其中128名（36.5%）符合sBPD标准。sBPD的时点患病率在各中心之间存在差异（11-58%; p < 0.001）。在sBPD婴儿中，在出生后28天（p < 0.001）和36周PMA（p = 0.001）时使用机械通气的中心之间存在差异。我们观察到利尿剂（p = 0.018）、吸入性皮质类固醇（p < 0.001）和吸入性β受体激动剂（p < 0.001）的使用存在差异。新生儿重症监护病房中sBPD的高患病率和可变管理强调了缺乏证据来指导最佳护理以改善这一高风险、研究不足人群的长期结局。
Despite improvements in survival of preterm infants, bronchopulmonary dysplasia (BPD) remains a persistent morbidity. The incidence, clinical course, and current management of severe BPD (sBPD) remain to be defined. To address these knowledge gaps, a multicenter collaborative was formed to improve outcomes in this population. We performed a “snapshot” in eight neonatal intensive care units (NICUs) on December 17, 2013. A standardized clinical data form for each inpatient born at < 32 weeks was completed and collated centrally for analysis. sBPD was defined as receiving ≥ 30% supplemental oxygen and/or receiving positive pressure ventilation at 36 weeks postmenstrual age (PMA). Of a total census of 710 inpatients, 351 infants were born at < 32 weeks and 128 of those (36.5%) met criteria for sBPD. The point prevalence of sBPD varied between centers (11–58%; p < 0.001). Among infants with sBPD there was a variation among centers in the use of mechanical ventilation at 28 days of life (p < 0.001) and at 36 weeks PMA (p = 0.001). We observed differences in the use of diuretics (p = 0.018), inhaled corticosteroids (p < 0.001), and inhaled β-agonists (p < 0.001). The high point prevalence of sBPD and variable management among NICUs emphasizes the lack of evidence in guiding optimal care to improve long-term outcomes of this high-risk, understudied population.