Early versus delayed umbilical cord clamping in infants with congenital heart disease: a pilot, randomized, controlled trial.
Early versus delayed umbilical cord clamping in infants with congenital heart disease: a pilot, randomized, controlled trial.
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DOI：
10.1038/jp.2015.89
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发表时间：
2015-10
影响因子：
2.9
通讯作者：
Hoffman, T. M.
中科院分区：
文献类型：
--
作者：
Backes, C. H.;Huang, H.;Cua, C. L.;Garg, V.;Smith, C. V.;Yin, H.;Galantowicz, M.;Bauer, J. A.;Hoffman, T. M.
出生时延迟脐带结扎（DCC）可能比早期脐带结扎（ECC）提供更好的新生儿健康状况。然而，DCC 在患有先天性心脏病 (CHD) 的婴儿中的安全性和可行性尚未得到测试。这是一项试点、随机、对照试验，旨在确定 DCC 在患有 CHD 的新生儿中的安全性和可行性。入院的孕龄 > 37 周且产前诊断为危重 CHD 的孕妇被纳入并随机分配至 ECC 或 DCC。对于 ECC，出生后 10 秒内夹住脐带；对于 DCC，分娩后约 120 秒夹住脐带。三十名婴儿在出生时被随机分组。 DCC 组和 ECC 组之间在出生胎龄或手术时间方面没有观察到差异。尽管注意到 DCC 组血清胆红素峰值水平（9.2 ± 2.2 vs 7.3 ± 3.2 mg dl−1，P = 0.08）高于 ECC 组，但所有安全措施均未观察到差异。尽管在以后的时间点相似，但在生命的前 72 小时内，DCC 婴儿的血细胞比容高于 ECC 婴儿。 DCC 婴儿在整个住院期间未接受输血的比例高于 ECC 婴儿（43% vs 7%，对数秩检验 P = 0.02）。危重先心病婴儿的 DCC 似乎既安全又可行，与 ECC 相比，接受红细胞输注的婴儿更少。有必要对这种做法进行更全面的评估。
Delayed umbilical cord clamping (DCC) at birth may provide a better neonatal health status than early umbilical cord clamping (ECC). However, the safety and feasibility of DCC in infants with congenital heart disease (CHD) have not been tested. This was a pilot, randomized, controlled trial to establish the safety and feasibility of DCC in neonates with CHD. Pregnant women admitted >37 weeks gestational age with prenatal diagnosis of critical CHD were enrolled and randomized to ECC or DCC. For ECC, the umbilical cord was clamped <10 s after birth; for DCC, the cord was clamped ~ 120 s after delivery. Thirty infants were randomized at birth. No differences between the DCC and ECC groups were observed in gestational age at birth or time of surgery. No differences were observed across all safety measures, although a trend for higher peak serum bilirubin levels (9.2 ± 2.2 vs 7.3 ± 3.2 mg dl− 1, P = 0.08) in the DCC group than in the ECC group was noted. Although similar at later time points, hematocrits were higher in the DCC than in the ECC infants during the first 72 h of life. The proportion of infants not receiving blood transfusions throughout hospitalization was higher in the DCC than in the ECC infants (43 vs 7%, log-rank test P = 0.02). DCC in infants with critical CHD appears both safe and feasible, with fewer infants exposed to red blood cell transfusions than with ECC. A more comprehensive appraisal of this practice is warranted.
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影响因子：
6
作者：
Jenkins, KJ;Gauvreau, K
通讯作者：
Gauvreau, K
DOI：
10.1038/sj.jp.7210970
发表时间：
2003-09-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Mercer, Judith S;McGrath, Margaret M;Oh, William
通讯作者：
Oh, William
影响因子：
105.7
作者：
PRENDIVILLE, WJ;HARDING, JE;STIRRAT, GM
通讯作者：
STIRRAT, GM
DOI：
10.1097/pcc.0b013e3181e30d43
发表时间：
2011-01
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Kipps AK;Wypij D;Thiagarajan RR;Bacha EA;Newburger JW
通讯作者：
Newburger JW
影响因子：
8
作者：
Ersdal, Hege Langli;Linde, Jorgen;Perlman, Jeffrey
通讯作者：
Perlman, Jeffrey