Delivery Room Intervention: Improving the Outcome
Delivery Room Intervention: Improving the Outcome
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DOI：
10.1016/j.clp.2010.01.011
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发表时间：
2010-03-01
影响因子：
2.1
通讯作者：
Finer, Neil N.
中科院分区：
文献类型：
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作者：
Rich, Wade D.;Leone, Tina;Finer, Neil N.
作者自 1999 年以来一直对新生儿复苏进行视频回顾。在这 10 年期间，我们的三个阶段的经验得到了认可。我们的早期审查帮助我们认识到我们在产房里所做的事情，这是在改进干预过程中被忽视的一个领域。人们注意到，在许多情况下，多人试图完成同一任务，袋子和面罩通气几乎完全是呼吸治疗师的职权范围，其他人执行得不好，低出生体重的婴儿在入院时往往体温过低。在确定正在做什么以及做得如何之后，我们开始讨论如何做得更好。这一时期包括通过使房间变暖、使用封闭包裹、使用比色二氧化碳探测器确定袋子和面罩通风的有效性以及引入机组资源管理来发展一致和有效的沟通来改变环境。我们经验的第三阶段和当前阶段是确定这些干预措施如何影响产房和可能的后续结果。仍需要精心设计的临床试验来进一步建立最佳的复苏干预措施。
The authors have conducted video review of neonatal resuscitations since 1999. Over this 10-year period 3 phases of our experience have been recognized. Our early reviews helped us recognize what we were doing in the delivery room, an area that had been ignored in improved intervention. It was noted that on many occasions multiple people were trying to accomplish the same task, that bag and mask ventilation was almost exclusively the purview of the respiratory therapists and was not performed well by others, and that infants with low birth weight were often hypothermic on admission. After determining what was being done and how well it was being done, we moved on to how to do it better. This period included making environmental changes by warming the room, the use of occlusive wrap, determining the effectiveness of bag and mask ventilation with colorimetric CO2 detectors, and the introduction of crew resource management to develop consistent and effective communication. The third and current phase of our experience is to determine how these interventions affect delivery room and potentially later outcomes. Well-designed clinical trials are still needed to further establish the most optimal resuscitation interventions.