Survey of vitamin A supplementation for extremely-low-birth-weight infants: Is clinical practice consistent with the evidence?
Survey of vitamin A supplementation for extremely-low-birth-weight infants: Is clinical practice consistent with the evidence?
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DOI：
10.1016/j.jpeds.2004.04.046
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发表时间：
2004-09-01
影响因子：
5.1
通讯作者：
Carlo, WA
中科院分区：
文献类型：
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作者：
Ambalavanan, N;Kennedy, K;Carlo, WA
目的 调查美国 III 级新生儿重症监护病房对极低出生体重（ELBW；出生体重小于或等于 1000 g）婴儿补充维生素 A 的态度和做法。 研究设计 向所有（n = 102）新生儿围产期培训项目主任（TPD）和随机抽取的 105 名 III 级新生儿重症监护病房主任（非培训项目主任、非培训项目主任、 NTPD)。结果 99% 的 TPD 和 94% 的 NTPD 做出了回应。在少数项目（20% TPD、13% NTPD）中，超过 90% 的符合资格的极低出生体重新生儿补充了维生素 A，而在大多数项目（69% TPD、82% NTPD）中，没有进行常规补充。大多数补充维生素 A 的中心（91% TPD、81% NTPD）使用的剂量为 5000 IU IM，每周 3 次，持续 4 周。 TPD 给出的不补充维生素 A 的最常见原因是认为获益较小，而 NTPD 最常见的原因是他们认为干预措施未经证实。 结论 这些发现表明新生儿实践中循证医学的不一致，其中治疗的安全性和益处证据往往比支持补充维生素 A 的证据更弱。可能需要教育干预来认可维生素 A 补充剂的益处和安全性。
Objective To survey the attitudes and practices among level III neonatal intensive care units in the United States regarding vitamin A supplementation for extremely-low-birth-weight (ELBW; birth weight less than or equal to1000 g) infants.Study design A pretested questionnaire regarding vitamin A supplementation was distributed to all (n = 102) neonatalperinatal training program directors (TPD) and 105 randomly selected directors of level III neonatal intensive care units (nontraining program directors, NTPD).Results Ninety-nine percent of TPD and 94% of NTPD responded. In a minority of programs (20% TPD, 13% NTPD), >90% of eligible extremely-low-birth-weight neonates are supplemented with vitamin A, whereas in most programs (69% TPD, 82% NTPD), routine supplementation is not practiced. Most centers (91% TPD, 81% NTPD) supplementing vitamin A use a dose of 5000 IU IM 3 times per week for 4 weeks. The most common reason that TPD give for not supplementing vitamin A is the perceived small benefit, whereas the most common reason for NTPD is that they consider the intervention unproven.Conclusions These findings indicate inconsistency in practicing evidence-based medicine in neonatal practice, where therapies are often administered on the basis of weaker evidence of safety and benefit than supports vitamin A supplementation. Educational interventions may be required to endorse the benefits and safety of vitamin A supplementation.