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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Use and timing of surfactant administration: impact on neonatal outcomes in extremely low gestational age infants born in Canadian Neonatal Intensive Care Units
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Use and timing of surfactant administration: impact on neonatal outcomes in extremely low gestational age infants born in Canadian Neonatal Intensive Care Units

机译：表面活性剂管理的使用和时间：对加拿大新生儿重症监护单位出生的极低孕龄婴幼儿的对新生儿结果的影响

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Background: Use, timing and doses of surfactant in preterm infants are variable in practice in modern NICUs. Objective: The objective of this study is to explore the association between use and timing of surfactant administration and common neonatal adverse outcomes in preterm infants with gestational age (GA) < 28 weeks. Material and methods: Neonates admitted to a participating Canadian Neonatal Network NICU between 2013 and 2015 were studied. Infants were divided into three groups based on surfactant administration: none, early (within 30min of life), and late surfactant (>30min). The primary outcome was a composite of >2 predefined outcomes: bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) and severe neurological injury (intraventricular hemorrhage or intraventricular hemorrhage (IVH) grade III/IV+- periventricular leukomalacia). Results: Of 2512 eligible neonates, 430 were in the early, and 1228 were in the late surfactant group. There was no difference in the primary outcome (p - .88). There was a slightly lower risk of late onset sepsis [25% versus 29%, adjusted odds ratio (aOR): 0.8; 95% Cl: 0.6-0.9] and ROP (12.4 versus 15%, aOR: 0.7; 95% Cl: 0.5-0.9) in the early surfactant group. Conclusions: In preterm neonates, early administration of surfactant within 30min of life was not associated with an increased risk of the primary composite outcome, but did have decreased rates of late onset sepsis and ROP.
机译：背景：在现代尼古斯的实践中，早产儿的使用，时序和剂量的表面活性剂是可变的。目的：本研究的目的是探讨表面活性剂施用的使用和时序与妊娠期（GA）<28周的早产儿的常见新生儿不良结果之间的关联。材料和方法：研究了2013年至2015年间参与参与的加拿大新生网络Nicu的新生儿。基于表面活性剂给药分为三组婴儿：无，早期（在寿命30分钟内），和晚期表面活性剂（> 30min）。主要结果是> 2个预定结果的复合材料：支气管扩漏剂（BPD），早熟（ROP）的视网膜病变和严重的神经损伤（脑室出血或脑内出血（IVH）级III级/ IV + - 绝经白血病）。结果：2512个符合条件的新生儿，430个早期，1228名是晚期表面活性剂组。主要结果没有差异（P - .88）。晚期发病败血症的风险略低[25％对29％，调整后的赔率比（AOR）：0.8; 95％Cl：0.6-0.9]和ROP（12.4与15％，AOR：0.7; 95％CL：0.5-0.9）在早期的表面活性剂组中。结论：在早产新生儿中，30min生活中的早期施用表面活性剂与原发性复合结果的风险增加无关，但确实减少了晚期发病败血症和ROP的速率。

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