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首页> 外文期刊>MCN: American Journal of Maternal-Child Nursing >IDENTIFYING AND ASSESSING THE SUBSTANCE-EXPOSED INFANT
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IDENTIFYING AND ASSESSING THE SUBSTANCE-EXPOSED INFANT

机译：识别和评估物质暴露的婴儿

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As the rate of opioid prescription grows, so does fetal exposure to opioids during pregnancy. With increasing fetal exposure to both prescription and nonprescription drugs, there has been a concurrent increase in identification of Neonatal Withdrawal Syndrome (NWS) and adaptation difficulties after birth. In addition, extended use of opioids, barbiturates, and benzodiazepines in neonatal intensive care has resulted in iatrogenic withdrawal syndromes. There is a lack of evidence to support the use of any one specific evaluation strategy to identify NWS. Clinicians caring for infants must use a multimethod approach to diagnosis, including interview and toxicology screening. Signs of NWS are widely variable, and reflect dysfunction in autonomic regulation, state control, and sensory and motor functioning. Several assessment tools have been developed for assessing severity of withdrawal in term neonates. These tools assist in determining need and duration of pharmacologic therapy and help in titration of these therapies. Considerable variability exists in the pharmacologic and nonpharmacologic approaches to affected babies across settings. An evidence-based protocol for identification, evaluation, and management of NWS should be in place in every nursery. This article provides an overview of identification and assessment considerations for providers who care for babies at risk for or who are experiencing alterations in state, behavior, and responses after prenatal or iatrogenic exposure to agents associated with the spectrum of withdrawal.
机译：随着阿片类药物处方率的增长，在怀孕期间胎儿对阿片类药物的接触也随之增加。随着胎儿暴露于处方药和非处方药的增加，新生儿戒断综合症（NWS）的识别和出生后适应困难也同时增加。此外，在新生儿重症监护中大量使用阿片类药物，巴比妥类药物和苯二氮类药物已导致医源性戒断综合症。缺乏证据支持使用任何一种特定的评估策略来识别NWS。照顾婴儿的临床医生必须使用多种方法进行诊断，包括访谈和毒理学筛查。 NWS的体征变化很大，反映出自主调节，状态控制以及感觉和运动功能障碍。已经开发了几种评估工具来评估足月新生儿的戒断严重程度。这些工具有助于确定药物治疗的需要和持续时间，并有助于滴定这些疗法。在不同地区，受影响婴儿的药理和非药理方法存在很大差异。每个苗圃都应有基于证据的NWS鉴定，评估和管理方案。本文概述了对于在产前或医源性暴露于与戒断谱相关的因素后照料处于危险中的婴儿或状态，行为和反应有所改变的婴儿的护理人员的识别和评估注意事项。

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