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NEJM:喉罩气道vs面罩通气用于新生儿窒息治疗

2020-11-26 MedSci原创 MedSci原创

喉罩气道通气用于新生儿窒息治疗是安全的,但其在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气

面罩通气是新生儿窒息最常见的复苏方法。在低收入国家,在新生儿复苏期间,使用喉罩气道(LMA)通气比面罩通气具有潜在的优势,但使用LMA对降低窒息新生儿的死亡率和不良事件风险的效果尚不明确。
 
本次III期研究在乌干达进行,需要正压通气的新生儿参与,由助产医护人员进行LMA或面罩通气治疗。参与研究的新生儿胎龄至少为34周,出生体重至少为2000克。研究的主要结果是住院7天内死亡、进入新生儿重症监护室(NICU)或在住院第1至5天出现中度至重度缺氧缺血性脑病。
 
99.2%新生儿完成研究。LMA组563例新生儿中的154例(27.4%)出现主要终点事件,而面罩组591例患儿中144例(24.4%)出现终点事件,调整后的相对危险度为1.16。21.7%的LMA组新生儿和18.4%的面罩组新生儿在7天内死亡(调整后的相对风险1.21),住院第1-5天因中度至重度缺氧缺血性脑病治疗的的新生儿分别占11.2%和10.1%(调整后的相对风险:1.27)。两组预先确定的干预相关不良事件的发生频率相似。
 
研究认为,喉罩气道通气用于新生儿窒息治疗是安全的,但其在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。
 
原始出处:
 
Nicolas J. Pejovic et al. A Randomized Trial of Laryngeal Mask Airway in Neonatal Resuscitation. N Engl J Med, November 26, 2020.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=913760, encodeId=9587913e6087, content=还是得结合实际,客观的选择合适的治疗方式。<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/05/13/5278ce3e7bbaac83661038bc2facdf85.jpg, createdBy=cf2a5328500, createdName=王志英, createdTime=Tue Jan 05 00:28:33 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545212, encodeId=f900154521272, content=<a href='/topic/show?id=3ecbe5565e2' target=_blank style='color:#2F92EE;'>#窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75565, encryptionId=3ecbe5565e2, topicName=窒息)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21f213689241, createdName=1508842480_96220441, createdTime=Sat Nov 28 10:32:19 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902764, encodeId=1555902e64e9, content=<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a> 喉罩气道通气用于新生儿窒息治疗是安全的,但在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。这也告诉我们,要客观辩证看待研究结果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Fri Nov 27 11:42:58 CST 2020, time=2020-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035512, encodeId=fd67103551246, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 22:32:19 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2021-01-05 王志英

    还是得结合实际,客观的选择合适的治疗方式。#新生儿窒息#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=913760, encodeId=9587913e6087, content=还是得结合实际,客观的选择合适的治疗方式。<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/05/13/5278ce3e7bbaac83661038bc2facdf85.jpg, createdBy=cf2a5328500, createdName=王志英, createdTime=Tue Jan 05 00:28:33 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545212, encodeId=f900154521272, content=<a href='/topic/show?id=3ecbe5565e2' target=_blank style='color:#2F92EE;'>#窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75565, encryptionId=3ecbe5565e2, topicName=窒息)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21f213689241, createdName=1508842480_96220441, createdTime=Sat Nov 28 10:32:19 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902764, encodeId=1555902e64e9, content=<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a> 喉罩气道通气用于新生儿窒息治疗是安全的,但在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。这也告诉我们,要客观辩证看待研究结果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Fri Nov 27 11:42:58 CST 2020, time=2020-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035512, encodeId=fd67103551246, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 22:32:19 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=913760, encodeId=9587913e6087, content=还是得结合实际,客观的选择合适的治疗方式。<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/05/13/5278ce3e7bbaac83661038bc2facdf85.jpg, createdBy=cf2a5328500, createdName=王志英, createdTime=Tue Jan 05 00:28:33 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545212, encodeId=f900154521272, content=<a href='/topic/show?id=3ecbe5565e2' target=_blank style='color:#2F92EE;'>#窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75565, encryptionId=3ecbe5565e2, topicName=窒息)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21f213689241, createdName=1508842480_96220441, createdTime=Sat Nov 28 10:32:19 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902764, encodeId=1555902e64e9, content=<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a> 喉罩气道通气用于新生儿窒息治疗是安全的,但在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。这也告诉我们,要客观辩证看待研究结果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Fri Nov 27 11:42:58 CST 2020, time=2020-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035512, encodeId=fd67103551246, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 22:32:19 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2020-11-27 BJying

    #新生儿窒息# 喉罩气道通气用于新生儿窒息治疗是安全的,但在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。这也告诉我们,要客观辩证看待研究结果。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=913760, encodeId=9587913e6087, content=还是得结合实际,客观的选择合适的治疗方式。<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2020/05/13/5278ce3e7bbaac83661038bc2facdf85.jpg, createdBy=cf2a5328500, createdName=王志英, createdTime=Tue Jan 05 00:28:33 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545212, encodeId=f900154521272, content=<a href='/topic/show?id=3ecbe5565e2' target=_blank style='color:#2F92EE;'>#窒息#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75565, encryptionId=3ecbe5565e2, topicName=窒息)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21f213689241, createdName=1508842480_96220441, createdTime=Sat Nov 28 10:32:19 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902764, encodeId=1555902e64e9, content=<a href='/topic/show?id=da3a1040624a' target=_blank style='color:#2F92EE;'>#新生儿窒息#</a> 喉罩气道通气用于新生儿窒息治疗是安全的,但在减少新生儿早期死亡和中重度缺氧缺血性脑病风险的效果不优于面罩通气。这也告诉我们,要客观辩证看待研究结果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104062, encryptionId=da3a1040624a, topicName=新生儿窒息)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Fri Nov 27 11:42:58 CST 2020, time=2020-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035512, encodeId=fd67103551246, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 22:32:19 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2020-11-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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