目的:检索、评价及总结新生儿外周静脉输液渗漏性损伤预防及管理的相关证据,为临床实践提供依据。方法:系统检索Up ToDate、BMJ Best Practice、中国知网、万方数据库等中英文数据库或网站中关于新生儿外周静脉输液渗漏性损伤预防及管...目的:检索、评价及总结新生儿外周静脉输液渗漏性损伤预防及管理的相关证据,为临床实践提供依据。方法:系统检索Up ToDate、BMJ Best Practice、中国知网、万方数据库等中英文数据库或网站中关于新生儿外周静脉输液渗漏性损伤预防及管理的证据,包括指南、临床决策、证据总结、系统评价、专家共识等。检索时限为2013年1月1日至2024年3月31日。由4名接受过循证护理培训的研究人员对文献质量进行独立评价并提取证据。结果:共纳入10篇文献,其中指南4篇、专家共识3篇、系统评价3篇。最终从穿刺前评估、导管留置期间评估、静脉输液渗漏性损伤的分级与处理、质量改进4个方面总结了24条证据。结论:该研究总结的新生儿外周静脉输液渗漏性损伤预防及管理的证据,可为临床静脉输液渗漏预防提供依据,建议临床基于证据结合科室和新生儿的实际情况,制定护理措施,减少新生儿外周静脉输液渗漏发生。展开更多
本综述全面研究了无创通气(NIV)策略在管理新生儿呼吸衰竭方面的最新进展,指出呼吸衰竭是早产儿发病和死亡的主要原因。当前的NIV技术,包括持续气道正压通气(CPAP)、鼻间歇正压通气(NIPPV)和高频振荡通气(NHFOV),在减少有创机械通气(IMV...本综述全面研究了无创通气(NIV)策略在管理新生儿呼吸衰竭方面的最新进展,指出呼吸衰竭是早产儿发病和死亡的主要原因。当前的NIV技术,包括持续气道正压通气(CPAP)、鼻间歇正压通气(NIPPV)和高频振荡通气(NHFOV),在减少有创机械通气(IMV)需求方面显示出显著的有效性。此外,最新的神经调节通气辅助(NAVA)和高流量鼻导管(HFNC)技术,以及联合NIV策略和新兴技术,进一步提高了呼吸支持效果。这些策略在临床实践中有效减少了支气管肺发育不良(BPD)的发病率,提高了新生儿的存活率,并改善了长期呼吸和神经发育结果。然而,NIV技术仍面临设备相关并发症、失败的预测因素以及大量培训的挑战。未来的研究方向应包括个性化医疗方法、新技术的开发和全球合作,以优化NIV策略并改善新生儿护理结果。This review comprehensively examines recent advances in noninvasive ventilation (NIV) strategies in the management of neonatal respiratory failure, indicating that respiratory failure is a leading cause of morbidity and mortality in preterm infants. Current NIV technologies, including continuous positive airway pressure (CPAP), nasal intermittent positive pressure ventilation (NIPPV), and high- frequency oscillatory ventilation (NHFOV), have shown significant effectiveness in reducing the need for invasive mechanical ventilation (IMV) sex. In addition, the latest neuroregulated ventilatory assist (NAVA) and high-flow nasal cannula (HFNC) technologies, as well as combined NIV strategies and emerging technologies, further improve respiratory support. These strategies have been effective in clinical practice in reducing the incidence of bronchopulmonary dysplasia (BPD), increasing neonatal survival, and improving long-term respiratory and neurodevelopmental outcomes. However, NIV technology still faces challenges with device-related complications, predictors of failure, and extensive training. Future research directions should include personalized medical approaches, the development of new technologies, and global collaborations to optimize NIV strategies and improve neonatal care outcomes.展开更多
文摘目的:检索、评价及总结新生儿外周静脉输液渗漏性损伤预防及管理的相关证据,为临床实践提供依据。方法:系统检索Up ToDate、BMJ Best Practice、中国知网、万方数据库等中英文数据库或网站中关于新生儿外周静脉输液渗漏性损伤预防及管理的证据,包括指南、临床决策、证据总结、系统评价、专家共识等。检索时限为2013年1月1日至2024年3月31日。由4名接受过循证护理培训的研究人员对文献质量进行独立评价并提取证据。结果:共纳入10篇文献,其中指南4篇、专家共识3篇、系统评价3篇。最终从穿刺前评估、导管留置期间评估、静脉输液渗漏性损伤的分级与处理、质量改进4个方面总结了24条证据。结论:该研究总结的新生儿外周静脉输液渗漏性损伤预防及管理的证据,可为临床静脉输液渗漏预防提供依据,建议临床基于证据结合科室和新生儿的实际情况,制定护理措施,减少新生儿外周静脉输液渗漏发生。
文摘本综述全面研究了无创通气(NIV)策略在管理新生儿呼吸衰竭方面的最新进展,指出呼吸衰竭是早产儿发病和死亡的主要原因。当前的NIV技术,包括持续气道正压通气(CPAP)、鼻间歇正压通气(NIPPV)和高频振荡通气(NHFOV),在减少有创机械通气(IMV)需求方面显示出显著的有效性。此外,最新的神经调节通气辅助(NAVA)和高流量鼻导管(HFNC)技术,以及联合NIV策略和新兴技术,进一步提高了呼吸支持效果。这些策略在临床实践中有效减少了支气管肺发育不良(BPD)的发病率,提高了新生儿的存活率,并改善了长期呼吸和神经发育结果。然而,NIV技术仍面临设备相关并发症、失败的预测因素以及大量培训的挑战。未来的研究方向应包括个性化医疗方法、新技术的开发和全球合作,以优化NIV策略并改善新生儿护理结果。This review comprehensively examines recent advances in noninvasive ventilation (NIV) strategies in the management of neonatal respiratory failure, indicating that respiratory failure is a leading cause of morbidity and mortality in preterm infants. Current NIV technologies, including continuous positive airway pressure (CPAP), nasal intermittent positive pressure ventilation (NIPPV), and high- frequency oscillatory ventilation (NHFOV), have shown significant effectiveness in reducing the need for invasive mechanical ventilation (IMV) sex. In addition, the latest neuroregulated ventilatory assist (NAVA) and high-flow nasal cannula (HFNC) technologies, as well as combined NIV strategies and emerging technologies, further improve respiratory support. These strategies have been effective in clinical practice in reducing the incidence of bronchopulmonary dysplasia (BPD), increasing neonatal survival, and improving long-term respiratory and neurodevelopmental outcomes. However, NIV technology still faces challenges with device-related complications, predictors of failure, and extensive training. Future research directions should include personalized medical approaches, the development of new technologies, and global collaborations to optimize NIV strategies and improve neonatal care outcomes.
