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“Minitouch” treatment of very low‐birth‐weight infants

 

作者: Thorkild Jacobsen,   John Grønvall,   Sten Petersen,   Gunnar Eg Andersen†,  

 

期刊: Acta Pædiatrica  (WILEY Available online 1993)
卷期: Volume 82, issue 12  

页码: 934-938

 

ISSN:0803-5253

 

年代: 1993

 

DOI:10.1111/j.1651-2227.1993.tb12603.x

 

出版商: Blackwell Publishing Ltd

 

关键词: Intracranial haemorrhage;nasal CPAP;preterm infants;respiratory distress syndrome;ventilator treatment

 

数据来源: WILEY

 

摘要:

In a cohort study with historical controls of non‐asphyxiated very low‐birth‐weight infants (birth weight 1500 g and gestational age<33 completed weeks), we evaluated the use of a “minitouch” regime for stabilization after birth and treatment of respiratory distress. This combination of early (prophylactic) treatment with nasal continuous positive airway pressure and minimal handling was introduced as a routine in our Department in 1986. We compared infants born in 1987 and in 1985, when ventilator treatment was used initially in all infants with progressing respiratory distress. The frequency of mechanical ventilation was reduced significantly from 76% in 1985 to 35% in 1987 (p =0.00001). This reduction reflected the smaller number of infants who received ventilator treatment for less than one week, whereas the frequency of long‐term ventilator treatment remained unchanged. Intracranial haemorrhage grade 11‐IV was reduced from 49% in 1985 to 25%) in 1987 (p =0.01). Mortality rate, average duration of hospitalization, numbcr of infants with pneumothorax, patent ductus arteriosus, need for oxygen at 28 days and number of surviving infants with handicap did not differ significantly between the two study periods. Septicaemia was diagnosed in 16%) of the infants in 1987 versus 7% in 1985 (p = 0.045). This difference coincided with an increased use of total parented nutrition (18% in 1987 versus 3%) in 1985,p= 0.007). We conclude that the minitouch regime prevents progression of respiratory distrcss, reduces the need for ventilator treatment and is a safe and convenient alternative to mechanical ventilation in preterm infants with mild respiratory problems. The infants need to be monitored continuously to recognize respiratory insufficiency demanding ventila

 

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