Trends in use of neonatal CPAP a population-based study 英文参考文献.docVIP

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Trends in use of neonatal CPAP a population-based study 英文参考文献.doc

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Trends in use of neonatal CPAP a population-based study 英文参考文献

Robertsetal.BMCPediatrics2011,11:89 /1471-2431/11/89 RESEARCH ARTICLE OpenAccess TrendsinuseofneonatalCPAP: apopulation-basedstudy ChristineLRoberts1*,TimBadgery-Parker1,2,CharlesSAlgert1,JenniferRBowen3andNatashaNassar1 Abstract Background:Continuouspositiveairwaypressure(CPAP)isusedwidelytoproviderespiratorysupportfor neonates,andisoftenthefirsttreatmentchoiceintertiarycentres.RecenttrialshavedemonstratedthatCPAP reducesneedforintubationandventilationforinfantsbornat25-28weeksgestation,andat32weeks,innon- tertiaryhospitals,CPAPreducesneedfortransfertoNICU.Theaimofthisstudywastoexaminerecentpopulation trendsintheuseofneonatalcontinuouspositiveairwaypressure. Methods:Weundertookapopulation-basedcohortstudyofall696,816livebornneonates≥24weeksgestationin NewSouthWales(NSW)Australia,2001-2008.Datawereobtainedfromlinkedbirthandhospitalizationsrecords, includingneonataltransfers.TheprimaryoutcomewasCPAPwithoutmechanicalventilation(viaendotracheal intubation)betweenbirthanddischargefromthehospitalsystem.Analyseswerestratifiedbyage≤32and32weeks gestation. Results:Neonatesreceivinganyventilatorysupportincreasedfrom1,480(17.9/1000)in2001to2,486(26.9/1000) in2008,including461(5.6/1000)to1,465(15.8/1000)neonateswhoreceivedCPAPalone.Therewasaconcurrent decreaseinmechanicalventilationusefrom12.3to11.0/1000.TheincreaseinCPAPusewasgreateramong neonates32weeks(from3.2to11.8/1000)comparedwithneonates≤32weeks(from18.1to32.7/1000).The proportionofCPAP32weeksinitiatedinnon-tertiaryhospitalsincreasedfrom6%to30%. Conclusions:TheuseofneonatalCPAPisincreasing,especially32weeksgestationandamongnon-tertiary hospitals.RecommendationsarerequiredregardingwhichinfantsshouldbeconsideredforCPAP,resources necessaryforaunittoofferCPAPandmonitoringoflongertermoutcomes. Background headboxoxygentherapy[4].CPAPisanattractiveoption Continuous positive airway pressure (CPAP) is used forsupportingneonateswithrespiratorydistress,because widelytoproviderespiratorysupportforneonates,andis itpreserves