Résumé
Events in the delivery room significantly impact the outcomes of newborns,especially for the very low birth weight infants. Quality improvement of delivery room management for very low birth weight in-fants will reduce the very low birth weight infants′mortality and improve their quality of life. The prenatal ,in-trapartum and postnatal interventions include delayed umbilical cord clamping,thermoregulation,starting resusci-tation with CPAP from the first breath and with low concentration oxygen. In this article,we reviewed researches about the improvements of delivery room management,and summed up the specific measures to reduce the very low birth weight infants′median durations of hospitalization and improve their long-term outcomes.
Résumé
Events in the delivery room significantly impact the outcomes of newborns,especially for the very low birth weight infants. Quality improvement of delivery room management for very low birth weight in-fants will reduce the very low birth weight infants′mortality and improve their quality of life. The prenatal ,in-trapartum and postnatal interventions include delayed umbilical cord clamping,thermoregulation,starting resusci-tation with CPAP from the first breath and with low concentration oxygen. In this article,we reviewed researches about the improvements of delivery room management,and summed up the specific measures to reduce the very low birth weight infants′median durations of hospitalization and improve their long-term outcomes.
Résumé
Delivery room management is the first step to the intact survival of preterm infants, especially in the first hour of an infant's life following delivery, "a golden hour". Admission temperature within a range of 36.5degrees C to 37.4degrees C, delayed umbilical cord clamping and cord milking, minimal oxygen supplementation, and prophylactic continuous positive airway pressure or surfactant without intubation are the cornerstones of recent delivery room management. Such managements can be supplied only by team approach including obstetrician, neonatologist, and nurses.
Sujets)
Humains , Nouveau-né , Constriction , Ventilation en pression positive continue , Salles d'accouchement , Prématuré , Intubation , Lait , Oxygène , Cordon ombilicalRésumé
OBJECTIVE: This study investigated the effects of modified neonatal resuscitation program (M-NRP) which intends to keep minimal handling, to stabilize initial vital signs in extremely low birth weight infants (ELBWI) in Samsung Medical Center, NICU. METHODS: Medical records of 128 ELBWI with gestational age (GA) < or =24 weeks who had been admitted to the NICU of SMC from January 2000 to December 2008 were reviewed retrospectively. The data of these patients with M-NRP (n=62) were compared with those with classic NRP (C-NRP) (n=66). RESULTS: These patients who received M-NRP had significantly higher in survived discharge rate (66% vs 47%, P=0.034), lower in mask ventilation (29% vs 97%, P<0.001), shorter incubator-in time (81+/-25min vs 138+/-50min, P<0.001), and higher 1'/5' APGAR score (1': 3.9+/-1.5 vs 2.6+/-1.3, P<0.001, 5': 6.6+/-1.7 vs 5.4+/-1.8, P<0.001) than those who received C-NRP. CONCLUSION: Improvement in survived discharge rate and 1'/5' APGAR score were noted in M-NRP group compared to C-NRP group in the management of GA < or =24 weeks ELBWI