中国实用儿科杂志

中国实用儿科杂志

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《2019年欧洲呼吸窘迫综合征管理指南》解读

  

  1. 中国医科大学附属盛京医院新生儿科，辽宁  沈阳  110004
  • 出版日期:2019-06-06 发布日期:2019-07-04

Interpretation of European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2019 Update

  1. Department of Neonatology，Shengjing Hospital of China Medical University，Shenyang  110004，China
  • Online:2019-06-06 Published:2019-07-04

摘要：

在《2016年欧洲呼吸窘迫综合征（RDS）管理指南》基础上，2019年版指南依据最新循证医学证据和医学文献，进行了补充和更新，使RDS管理策略不断优化。内容涉及早产发生风险的预测及产前糖皮质激素的规范使用、产房管理更加循证化、肺保护性通气策略的出生后早期应用，仍强调肺表面活性物质的替代治疗是RDS治疗至关重要的环节，无创呼吸支持能降低早产儿慢性肺疾病的发生率，产前糖皮质激素的使用和咖啡因的应用均显著降低了机械通气时间。此外，适宜的温度调控，精确的液体和营养管理，维持良好的血液灌注以及谨慎使用抗生素均能改善早产儿的预后。

关键词: 呼吸窘迫综合征, 管理指南, 早产儿, 解读

Abstract:

The 2019 European Guideline on Respiratory Distress Syndrome（RDS） updated and supplemented the 2016 version according to newly-published evidence and literature，in order to optimize the management of RDS. The updates includes risk factors of preterm births，the standardized use of prenatal glucocorticoids protocol，the evidence-based delivery room management and the early application of protective pulmonary ventilation after birth；pulmonary surfactant administration as the crucial treatment for RDS；the incidence chronic lung disease can be reduced by non-invasive respiratory support. Prenatal glucocorticoids use and caffeine administration can significantly shorten the duration of mechanical ventilation. In addition，good temperature control，precise fluid and nutrition management，perfusion maintenance and cautious antibiotic use can help improve the outcome of preterm births.

Key words: respiratory distress syndrome, management guidelines, preterm, interpretation