AerVia声门上气道装置与气管插管在新生儿产房复苏中的比较：一项前瞻性队列研究
The AerVia supraglottic airway device versus the endotracheal tube in neonatal delivery room resuscitation: a prospective cohort study.
文献信息
| PMID | 42824452 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Naser Aldain A Abu Lehyah |
| 作者单位 | Division of Neonatology, Department of Pediatrics, Women's and Children's Hospital, Al Bashir Hospitals, Amman, Jordan. |
| 期刊 | Frontiers in pediatrics |
| SCI 分区 | Q2 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估声门上气道装置（SAD）作为气管插管（ETT）替代方案在产房需要复苏婴儿中的应用。
研究设计： 在约旦安曼Al Bashir医院，因通气不足或持续心动过缓而需要面罩通气以外复苏的新生儿，使用AerVia SAD进行复苏（n=73），并与既往使用ETT复苏的队列（n=80）进行比较。
结果： AerVia队列与ETT队列的平均胎龄相似（32.0±2.8周 vs. 32.7±2.3周，p=0.13），出生体重也相似（1.63±0.44 kg vs. 1.68±0.37 kg，p=0.48）。尽管若干比较显示出有利于AerVia SAD的临床重要差异，但并非所有差异均达到传统统计学显著性。AerVia首次尝试成功率高于ETT（99% vs. 90%，p=0.055）。AerVia置入所需尝试次数更少（1.0±0.1 vs. 1.1±0.3，p=0.07），速度更快（9±2秒 vs. 11±3秒，p=0.001），并且自主呼吸恢复时间相当（45±12秒 vs. 42±8秒，p=0.07）。在多变量分析中，与ETT相比，使用SAD与首次尝试成功几率增加相关（校正比值比9.28，95% CI 0.89-96.76，p=0.063）。AerVia与ETT的并发症发生率相当（18% vs. 23%，p=0.55）；AerVia队列最常见的并发症为轻度腹部膨隆（N=6），而ETT队列为气道创伤（N=12）。83名婴儿胎龄<34周（AerVia=47，ETT=36），该亚组的比较结果相似。
结论： 与ETT相比，AerVia SAD与较少的气道创伤相关。尽管置入似乎更快且所需尝试次数更少，但这些差异未达到统计学显著性。对于产房中的高级新生儿复苏，SAD似乎是ETT的合理替代方案。我们的研究结果提示，适当尺寸的新生儿SAD在部分胎龄<34周的婴儿中也可能可行，并支持进一步研究。
英文摘要
OBJECTIVE: To evaluate a supraglottic airway device (SAD) as an alternative to the endotracheal tube (ETT) in infants requiring resuscitation in the delivery room.
STUDY DESIGN: Newborns requiring resuscitation beyond face mask ventilation due to inadequate ventilation or persistent bradycardia at Al Bashir Hospital in Amman, Jordan, were resuscitated using the AerVia SAD (n = 73) and compared with a historic cohort resuscitated by the ETT (n = 80).
RESULTS: AerVia and ETT cohorts had similar mean gestational age (32.0 ± 2.8 vs. 32.7 ± 2.3 weeks, p = 0.13) and birth weight (1.63 ± 0.44 vs. 1.68 ± 0.37 kg, p = 0.48). Although several comparisons demonstrated clinically important differences favoring the AerVia SAD, not all reached conventional statistical significance. First-attempt success was higher for AerVia than for the ETT (99% vs. 90%, p = 0.055). AerVia placement required fewer attempts (1.0 ± 0.1 vs. 1.1 ± 0.3, p = 0.07), was faster (9 ± 2 vs. 11 ± 3 s, p = 0.001), and resulted in comparable return of spontaneous breathing (45 ± 12 vs. 42 ± 8 s, p = 0.07). In a multivariate analysis, use of an SAD was associated with increased odds of first-attempt success compared with the ETT (adjusted odds ratio 9.28, 95% CI 0.89-96.76, p = 0.063). Complication rates were comparable for AerVia (18% vs. 23%, p = 0.55); the most common complication in the AerVia cohort was mild abdominal distension (N = 6) and in the ETT cohort airway trauma (N = 12). Eighty-three infants were <34 weeks' gestation (AerVia = 47, ETT = 36), and comparisons in this subgroup were similar.
CONCLUSION: The AerVia SAD was associated with less airway trauma compared with the ETT. Although placement appeared faster and required fewer attempts, these differences did not reach statistical significance. SADs appear to be a reasonable alternative to an ETT for advanced neonatal resuscitation in the delivery room. Our findings suggest that appropriately sized neonatal SADs may also be feasible in selected infants born <34 weeks' gestation and support further studies.