RESUMO
OBJECTIVE: To explore the possible association between rewarming rate and neonatal outcomes in extremely low birth weight infants (ELBWIs) with hypothermia. STUDY DESIGN: All ELBWIs with hypothermia (temperature < 36.0°C) on neonatal intensive care unit (NICU) admission were retrospectively evaluated. Rewarming rate was analyzed as both a dichotomous (≥ 0.5°C/h rapid group; < 0.5°C/h slow group) and a continuous variable. Multivariable analysis was performed to explore the relation between rewarming rate and several outcomes, adjusting for clinically relevant confounders. RESULTS: Hypothermia on NICU admission was present in 182 out of 744 ELBWIs (24.5%). The rewarming rate was slow in 109 subjects (59.9%) and rapid in 73 subjects (40.1%), with a median rewarming rate of 0.29°C/h (IQR 0.2-0.35) and 0.76°C/h (IQR 0.61-1.09), respectively (P < .0001). The median rewarming time was 340 minutes (IQR 250-480) and 170 minutes (IQR 110-230), respectively (P < .0001). After adjusting for clinically relevant confounders, we did not find significant associations between rewarming rate group (≥ 0.5°C/h vs < 0.5°C/h) and neonatal outcomes. When we considered the rewarming rate as continuous variable, a higher rewarming rate was identified as a protective factor for respiratory distress syndrome (OR 0.39, 95% CI 0.17-0.87; P = .02). CONCLUSIONS: In ELBWIs with hypothermia upon NICU admission, there were no significant differences between rapid or slow rewarming rate and major neonatal outcomes. A higher rewarming rate was associated with a reduced incidence of respiratory distress syndrome.
Assuntos
Hipotermia/terapia , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Reaquecimento/métodos , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Gravidez , Estudos Retrospectivos , Resultado do TratamentoRESUMO
No se sabe todavía si la prescripción farmacológica durante el embarazo está caracterizada por necesidades terapéuticas-preventivas reales, por exceso de medicación (en caso de hipertensión, amenaza de aborto) o simplemente porque se prolonga la atención sintomática (mediante autoprescripción). En realidad, hasta la fecha ningún estudio formal ha tenido el objetivo de dar respuesta a éstas preguntas