【正文】
No enough data from ibuprofen trial. ● Indomethacin significant reduced 35% of pulmonary hemorrhage only in first week of life. ● Side effect: Oliguria (indomethacin) Pulmonary hypertension (ibuprofen) 臨床表現(xiàn) ? 原發(fā)病表現(xiàn) ? 全身癥狀 低體溫,皮膚蒼白,發(fā)紺.活動(dòng)力低下,呈休克狀態(tài),或可見皮膚出血斑,穿刺部位不易止血 ? 呼吸障礙 呼吸障礙:呼吸暫停,呼吸困難,吸氣性凹蹈,呻吟,發(fā)紺.呼吸增快或在原發(fā)病癥狀基礎(chǔ)上臨床表現(xiàn)突然加重 ? 出血表現(xiàn) 鼻腔、口腔流出或噴出血性液體,或于氣管插管后流出或吸 出泡沫樣血性 ? 肺部體征: 呼吸音減低或有濕噦音 肺出血的臨床診斷 是指在原發(fā)病基礎(chǔ)上口鼻及氣管內(nèi)有血性液流出者, 病理診斷 是指肉眼見肺出血總面積占全部肺面積的兩葉 上,鏡檢能見到大片出血者 (稱彌漫性肺出血 ) ? 為避免誤診,減步漏診.臨床應(yīng)以氣管內(nèi)吸出血性液而胃管內(nèi)無血性液為診斷依據(jù)。 RR: [,] RD: [,] NNT 4 ● Reduction of Gr 3 or 4 IVH [,] ● No significant reduction of PH RR= [,], RD [, ] ● No difference in mortality, RR= [ to ] ● Increase incidence of oliguria [,] Ibuprofen prophylaxis ● Significant reduced incidence of PDA [,], [,], NNT 3 ● Only 1 trial report incidence of PH (8% vs 3%) ● No difference in mortality, Gr 3/4 IVH, urine output ● One trial (Gournay 2022) stopped due to 3 cases severe pulmonary hypertension De