Surfactant without Intubation in Preterm Infants with Respiratory Distress: First Multi-center Data

被引：86

作者：

Kribs, A. ^{[1
]}

Haertel, C. ^{[2
]}

Kattner, E. ^{[3
]}

Vochem, M. ^{[4
]}

Kuester, H. ^{[5
]}

Moeller, J. ^{[6
]}

Mueller, D. ^{[7
]}

Segerer, H. ^{[8
]}

Wieg, C.

Gebauer, C. ^{[9
]}

Nikischin, W. ^{[11
]}

v. d. Wense, A. ^{[10
]}

Herting, E. ^{[2
]}

Roth, B. ^{[1
]}

Goepel, W. ^{[2
]}

机构：

[1] Univ Kinderklin Koln, D-50937 Cologne, Germany

[2] Univ Klinikum Schleswig Holstein, Klin Kinder & Jugendmed, Campus Lubeck, Germany

[3] Kinderklin Bult, Hannover, Germany

[4] Olga Hosp, Kinderklin, Stuttgart, Germany

[5] Ernst Moritz Arndt Univ Greifswald, Univ Klinikum, Klin & Poliklin Kinder & Jugendmed, Greifswald, Germany

[6] Klinikum Saarbrucken, Klin Kinder & Jugendmed, Saarbrucken, Germany

[7] Klinikum Kassel, Klin Kinder & Jugendmed, Kassel, Germany

[8] Univ Regensburg, Klin Kinder & Jugendmed, D-8400 Regensburg, Germany

[9] Univ Kinderklin, Leipzig, Germany

[10] Altonaer Kinderkrankenhaus, Hamburg, Germany

[11] Univ Klinikum Schleswig Holstein, Klin Kinder & Jugendmed, Campus Kiel, Germany

来源：

KLINISCHE PADIATRIE | 2010年 / 222卷 / 01期

关键词：

surfactant; respiratory distress syndrome (RDS); very low birth weight infant (VLBW infant); bronchopulmonary dysplasia (BPD); POSITIVE AIRWAY PRESSURE; LARYNGEAL MASK AIRWAY; BABOON MODEL; NASAL CPAP; BIRTH; NCPAP;

D O I：

10.1055/s-0029-1241867

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Background: Recently in a report of a single center a method has been described to apply surfactant via a thin endotracheal catheter to very low birth weight infants spontaneously breathing with nasal continuous positive airway pressure. We now analyzed available multicenter data. Patients and Methods: In a multicenter study investigating genetic risk factors, clinical and outcome data and data of antenatal and postnatal treatment of infants with a birth weight below 1 500 g were prospectively recorded. The measures of infants treated with the new method of surfactant application were compared to those of infants who received standard care. The analysis was restricted to infants with a gestational age below 31 weeks (n = 1 541). Results: 319 infants were treated with the new method and 1 222 with standard care. The need for mechanical ventilation during the first 72 h ( 29 % vs. 53 %, p < 0.001), the rate of bronchopulmonary dysplasia defined as oxygen at 36 weeks of postmenstrual age (10.9% vs. 17.5%, p = 0.004) and the rate of death or bronchopulmonary dysplasia were significantly lower in the treatment group than in the standard care group. Surfactant, theophyllin, caffeine and doxapram were significantly more often and analgetics, catecholamines and dexamethasone were significantly less frequently used in the treatment group. Conclusions: A new method of surfactant application was associated with a lower prevalence of mechanical ventilation and better pulmonary outcome. A prospective controlled trial is required to determine whether this approach is superior to standard care.

引用

页码：13 / 17

页数：5

共 23 条

[1] Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants? [J].