Surfactant administration by transient intubation in infants 29 to 35 weeks' gestation with respiratory distress syndrome decreases the likelihood of later mechanical ventilation: A randomized controlled trial

被引：88

作者：

Reininger A. ^{[1
]}

Khalak R. ^{[2
]}

Kendig J.W. ^{[3
]}

Ryan R.M. ^{[4
]}

Stevens T.P. ^{[1
]}

Reubens L. ^{[1
]}

D'Angio C.T. ^{[1
,5
]}

机构：

[1] Strong Children's Research Center, University of Rochester, Rochester, NY

[2] Department of Pediatrics, St. Peter's Hospital, Albany, NY

[3] Department of Pediatrics, Hershey Medical Center, Penn State University, Hershey, PA

[4] Department of Pediatrics, Children's Hospital of Buffalo, SUNY at Buffalo, Buffalo, NY

[5] Golisano Children's Hospital at Strong, Rochester, NY 14642

来源：

Journal of Perinatology | 2005年 / 25卷 / 11期

关键词：

D O I：

10.1038/sj.jp.7211381

中图分类号：

学科分类号：

摘要：

Objective: To assess, among premature infants with early respiratory distress syndrome (RDS), the effect of one dose of intratracheally administered surfactant followed by extubation to nasal continuous positive airway pressure (NCPAP) on subsequent mechanical ventilation (MV), when compared with NCPAP alone. Study design: Randomized, blinded trial in infants 29 to 35 weeks' gestation with mild-to-moderate RDS requiring supplemental oxygen and NCPAP. Infants were randomized to intubation, surfactant treatment, and immediate extubation (surfactant group N = 52), or to no intervention (control group N = 53). All infants were subsequently managed with NCPAP. Results: Need for later MV was 70% in the control group and 50% in the surfactant group. Surfactant group subjects had lower inspired oxygen fraction (FiO2) after study intervention and were less likely to require subsequent surfactant. Overall surfactant use, duration of O2 therapy, length of stay, and bronchopulmonary dysplasia were unaffected. Conclusion: Among premature infants with mild-to-moder ate RDS, transient intubation for surfactant administration reduces later MV. © 2005 Nature Publishing Group All rights reserved.

引用

页码：703 / 708

页数：5

共 24 条

[1]

Rodriguez R.J., Management of respiratory distress syndrome: An update, Respir. Care, 48, pp. 279-287, (2003)

[2]

Schimmel M.S., Hammerman C., Early nasal continuous positive airway pressure with or without prophylactic surfactant therapy in the premature infant with respiratory distress syndrome, Pediatr. Radiol., 30, pp. 713-714, (2000)

[3]

Egberts J., Brand R., Walti H., Bevilacqua G., Breart G., Gardini F., Mortality, severe respiratory distress syndrome, and chronic lung disease of the newborn are reduced more after prophylactic than after therapeutic administration of the surfactant Curosurf, Pediatrics, 100, (1997)

[4]

Avery M.E., Mead J., Surface properties in relation to atelectasis and hyaline membrane disease, Am. J. Dis. Child, 97, pp. 517-523, (1959)

[5]

Verder H., Robertson B., Greisen G., Et al., Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome, N. Engl. J. Med., 331, pp. 1051-1055, (1994)

[6]

Verder H., Albertsen P., Ebbesen F., Et al., Nasal continuous positive airway pressure and early surfactant therapy for respiratory distress syndrome in newborns of less than 30 weeks' gestation, Pediatrics, 103, (1999)

[7]

Kendig J.W., Notter R.H., Cox C., Et al., Surfactant replacement therapy at birth: Final analysis of a clinical trial and comparisons with similar trials, Pediatrics, 82, pp. 756-762, (1988)

[8]

Victorin L.H., Deverajan L.V., Curstedt T., Robertson B., Surfactant replacement in spontaneously breathing babies with hyaline membrane disease - A pilot study, Biol. Neonate., 58, pp. 121-126, (1990)

[9]

Long W., Corbet A., Cotton R., Et al., A controlled trial of synthetic surfactant in infants weighing 1250 g or more with respiratory distress syndrome, N. Engl. J. Med., 325, pp. 1696-1703, (1991)

[10]

Alba J., Agarwal R., Hegyi T., Hiatt I.M., Efficacy of surfactant therapy in infants managed with CPAP, Pediatr. Pulm., 20, pp. 172-176, (1995)

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