European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2010 Update

Sweet, David G.; Carnielli, Virgilio P.; Greisen, Gorm; Hallman, Mikko; Özek, Eren; Plavka, R; Saugstad, Ola Didrik; Simeoni, Umberto; Speer, Christian P.; Halliday, Henry L.

doi:10.1159/000297773

Cited by 233 publications

(197 citation statements)

References 266 publications

(123 reference statements)

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“…Treatment with higher doses has been shown to result in lower BPD and mortality, less intraventricular hemorrhage, longer duration of action, faster weaning of oxygen, less air leaks, longer half-life, and less need for re-dosing [78][79][80][81][82]. The European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants [83] recommend an initial dose of 200 mg/kg dose of PA for the treatment of RDS, which is also endorsed by the European Association of Perinatal Medicine.…”

Section: Animal Derived Surfactantsmentioning

confidence: 99%

Non-Invasive Ventilation and Surfactant Therapy

Ramanathan

Paz²,

Biniwale³

2013

J Pulm Respir Med

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The lungs of premature infants are more vulnerable than term infants to the effects of invasive positive pressure ventilation. Published literature supporting the use of non-invasive respiratory support with CPAP, bi-level CPAP mode, such as, SiPAP and Nasal Intermittent Positive Pressure Ventilation (NIPPV), and surfactant administration strategies are discussed. This review focuses on non-invasive respiratory support strategies and selective early use of surfactant that may reduce the incidence of bronchopulmonary dysplasia. Invasive VentilationBronchopulmonary Dysplasia (BPD) remains major pulmonary morbidity in preterm infants with Respiratory Distress Syndrome (RDS), especially among the Extremely Low Birth Weight (ELBW) infants, [1] and is associated with short-and long-term adverse pulmonary and non-pulmonary outcomes. Advances in perinatal care, including antenatal corticosteroid use, advances in invasive mechanical ventilation modes, and postnatal surfactant therapy have significantly decreased the severity of RDS and neonatal mortality. Despite these changes, invasive ventilation via an endotracheal tube remains as one of the major reasons for the development of BPD. Prophylactic or rescue surfactant therapy alone has not been shown to decrease BPD rate. Noninvasive respiratory support modes, especially bilevel CPAP or SiPAP mode, have not been shown to impact BPD rate. However, use of early, rescue surfactant therapy and NIPPV mode has been shown to decrease BPD rate. This review will focus on the benefits of surfactant therapy used in combination with NIPPV mode of respiratory support in preterm infants.

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Section: Animal Derived Surfactantsmentioning

confidence: 99%

Non-Invasive Ventilation and Surfactant Therapy

Ramanathan

Paz²,

Biniwale³

2013

J Pulm Respir Med

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“…1 Respiratory distress syndrome (RDS) is common in preterm infants born at Ͻ 32 weeks of gestational age, [2][3][4] and surfactant and mechanical ventilation have been the standard treatment. 5 However, despite advances in neonatal respiratory care, a considerable number of preterm infants develop chronic lung disease, termed bronchopulmonary dysplasia (BPD), [5][6][7][8] that is associated with neonatal death, prolonged NICU stay, and impaired neurodevelopment. 9 BPD has a multifactorial pathogenesis, and invasive mechanical ventilation is one of its most important causes.…”

Section: Introductionmentioning

confidence: 99%

High-Frequency Oscillatory Ventilation Versus Synchronized Intermittent Mandatory Ventilation Plus Pressure Support in Preterm Infants With Severe Respiratory Distress Syndrome

et al. 2013

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BACKGROUND: Mechanical ventilation and surfactants are the standard treatment of preterm respiratory distress syndrome (RDS). The effects of the primary ventilation model on bronchopulmonary dysplasia (BPD) and long-term neurodevelopment outcomes are controversial. The purpose of this study was to compare the efficacy and safety of high-frequency oscillatory ventilation (HFOV) and synchronized intermittent mandatory ventilation plus pressure support ventilation (SIMV-PSV) in preterm infants with severe RDS. METHODS: A total of 366 eligible preterm infants were randomly assigned to treatment with HFOV (n ‫؍‬ 184) or SIMV-PSV (n ‫؍‬ 182). Surfactant was applied if P aO 2 /F IO 2 was < 200 mm Hg after 2 hours of ventilation. Primary outcomes were mortality or incidence of BPD. Secondary outcomes were duration of ventilation and hospitalization, surfactant requirements, pneumothorax, retinopathy of prematurity > stage 2, and neurodevelopment at 18 months of corrected age. RESULTS: Survival and complete outcome data were available for 288 infants at 18 months of corrected age. The incidence of death or BPD was significantly higher in the SIMV-PSV group (P ‫؍‬ .001). The duration of mechanical ventilation and hospitalization was shorter and the incidence of surfactant requirement and retinopathy of prematurity was lower in the HFOV group (P < .001, P ‫؍‬ .002, P ‫؍‬ .04, respectively). Moderate or severe neurological disability was less frequent in the HFOV group than in the SIMV-PSV group at 18 months (P ‫؍‬ .

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“…(12)(13)(14) Of the 40 defining characteristics submitted, 26 (65.0%) obtained an agreement greater than 80%.…”

Section: Discussionmentioning

confidence: 99%

Conceptual validation of the defining characteristics of respiratory nursing diagnoses in neonates

Avena¹,

Peterlini²,

Gutiérrez³

2014

Acta paul. enferm.

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Objective: To develop and validate conceptual and operational definitions for the defining characteristics of the respiratory nursing diagnoses, ineffective breathing pattern, impaired gas exchange and impaired spontaneous ventilation, in newborns. Methods: This was a methodological study of conceptual validation of the defining characteristics of three respiratory nursing diagnoses, by consensus analysis of a committee of five specialist nurses, and then a group of five non-nursing professionals, using the Delphi technique. Results: After two rounds of evaluation, consensus was obtained that was equal to or greater than 80% on all of the definitions, which were then considered validated. Conclusion: The definitions developed for the defining characteristics of three nursing diagnoses were validated with a high level of consensus. ResumoObjetivo: Elaborar e validar definições conceituais e operacionais para as características definidoras dos diagnósticos de enfermagem respiratórios, Padrão Respiratório Ineficaz, Troca de Gases Prejudicada e Ventilação Espontânea Prejudicada em recém-nascidos. Métodos: Estudo metodológico, de validação conceitual das características definidoras dos três diagnósticos de enfermagem respiratórios por meio da análise de consenso de um comitê de cinco enfermeiras especialistas e de cinco profissionais não enfermeiros, utilizando a técnica Delphi. Resultados: Após duas rodadas de avaliação, obteve-se consenso igual ou superior a 80% na totalidade das definições, sendo consideradas validadas. Conclusão: As definições elaboradas para as características definidoras dos três diagnósticos de enfermagem foram validadas com elevado grau de consenso.

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European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2010 Update

Cited by 233 publications

References 266 publications

Non-Invasive Ventilation and Surfactant Therapy

Non-Invasive Ventilation and Surfactant Therapy

High-Frequency Oscillatory Ventilation Versus Synchronized Intermittent Mandatory Ventilation Plus Pressure Support in Preterm Infants With Severe Respiratory Distress Syndrome

Conceptual validation of the defining characteristics of respiratory nursing diagnoses in neonates

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