Nasal CPAP vs. mechanical ventilation in 28-32 weeks preterm infants with early surfactant administration

Pérez, Luis; González, Diana Marcela; Álvarez, Karen Margarita de Jesús; Díaz‐Martínez, Luis Alfonso

doi:10.7705/biomedica.v34i4.2163

Cited by 6 publications

(4 citation statements)

References 36 publications

(56 reference statements)

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“…Two relevant studies performed showed that early surfactant had significant benefits in managing this syndrome in newborns under 33 weeks gestation. In one study conducted in 2014, the use of CPAP after early surfactant administration showed a significantly lower incidence of CPAP failure, death, chronic lung disease, intracranial hemorrhage, and sepsis compared to newborns assisted with MV (19).…”

Section: Discussionmentioning

confidence: 99%

Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome

et al. 2021

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Background: INSURE (Intubation, Surfactant administration, and Extubation) therapy is controversial in managing respiratory distress syndrome (RDS) in late preterm newborns. This study aims to determine whether the use of the INSURE in late preterm infants with RDS is associated with improved outcomes compared to similar infants managed with CPAP alone. Methods: A retrospective cohort study compared two different neonatal care units with two different treatments of RDS in late preterm infants in Bucaramanga, Colombia. One cohort used selective bubble CPAP and rescue surfactant, the second cohort used selective bubble CPAP and INSURE within the first hour of life. We included all the newborns with gestational age between 33 - 366/7 weeks, born between 2012 to 2017, that developed early RDS and were treated with CPAP. Results: We recruited 208 patients (57 CPAP and rescue surfactant and 151 CPAP + INSURE). Early INSURE was reported in 117 patients (56.3 %). INSURE therapy was associated with a reduced risk of CPAP failure (RR = 0.50; 95 % CI 0.26 - 0.98); this effect was evident only when surfactant was administered within the first two hours of life (RR = 0.29; 95 % CI 0.12 - 0.69). Early INSURE was associated with a decreased risk of pneumothorax (RR = 0.07; 95 % CI 0.01 - 0.77) and pulmonary hypertension (RR = 0.34; 95 % CI 0.14 - 0.78). Conclusions: Early INSURE therapy was associated with a reduced incidence of CPAP failure, pneumothorax, and pulmonary hypertension in late preterm infants with moderate to severe RDS. Large, well-powered randomized controlled trials are needed to confirm these observations, but its use is supported by studies with similar results in more premature infants.

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Section: Discussionmentioning

confidence: 99%

Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome

et al. 2021

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“…Інша теоретична можливість підвищення ефективності початкової НДП передбачала застосування у комплексі реанімаційних заходів після народження вищого початкового постійного позитивного тиску замість неінвазивної вентиляції легень під позитивним тиском. Теоретичні міркування й експериментальні дані вказували на те, що таке подовжене наповнення (sustained inflation) незрілих легень газом після народження може допомогти ефективніше звільнити легені від рідини, забезпечити формування ФЗЄЛ і полегшити постнатальну респіраторну адаптацію передчасно народженої дитини у випадках пригнічення або відсутності самостійного дихання [17,18]. Заданими декількох невеликих досліджень таке втручання зменшувало потребу застосування ШВЛ в перші 72 год життя [19,20].…”

Section: аналітичні огляди / Analytical Reviewsunclassified

Early Use of Continuous Positive Air Way Pressure for Prevention and Treatment of Respiratory Distress Syndrome in Preterm Infants

Menshykova¹,

Dobryanskyy²

2020

Neonatol. hìr. perinat. med.

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“…4 Perez et al observed no difference in the incidence of air leak syndromes in two groups of preterm infants treated with surfactant managed with either continuous positive airway pressure (CPAP) or invasive ventilation. 5 No data comparing PM caused by invasive vs non-invasive ventilation in adults were found for this review.…”

Section: Incidencementioning

confidence: 99%

Pneumomediastinum secondary to invasive and non-invasive mechanical ventilation

Mousa¹,

Edriss²

2019

The Chronicles

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Pneumomediastinum (PM) is defined as the presence of abnormal gas in the mediastinum.It is a known complication of invasive mechanical ventilation and has been reported withnon-invasive ventilation. Recent studies have reported that the incidence of barotrauma islowest in post-operative patients and is highest in mechanically ventilated patients with acuterespiratory distress syndrome. The incidence has dropped with the low tidal volume ventilationtechnique. Chest x-rays can miss up to 25% of small PMs detected by computed tomographyscans of the chest. Pneumomediastinum is managed with low tidal volume ventilation withplateau pressures <30 cm H2O and treatment of the underlying lung disease. Novel ways ofventilation, such as high frequency oscillatory ventilation and asynchronous independent lungventilation, may improve ventilation in some patients.

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Nasal CPAP vs. mechanical ventilation in 28-32 weeks preterm infants with early surfactant administration

Cited by 6 publications

References 36 publications

Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome

Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome

Early Use of Continuous Positive Air Way Pressure for Prevention and Treatment of Respiratory Distress Syndrome in Preterm Infants

Pneumomediastinum secondary to invasive and non-invasive mechanical ventilation

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