Document Detail


Early rescue administration of surfactant and nasal continuous positive airway pressure in preterm infants <32 weeks gestation.
MedLine Citation:
PMID:  21169644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study reports our institutional experience on the outcome after prophylactic and early rescue endotracheal instillation of surfactant within 20 minutes of birth, followed by extubation and nasal continuous positive airway pressure (NCPAP) in preterm infants <32 weeks gestational age.
PATIENTS AND METHODS: A total of 142 infants were prospectively studied (42, gestational age from 23 to 27 and 100, from 28 up to 32 weeks). All infants were electively intubated for administration of 200 mg/kg porcine isolated surfactant (Curosurf, Chiesi Farmaceutici SPA, Parma, Italy) as soon as practicably possible (within 20 min after birth) and NCPAP was then initiated.
RESULTS: Extubation and switch to NCPAP at 6 h was successful in 6/42 (14.3%) infants less than 28 weeks gestational age and 75/100 (75%) infants 28-32 weeks gestational age. Out of 81 infants that were successfully extubated, 76 (93.83%) never required re-ventilation. At 96 h of age, need for continuing intubation and ventilation was required by 6/38 (15.8%) alive infants <28 weeks gestational age and 8/100 (8%) infants 28-32 weeks gestational age. Mean duration of NCPAP post-extubation was 38±20 hours for infants 23-27 wks and 29±15 hours for infants 28-32 wks gestational age. The mortality rate was 2.81% (4/142).
CONCLUSION: Implementation of prophylactic or early rescue administration of surfactant with NCPAP in infants at high risk for developing RDS in neonatal ICU is a safe modality of respiratory support in preterm infants.
Authors:
Christos Tsakalidis; Maria Kourti; Paraskevi Karagianni; Dimitris Rallis; Maria Porpodi; Nikolaos Nikolaidis
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Publication Detail:
Type:  Journal Article     Date:  2010-11-30
Journal Detail:
Title:  Indian pediatrics     Volume:  48     ISSN:  0974-7559     ISO Abbreviation:  Indian Pediatr     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-09-15     Completed Date:  2012-02-09     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  601-5     Citation Subset:  IM    
Affiliation:
Second NICU and Neonatology Department, Aristotle University of Thessaloniki, GPN Papageorgiou, Ring Road Nea Efkarpia, 56403 Thessaloniki, Greece. makourti@med.auth.gr
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Biological Agents / administration & dosage
Continuous Positive Airway Pressure*
Female
Greece
Humans
Infant, Newborn
Infant, Premature
Male
Phospholipids / administration & dosage
Prospective Studies
Pulmonary Surfactants / administration & dosage*
Respiratory Distress Syndrome, Newborn / drug therapy,  prevention & control,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; KE3U2023NP/poractant alfa

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