Document Detail


Pharyngeal instillation of surfactant before the first breath for prevention of morbidity and mortality in preterm infants at risk of respiratory distress syndrome.
MedLine Citation:
PMID:  21412918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intrapartum pharyngeal instillation of surfactant before the first breath may result in surfactant administration to the infant lung, with the potential benefit of avoiding endotracheal intubation and ventilation, ventilator induced lung injury and bronchopulmonary dysplasia.
OBJECTIVES: To determine the effect of pharyngeal instillation of surfactant before the first breath compared to placebo, no treatment or intratracheal surfactant administration followed by intermittent positive pressure ventilation (IPPV) on morbidity and mortality in preterm infants at risk of respiratory distress syndrome (RDS).
SEARCH STRATEGY: Searches were made of CENTRAL (The Cochrane Library, to September 2010), MEDLINE and PREMEDLINE (1950 to September 2010), EMBASE (1980 to 2010) and CINAHL (1982 to 2010). This strategy was supplemented by searches of proceedings of scientific meetings, Google Scholar and reference lists of identified studies, as well as contact with expert informants and surfactant manufacturers.
SELECTION CRITERIA: Published, unpublished and ongoing randomised controlled or quasi-randomised trials (using individual or cluster allocation) of pharyngeal instillation of surfactant before the first breath compared to placebo or no treatment, or intratracheal surfactant instillation followed by IPPV, on morbidity and mortality in preterm infants at risk of RDS.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed study eligibility and quality.
MAIN RESULTS: No published, unpublished or ongoing trials that met the inclusion criteria for this review were found.
AUTHORS' CONCLUSIONS: There were no data from randomised controlled or quasi-randomised trials that evaluated the effect of intrapartum instillation of pharyngeal surfactant before the first breath. Evidence from animal and observational human studies suggest that pharyngeal instillation of surfactant before the first breath is potentially safe, feasible and may be effective. Well designed trials are needed.
Authors:
Mohamed E Abdel-Latif; David A Osborn
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-03-16
Journal Detail:
Title:  Cochrane database of systematic reviews (Online)     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2011  
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-04-01     Revised Date:  2011-06-16    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD008311     Citation Subset:  IM    
Affiliation:
Department of Neonatology, Australian National University Medical School, PO Box 11, Woden, ACT, Australia, 2606.
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MeSH Terms
Descriptor/Qualifier:
Humans
Infant, Newborn
Infant, Premature
Instillation, Drug
Pharynx
Pulmonary Surfactants / administration & dosage*
Respiration*
Respiratory Distress Syndrome, Newborn / prevention & control*
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants

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