| Randomized Trial of Early Bubble Continuous Positive Airway Pressure for Very Low Birth Weight Infants. | |
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MedLine Citation:
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PMID: 22402568 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether very low birth weight infants (VLBWIs), initially supported with continuous positive airway pressure (CPAP) and then selectively treated with the INSURE (intubation, surfactant, and extubation to CPAP; CPAP/INSURE) protocol, need less mechanical ventilation than those supported with supplemental oxygen, surfactant, and mechanical ventilation if required (Oxygen/mechanical ventilation [MV]). STUDY DESIGN: In a multicenter randomized controlled trial, spontaneously breathing VLBWIs weighing 800-1500 g were allocated to receive either therapy. In the CPAP/INSURE group, if respiratory distress syndrome (RDS) did not occur, CPAP was discontinued after 3-6 hours. If RDS developed and the fraction of inspired oxygen (FiO(2)) was >0.35, the INSURE protocol was indicated. Failure criteria included FiO(2) >0.60, severe apnea or respiratory acidosis, and receipt of more than 2 doses of surfactant. In the Oxygen/MV group, in the presence of RDS, supplemental oxygen without CPAP was given, and if FiO(2) was >0.35, surfactant and mechanical ventilation were provided. RESULTS: A total of 256 patients were randomized to either the CPAP/INSURE group (n = 131) or the Oxygen/MV group (n = 125). The need for mechanical ventilation was lower in the CPAP/INSURE group (29.8% vs 50.4%; P = .001), as was the use of surfactant (27.5% vs 46.4%; P = .002). There were no differences in death, pneumothorax, bronchopulmonary dysplasia, and other complications of prematurity between the 2 groups. CONCLUSION: CPAP and early selective INSURE reduced the need for mechanical ventilation and surfactant in VLBWIs without increasing morbidity and death. These results may be particularly relevant for resource-limited regions. |
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Authors:
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Jose L Tapia; Soledad Urzua; Aldo Bancalari; Javier Meritano; Gabriela Torres; Jorge Fabres; Claudia A Toro; Fabiola Rivera; Elizabeth Cespedes; Jaime F Burgos; Gonzalo Mariani; Liliana Roldan; Fernando Silvera; Agustina Gonzalez; Angelica Dominguez; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-6 |
Journal Detail:
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Title: The Journal of pediatrics Volume: - ISSN: 1097-6833 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-3-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Pediatrics, Pontificia Universidad Catolica de Chile, Santiago, Chile. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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