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Surfactant lavage therapy for respiratory deterioration in extremely premature infants.
MedLine Citation:
PMID:  23110542     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Extremely premature infants with respiratory distress syndrome (RDS) are at high risk for death and developing bronchopulmonary dysplasia (BPD). Despite surfactant treatment for RDS at birth, many premature infants with prolonged ventilation will develop respiratory deterioration necessitating increased oxygen and pressure, as early as the second week of life. To date, however, there is no established treatment for respiratory deterioration in infants at risk of BPD. OBJECTIVE: To determine the short-term safety and efficacy of surfactant lavage therapy (SLT) for respiratory deterioration in ventilated extremely premature infants at risk of BPD. METHODS: Sixteen infants born <28 weeks gestation treated with SLT for respiratory deterioration between day of life 7 and 28 were studied. Tracheal lavage with 0.5 ml of surfactant solution in saline was repeated every 2-3 h until 24 h after SLT initiation. Changes in fraction of inspired oxygen (F(I) O(2) ), mean airway pressure (MAP), and the respiratory severity score (RSS = F(I) O(2) × MAP) before and after SLT were studied. RESULTS: F(I) O(2) was significantly lower at 24 h (43% vs. 29%, p < 0.001) and 48 h (43% vs. 35%, p < 0.01) after SLT initiation, although MAP remained unchanged. RSS was lower at 24 h (3.4 vs. 2.3, p < 0.001) and 48 h (3.4 vs. 2.8, p < 0.01) after SLT initiation. No infant showed tube obstruction or air leak. CONCLUSIONS: SLT is safe in short-term and effective in reducing oxygen requirement in ventilated extremely premature infants at risk of BPD.
Authors:
Sota Iwatani; Masami Mizobuchi; Satoshi Tanaka; Kei Inomata; Hitomi Sakai; Seiji Yoshimoto; Hideto Nakao
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-30
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  Pediatr Int     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Affiliation:
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Hyogo, Japan.
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