Document Detail


Surfactant without intubation in preterm infants with respiratory distress: first multi-center data.
MedLine Citation:
PMID:  20084586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recently in a report of a single center a method has been described to apply surfactant via a thin endotracheal catheter to very low birth weight infants spontaneously breathing with nasal continuous positive airway pressure. We now analyzed available multicenter data.
PATIENTS AND METHODS: In a multicenter study investigating genetic risk factors, clinical and outcome data and data of antenatal and postnatal treatment of infants with a birth weight below 1,500 g were prospectively recorded. The measures of infants treated with the new method of surfactant application were compared to those of infants who received standard care. The analysis was restricted to infants with a gestational age below 31 weeks (n=1,541).
RESULTS: 319 infants were treated with the new method and 1,222 with standard care. The need for mechanical ventilation during the first 72 h (29% vs. 53%, p<0.001), the rate of bronchopulmonary dysplasia defined as oxygen at 36 weeks of postmenstrual age (10.9 % vs. 17.5%, p=0.004) and the rate of death or bronchopulmonary dysplasia were significantly lower in the treatment group than in the standard care group. Surfactant, theophyllin, caffeine and doxapram were significantly more often and analgetics, catecholamines and dexamethasone were significantly less frequently used in the treatment group.
CONCLUSIONS: A new method of surfactant application was associated with a lower prevalence of mechanical ventilation and better pulmonary outcome. A prospective controlled trial is required to determine whether this approach is superior to standard care.
Authors:
Angela Kribs; C Härtel; E Kattner; M Vochem; H Küster; J Möller; D Müller; H Segerer; C Wieg; C Gebauer; W Nikischin; A v d Wense; E Herting; B Roth; W Göpel
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study     Date:  2010-01-18
Journal Detail:
Title:  Klinische Pädiatrie     Volume:  222     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-04-02     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  13-7     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart * New York.
Affiliation:
Neonatologie, Universitätskinderklinik Köln, Köln, Germany. angela.kribs@uk-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Biological Agents / administration & dosage
Bronchopulmonary Dysplasia / mortality,  prevention & control
Cohort Studies
Continuous Positive Airway Pressure
Female
Gestational Age
Humans
Infant, Extremely Low Birth Weight*
Infant, Newborn
Infant, Very Low Birth Weight*
Instillation, Drug
Intubation, Intratracheal / instrumentation*
Male
Oxygen Inhalation Therapy
Phospholipids / administration & dosage
Prospective Studies
Pulmonary Surfactants / administration & dosage*
Respiratory Distress Syndrome, Newborn / drug therapy*,  mortality
Survival Analysis
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; 0/SF-RI 1, bovine surfactant preparation; 108778-82-1/beractant; KE3U2023NP/poractant alfa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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