| Technique for intrapartum administration of surfactant without requirement for an endotracheal tube. | |
| | |
MedLine Citation:
|
PMID: 15085166 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To evaluate the feasibility and safety of administering surfactant into the nasopharynx during delivery, thus permitting the baby to aspirate the solution into the fluid-filled airway as an air-fluid interface is established. This process avoids the endotracheal intubation (ETI) and positive pressure ventilation (PPV) usually associated with prophylaxis, thus avoiding the pulmonary barotrauma associated with the conventional method of surfactant administration. STUDY DESIGN: In all, 23 neonates weighing 560 to 1804 g and born at 27 to 30 weeks had their nasopharyngeal airways suctioned and then 3.0-4.5 ml Infasurf instilled into the nasopharynx before delivery of the shoulders. Continuous positive airway pressure (CPAP) of 10 cmH(2)O was administered by mask as the babies initiated breathing. Nasal CPAP at 6 cmH(2)O was then continued for a minimum of 48 hours. RESULTS: In all, 13 of 15 babies delivered vaginally were weaned quickly to room air and required no further surfactant or endotracheal intubation for RDS. Five of eight babies delivered by C-section required subsequent endotracheal intubation soon after birth and two received subsequent endotracheal tube surfactant. CONCLUSION: Nasopharyngeal surfactant instillation at birth appears to be relatively safe and simple to accomplish, especially for vaginal births. A large randomized clinical trial will be required to determine the efficacy of this technique when compared to prophylaxis by endotracheal intubation and to nCPAP alone. |
| | |
Authors:
|
John Kattwinkel; Melinda Robinson; Barry T Bloom; Paula Delmore; James E Ferguson |
Related Documents
:
|
16998926 - Lung function measurements in a preterm animal model of respiratory failure: comparison... 15181296 - Continuous positive airway pressure - a gentler approach to ventilation. 9785156 - Emergency intubation of infants: does laryngoscope blade design make any difference? 22938036 - Necrotizing enterocolitis after red blood cell transfusion in preterm infants with pate... 9135286 - Unilateral neonatal cerebral infarction in full term infants. 17354646 - Fetal and perinatal mortality, united states, 2003. |
Publication Detail:
|
Type: Clinical Trial; Journal Article |
Journal Detail:
|
Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 24 ISSN: 0743-8346 ISO Abbreviation: J Perinatol Publication Date: 2004 Jun |
Date Detail:
|
Created Date: 2004-05-28 Completed Date: 2004-09-30 Revised Date: 2005-08-30 |
Medline Journal Info:
|
Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
|
Languages: eng Pagination: 360-5 Citation Subset: IM |
Affiliation:
|
Department of Pediatrics, University of Virginia, Box 800386, Charlottesville, VA 22908, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Biological Products
/
administration & dosage* Continuous Positive Airway Pressure Delivery, Obstetric* Female Humans Infant, Newborn Infant, Premature* Instillation, Drug Intubation, Intratracheal Male Nasopharynx* Pregnancy Respiratory Distress Syndrome, Newborn / therapy* |
| Chemical | |
Reg. No./Substance:
|
0/Biological Products; 0/calfactant |
| Comments/Corrections | |
Comment In:
|
J Perinatol. 2005 May;25(5):361-2; author reply 363
[PMID:
15861205
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hospital factors and nontransfer of small babies: a marker of deregionalized perinatal care?
Next Document: Albuminuria predicts cardiovascular events independently of left ventricular mass in hypertension: a...