surfactant administration via thin catheter during spontaneous breathing: randomized controlled trial in alzahra hospital

Authors

kayvan mirnia neonatologist, pediatrics health research center, tabriz university of medical sciences, tabriz, iran

mohammad heidarzadeh assistant prof. of neonatology, dept. of pediatrics, tabriz university of medical sciences, director of dept. of neonatal health, ministry of health & medical education, tabriz ,iran

mohammad bagher hoseini associated prof. of neonatology, dept. of pediatrics, tabriz university of medical sciences, tabriz, iran

alireza sadeghnia assistant prof. of neonatology, isfahan university of medical sciences, isfahan, iran

abstract

introduction respiratory distress syndrome (rds) is a current cause of morbidity in premature infants resulted from surfactant deficiency. the primary aim of this randomized study was to describe the feasibility of early administration of surfactant via a thin catheter during spontaneous breathing (tec) and compare its outcomes with the insure (intubate, surfactant, extubate) procedure materials and methods premature infants with rds, who were ≤ 32 weeks old and stabilized with nasal continuous positive airway pressure (ncpap), were randomized to receive surfactant either by the tec or insure technique. tracheal instillation of 200 mg/kg curosorf via 5-f catheter during spontaneous breathing under ncpap was performed in the intervention group (n=38). in the insure group (n=40), infants were intubated, received positive pressure ventilation for 30 seconds after surfactant instillation, and placed on ncpap immediately results necrotizing enterocolitis rate was significantly lower in tec group, than insure group, [p<0.02, rr=0.49, ci=%95(0.39_0.62)]. but rate of other morbidities did not significant difference between two groups. although mechanical ventilation duration did not significant different between two groups (p=0.2), but total cpap duration was shorter in tec group, significantly [p<0.01, rr=8.2, ci=%95 (-37.9_-4.8)]. need for o2 supplement and mean of total hospital duration was also lower in tec group, but was not significant, statistically conclusion the tec technique is feasible for the treatment of respiratory distress syndrome in infants with very low birth weight and decreases total ncpap duration, significantly. but judgment of substitution tec instead of insure as a routine technique need to more studies.

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Journal title:
iranian journal of neonatology

جلد ۴، شماره ۲، صفحات ۵-۹

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