Background: The cornerstone of the treatment of respiratory distress syndrome (RDS) is respiratory support and surfactant replacement therapy. The administration of surfactant through a thin intratracheal catheter is one of the methods used to reduce one of the standard technique complications of a surfactant injection (Intubation-Surfactant-Extubation method [INSURE]). The aim of this study wa...

BACKGROUND The INtubation-SURfactant-Extubation (INSURE) is a procedure that is increasingly being used to treat the respiratory distress syndrome in preterm infants. The objective of this study was to identify predictors for an unsuccessful INSURE procedure. METHODS The neonates included were less than 32 weeks' gestation, treated with surfactant in the neonatal intensive care unit, and born...

large preterm infants are generally not considered good candidates for surfactant treatment until they have been intubated for progressing respiratory distress. this study has been done to detect the effect of electively providing early single-dose surfactant to large preterm babies with mild to moderate respiratory distress syndrome (rds). a randomized clinical trial was performed on 45 infant...

Recent human and animal studies demonstrated that surfactant can be delivered intratracheally without traditional intubation and bagging, but using a fine catheter inserted into the trachea of spontaneously breathing preterm infants on CPAP. This strategy, known as LISA (less invasive surfactant administration) or MIST (minimal invasive surfactant therapy), seems to reduce failure of non-invasi...

CPAP is the most studied form of noninvasive ventilation in neonates, and early investigations focused on the use of CPAP following surfactant administration, to minimize the need for invasive mechanical ventilation.1 Verder and colleagues demonstrated that a strategy of CPAP following brief intubation and surfactant administration (the INSURE technique: INtubation, SURfactant, Extubation) impr...

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recen...

background:respiratory distress syndrome is the most common respiratory disease in premature neonate and the most important cause of death among them. we aimed to investigate factors to predict successful or failure of insure method as a therapeutic method of rds.methods:in a cohort study,45 neonates with diagnosed rds and birth weight lower than 1500g were included and they underwent insure fo...

BACKGROUND It is now recognized that preterm infants ≤28 weeks gestation can be effectively supported from the outset with nasal continuous positive airway pressure. However, this form of respiratory therapy may fail to adequately support those infants with significant surfactant deficiency, with the result that intubation and delayed surfactant therapy are then required. Infants following this...

Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in preterm infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/sepsis, and perhaps p...