Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study
Studies on early surfactant administration during nasal continuous positive airway pressure (NCPAP) [intubate–surfactant–extubate (INSURE)] have used continuous positive airway pressure and INSURE in the first hours after birth, but in many centers patients are transported from far away hospitals, r...
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doaj-9e92ae3609124146b0b4c30b31e088092020-11-24T23:02:05ZengElsevierPediatrics and Neonatology1875-95722015-04-01562889410.1016/j.pedneo.2014.05.006Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled StudyMaryam Nakhshab0Mehdi Tajbakhsh1Soghra Khani2Roya Farhadi3Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, IranDepartment of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, IranFaculty of Nursing, Mazandaran University of Medical Sciences, Sari, Mazandaran, IranDepartment of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, IranStudies on early surfactant administration during nasal continuous positive airway pressure (NCPAP) [intubate–surfactant–extubate (INSURE)] have used continuous positive airway pressure and INSURE in the first hours after birth, but in many centers patients are transported from far away hospitals, reaching the center at a later time. The aim of this study was to compare the effect of INSURE with only NCPAP in the management of respiratory distress syndrome (RDS) in an outborn hospital. Methods: This study was a controlled randomized clinical trial on 60 neonates who were transported to the neonatal intensive care unit of Boo-Ali Sina Hospital. Neonates born at 270/7 to 346/7 weeks of gestation, aged ≤12 hours, and diagnosed with RDS were placed on NCPAP and then randomly assigned to INSURE or NCPAP alone. The primary outcome was the need for intubation and mechanical ventilation on the basis of the criteria defined by us, and the secondary outcomes were neonatal mortality and other complications of RDS. Results: In 13 months, 60 eligible neonates were enrolled. Our participants in INSURE group received surfactant at the mean age of 5.1 hours. The relative risk of need for mechanical ventilation was 0.55 (95% confidence interval: 0.15–1.9, p = 0.53), and the rate of mortality or other complications of RDS was statistically similar between the two groups. Conclusion: After the first few hours of life (mean age of 5.1 hours), the rate of mortality and chronic lung disease and the need for mechanical ventilation were not statistically different between patients receiving INSURE and those in receipt of NCPAP alone.http://www.sciencedirect.com/science/article/pii/S187595721400134Xcontinuous positive airway pressurepreterm neonaterespiratory distress syndromesurfactant |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maryam Nakhshab Mehdi Tajbakhsh Soghra Khani Roya Farhadi |
spellingShingle |
Maryam Nakhshab Mehdi Tajbakhsh Soghra Khani Roya Farhadi Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study Pediatrics and Neonatology continuous positive airway pressure preterm neonate respiratory distress syndrome surfactant |
author_facet |
Maryam Nakhshab Mehdi Tajbakhsh Soghra Khani Roya Farhadi |
author_sort |
Maryam Nakhshab |
title |
Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study |
title_short |
Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study |
title_full |
Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study |
title_fullStr |
Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study |
title_full_unstemmed |
Comparison of the Effect of Surfactant Administration During Nasal Continuous Positive Airway Pressure with that of Nasal Continuous Positive Airway Pressure Alone on Complications of Respiratory Distress Syndrome: A Randomized Controlled Study |
title_sort |
comparison of the effect of surfactant administration during nasal continuous positive airway pressure with that of nasal continuous positive airway pressure alone on complications of respiratory distress syndrome: a randomized controlled study |
publisher |
Elsevier |
series |
Pediatrics and Neonatology |
issn |
1875-9572 |
publishDate |
2015-04-01 |
description |
Studies on early surfactant administration during nasal continuous positive airway pressure (NCPAP) [intubate–surfactant–extubate (INSURE)] have used continuous positive airway pressure and INSURE in the first hours after birth, but in many centers patients are transported from far away hospitals, reaching the center at a later time. The aim of this study was to compare the effect of INSURE with only NCPAP in the management of respiratory distress syndrome (RDS) in an outborn hospital.
Methods: This study was a controlled randomized clinical trial on 60 neonates who were transported to the neonatal intensive care unit of Boo-Ali Sina Hospital. Neonates born at 270/7 to 346/7 weeks of gestation, aged ≤12 hours, and diagnosed with RDS were placed on NCPAP and then randomly assigned to INSURE or NCPAP alone. The primary outcome was the need for intubation and mechanical ventilation on the basis of the criteria defined by us, and the secondary outcomes were neonatal mortality and other complications of RDS.
Results: In 13 months, 60 eligible neonates were enrolled. Our participants in INSURE group received surfactant at the mean age of 5.1 hours. The relative risk of need for mechanical ventilation was 0.55 (95% confidence interval: 0.15–1.9, p = 0.53), and the rate of mortality or other complications of RDS was statistically similar between the two groups.
Conclusion: After the first few hours of life (mean age of 5.1 hours), the rate of mortality and chronic lung disease and the need for mechanical ventilation were not statistically different between patients receiving INSURE and those in receipt of NCPAP alone. |
topic |
continuous positive airway pressure preterm neonate respiratory distress syndrome surfactant |
url |
http://www.sciencedirect.com/science/article/pii/S187595721400134X |
work_keys_str_mv |
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