Enhanced INSURE (ENSURE): an updated and standardised reference for surfactant administration
| Autor: | Rafik Ben-Ammar, Shivani Shankar-Aguilera, Feriel Fortas, Daniele De Luca, Barbara Loi, Giulia Regiroli, Nadya Yousef, Roberta Centorrino |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Clinical Algorithm
Surface-Active Agents Neonate Preterm Surfactant Intubation Intratracheal Medicine Humans Duration (project management) RDS LISA Respiratory Distress Syndrome Newborn Standardised technique Continuous Positive Airway Pressure business.industry Infant Newborn Clinical Practice Observational Studies as Topic Cross-Sectional Studies Risk analysis (engineering) Pediatrics Perinatology and Child Health Airway Extubation Observational study business Intubation Respiratory care Infant Premature |
| Zdroj: | European Journal of Pediatrics |
| ISSN: | 1432-1076 0340-6199 |
| Popis: | There is no firm consensus about the optimal technique for the administration of exogenous surfactant in preterm neonates, and different techniques may be equally effective. The intubation-surfactant-extubation (INSURE) procedure has not been fully described, and important details, such as duration and mode of ventilation, remain unclear, leading to significant clinical practice variations and influencing its suitability and feasibility. Since the first INSURE description, our knowledge in respiratory care has largely progressed, but the technique has not been updated according to current evidence-based practice. Thus, our aim is to formally describe a modern way to perform INSURE, based on the current knowledge and technology, to increase its feasibility and patients’ safety. We offer ENSURE (Enhanced INSURE) as an updated and standardised technique for surfactant administration, clarifying crucial issues of the original method by applying current state-of-the-art concepts of respiratory care. We performed a cross-sectional observational study enrolling 57 preterm neonates describing ENSURE feasibility and safety. Conclusion: ENSURE can be used as a reference technique in clinical practice, teaching and research. What is Known:• There is no consensus about the optimal method for surfactant administration. INSURE technique has been originally described many years ago without considering modern principles of neonatal respiratory care and the available state-of-the-art technology.What is New:• We here describe a modern way to perform INSURE, based on the current knowledge and technology. We called it ENSURE (Enhanced INSURE) and clarified crucial points of the original technique, in light of the current knowledge. We verified feasibility and safety of ENSURE in a cross-sectional observational study enrolling 57 preterm neonates. Supplementary information The online version contains supplementary material available at 10.1007/s00431-021-04301-x. |
| Databáze: | OpenAIRE |
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