Neonatal Preterm Respiratory Care in Ukraine: An Observational Study of Outcomes in Relation to Timing and Methods of Surfactant Treatment
| Autor: | Anna Menshykova, Zoriana V. Salabay, Dmytro Dobryanskyy, Olga Y. Detsyk |
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| Rok vydání: | 2020 |
| Předmět: |
Resuscitation
Pediatrics medicine.medical_specialty medicine.medical_treatment Birth weight Antenatal steroid 03 medical and health sciences Surface-Active Agents 0302 clinical medicine Pregnancy 030225 pediatrics Medicine Humans 030212 general & internal medicine Continuous positive airway pressure Retrospective Studies Mechanical ventilation Respiratory Distress Syndrome Respiratory Distress Syndrome Newborn Respiratory distress Continuous Positive Airway Pressure business.industry Infant Newborn Obstetrics and Gynecology Gestational age Infant Retrospective cohort study Pulmonary Surfactants Child Preschool Pediatrics Perinatology and Child Health Female business Ukraine Infant Premature |
| Zdroj: | American journal of perinatology. 39(8) |
| ISSN: | 1098-8785 |
| Popis: | Objective Timely and effective noninvasive respiratory support and surfactant administration are the key determinants of clinical outcomes in very preterm infants. The objective of this study was to evaluate the impact of the changes in clinical practice of surfactant administration on clinical outcomes and the incidence of continuous positive airway pressure (CPAP) failure defined as the need for mechanical ventilation (MV) during the first 5 days of life in preterm infants Study Design One hundred sixty-five outborn very preterm infants with respiratory distress syndrome (RDS), initially managed on CPAP, were enrolled in a retrospective cohort study. Fifty-two infants treated with surfactant using less invasive or INSURE technique were included in the surfactant group. One hundred thirteen control infants received surfactant only in case of CPAP failure. Results The study groups were similar in gestational age, rates of main obstetric complications, and antenatal steroid prophylaxis. The rate of cesarean delivery was significantly higher but birth weight and need for resuscitation were lower in infants from the surfactant group. Fifty-five infants with CPAP failure (49%) received surfactant after initiation of MV in the control group in comparison with 52 (100%) in the surfactant group (p Conclusion Adherence to the European RDS guidelines with early rescue, less invasive surfactant administration in very preterm infants decreased the probability of CPAP failure which was significantly associated with higher morbidity and mortality. Key Points |
| Databáze: | OpenAIRE |
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