Effect and security of minimally invasive surfactant therapy in neonatal respiratory distress syndrome
10.3760/cma.j.issn.2095-428X.2018.14.007
- VernacularTitle: 微创肺表面活性物质治疗在新生儿呼吸窘迫综合征中的疗效与安全性
- Author:
Xiao RONG
1
;
Wei ZHOU
;
Xiaopeng ZHAO
;
Weineng LU
;
Jinghua ZHANG
;
Ting SHEN
;
Ruilian GUAN
;
Li SUN
Author Information
1. Department of Neonatology, Guangzhou Women and Children′s Medical Center, Guangzhou 510623, China
- Publication Type:Journal Article
- Keywords:
Minimally invasive surfactant therapy;
Neonatal respiratory distress syndrome;
Infant, preterm
- From:
Chinese Journal of Applied Clinical Pediatrics
2018;33(14):1071-1074
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect and security of minimally invasive surfactant therapy (MIST) in treatment of preterm infants with neonatal respiratory distress syndrome (NRDS).
Methods:A total of 48 pretrm infants with gestational ages between 30-36 weeks diagnosed with NRDS in Guangzhou Women and Children′s Medical Center from January 2017 to January 2018 were randomly divided into MIST group (23 cases) and intubation-surfactant-extubation+ continuous positive airway pressure ventilation (INSURE) group (25 cases) by adopting random number table method.The patients in MIST group were put on nasal continuous positive airway pressure (nCPAP) and a thin vascular catheter was inserted through the vocal cords under direct vision with direct laryngoscope then infused pulmonary surfactant(PS) into the lung; the patients in INSURE group were endotracheally intubated and infused with PS into the lung through endotracheal tube with positive airway pressure, then extubated and put on nCPAP again.The incidences of adverse reactions and various complications related to the 2 groups were observed.
Results:There were no significant differences between 2 groups in oxygen saturation decrease(26.1% vs.36.0%), bradycardia (13.0% vs.24.0%) and reuse PS (8.7% vs.4.0%) (all P>0.05). There were no significant differences between 2 groups in noninvasive ventilation time [8 d (5.5-12.5 d) vs.7 d(5.0-14.0 d)], total oxygen intake time [12 d(7.0-26.5 d) vs.10 d(10.0-23.0 d)] and length of hospital stay [(34.22±16.06) d vs.(30.88±14.35) d] (all P>0.05). There was no death or intraventricular hemorrhage in both groups, and there were no significant differences between 2 groups in the incidences of pneumothorax (0 vs.4.0%), bronchopulmonary dysplasia (21.7% vs.16.0%), retinopathy of prematurity (21.7% vs.12.0%) and necrotizing enterocolitis (21.7% vs.12.0%) (all P>0.05).
Conclusions:MIST technique is a safe and effective method to administrate surfactant in preterm infants with NRDS.In the NRDS patients who do not need intubation and mechanical ventilation, MIST technique can be used to administrate PS.
