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minimally invasive surfactant therapy

Gyu-Hong Shim
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. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
Peter A Dargaville, Sanoj K M Ali, Hamish D Jackson, Christopher Williams, Antonio G De Paoli
BACKGROUND: Most preterm infants born at 29-32 weeks gestation now avoid intubation in early life, and thus lack the usual conduit through which exogenous surfactant is given if needed. OBJECTIVE: The aim of this work was to examine whether a technique of minimally invasive surfactant therapy used selectively at 29-32 weeks gestation would improve outcomes. METHODS: We studied the impact of selective administration of surfactant (poractant alfa 100-200 mg/kg) by thin catheter in infants with respiratory distress syndrome on continuous positive airway pressure (CPAP)...
2018: Neonatology
Clément Chollat, Fabien Tourrel, Stéphane Marret
No abstract text is available yet for this article.
2017: Neonatology
Rampal Singh Tomar, Ranjit Ghuliani, Dinesh Yadav
OBJECTIVE: To assess the outcome of a modified method of Minimally Invasive Surfactant Therapy (MIST) therapy where an orogastric tube was used for tracheal catherization to deliver surfactant in preterm newborns less than 34 wk of gestation with respiratory distress syndrome (RDS). METHODS: A single centre, prospective observational study was conducted to enroll eligible inborn preterm neonates with gestation age more than 24 wk but less than 34 wk and suffering from RDS to receive surfactant using MIST...
April 2017: Indian Journal of Pediatrics
Daniel Klotz, Ugo Porcaro, Thilo Fleck, Hans Fuchs
Less invasive surfactant administration or minimally invasive surfactant therapy (LISA/MIST) has been proposed for the administration of surfactant in preterm infants without intubation. The aim of our survey was to assess the rate of utilization, premedication as well as technique and equipment used for LISA/MIST. Furthermore, attitudes and experiences in regard to indications, side effects, and efficacy should be assessed. An online-based survey was sent to 324 neonatologists from different centers within 37 European countries between December 2015 and March 2016...
February 2017: European Journal of Pediatrics
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
2017: Neonatology
Maria Katarzyna Borszewska-Kornacka, Marzena Kostuch, Piotr Korbal, Paweł Krajewski
BACKGROUND: The efficiency of routine practices in the management of neonatal respiratory distress syndrome (RDS) have never been systematically investigated in Poland. OBJECTIVE: To evaluate RDS treatment policies and short-term outcomes in neonatal intensive care units (NICUs). MATERIAL AND METHODS: We retrospectively analyzed medical records of premature neonates ≤ 32 weeks' gestation, diagnosed with RDS in level-2 and level-3 referral centers...
July 2015: Developmental Period Medicine
Janneke Dekker, Enrico Lopriore, Monique Rijken, Esther Rijntjes-Jacobs, Vivianne Smits-Wintjens, Arjan Te Pas
BACKGROUND: There is no data available whether sedation should be given during minimally invasive surfactant therapy (MIST). OBJECTIVE: To compare the level of comfort of preterm infants receiving sedation versus no sedation for MIST. METHODS: A retrospective study of preterm infants receiving MIST was performed in Leiden University Medical Center in 2014. Sedation (propofol 1 mg/kg) was optional and left to the discretion of the caregiver...
2016: Neonatology
Pauline S van der Burg, Frans H de Jongh, Martijn Miedema, Inez Frerichs, Anton H van Kaam
OBJECTIVE: To assess the changes in (regional) lung volume and gas exchange during minimally invasive surfactant therapy (MIST) in preterm infants with respiratory distress syndrome. STUDY DESIGN: In this prospective observational study, infants requiring a fraction of inspired oxygen (FiO2) ≥ 0.30 during nasal continuous positive airway pressure of 6 cmH2O were eligible for MIST. Surfactant (160-240 mg/kg) was administered in supine position in 1-3 minutes via an umbilical catheter placed 2 cm below the vocal cords...
March 2016: Journal of Pediatrics
Mehmet Yekta Oncel, Sema Arayici, Nurdan Uras, Evrim Alyamac-Dizdar, Fatma Nur Sari, Sevilay Karahan, Fuat Emre Canpolat, Serife Suna Oguz, Ugur Dilmen
OBJECTIVE: To compare the effectiveness of nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive-pressure ventilation (NIPPV) as the initial respiratory support within the minimally invasive surfactant therapy (MIST) approach in preterm infants with respiratory distress syndrome. DESIGN: Prospective, randomised controlled study. SETTING: Tertiary neonatal intensive care unit. PATIENTS AND INTERVENTIONS: This study enrolled 200 preterm infants with a gestational age of 26-32 weeks who showed signs of respiratory distress but did not require intubation in the delivery room...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
G Lista, A La Verde, F Castoldi
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-invasive respiratory approach. Avoiding mechanical ventilation and manual inflation it is possible to reduce lung injury due to baro-volutrauma...
June 29, 2015: Acta Bio-medica: Atenei Parmensis
F J Canals Candela, C Vizcaíno Díaz, M J Ferrández Berenguer, M I Serrano Robles, C Vázquez Gomis, J L Quiles Durá
INTRODUCTION: Surfactant delivered using a minimally invasive technique, known as MIST (Minimally Invasive Surfactant Therapy) is a method which allows surfactant to be administered to a patient connected to non-invasive respiratory support. This is an increasingly used therapy in Neonatal Units that reduces the intubation rate and the pathology associated with intubation and allows the surfactant to be administered to the patients who clinically need it. PATIENTS AND METHODS: In years 2013 and 2014 in the Hospital General Universitario de Elche surfactant was delivered using this method to 19 patients, five of whom were 28 or less weeks of gestation age at birth...
February 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Peter A Dargaville, Camille Omar F Kamlin, Antonio G De Paoli, John B Carlin, Francesca Orsini, Roger F Soll, Peter G Davis
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 path are known to have a higher risk of adverse outcomes, including death, bronchopulmonary dysplasia and other morbidities...
August 27, 2014: BMC Pediatrics
Kiran More, Pankaj Sakhuja, Prakesh S Shah
IMPORTANCE: Surfactant administration by minimally invasive methods that allow for spontaneous breathing might be safer and more effective than administration with endotracheal intubation and mechanical ventilation; however, the efficacy and safety of minimally invasive methods have not been reviewed. OBJECTIVE: To conduct a meta-narrative review of the efficacy and safety of minimally invasive surfactant administration using a thin catheter, aerosolization, a laryngeal mask airway, and pharyngeal administration in preterm infants with or at risk for respiratory distress syndrome...
October 2014: JAMA Pediatrics
Marta Aguar, María Cernada, María Brugada, Ana Gimeno, Antonio Gutierrez, Máximo Vento
AIM: Preterm infants requiring surfactant replacement have been treated using the INSURE technique, which requires sedation and comprises tracheal intubation, surfactant instillation and extubation. However, minimally invasive surfactant therapy (MIST) does not require sedation, minimises airway injury and avoids placing positive pressure ventilation on an immature lung. This study compared the feasibility of the two techniques and the outcomes in preterm babies with respiratory distress syndrome (RDS)...
June 2014: Acta Paediatrica
Emmanuel Lopez, Géraldine Gascoin, Cyril Flamant, Mona Merhi, Pierre Tourneux, Olivier Baud
BACKGROUND: Surfactant therapy is one of the few treatments that have dramatically changed clinical practice in neonatology. In addition to respiratory distress syndrome (RDS), surfactant deficiency is observed in many other clinical situations in term and preterm infants, raising several questions regarding the use of surfactant therapy. OBJECTIVES: This review focuses on several points of interest, including some controversial or confusing topics being faced by clinicians together with emerging or innovative concepts and techniques, according to the state of the art and the published literature as of 2013...
2013: BMC Pediatrics
Yahya Al Ethawi
No abstract text is available yet for this article.
April 2012: Journal of Clinical Neonatology
Ya-Mei Wang, Yu-Hong Tao
The goal of mechanically ventilating patients with acute respiratory distress syndrome (ARDS) is to ensure adequate oxygenation and minimal ventilator-associated lung injury. Non-invasive ventilation should be cautiously used in patients with ARDS. Protective ARDS mechanical ventilation strategies with low tidal volumes can reduce mortality. Driving pressure is the most reasonable parameter to optimize tidal volume. Available evidence does not support the routine use of higher positive end expiratory pressure (PEEP) in patients with ARDS...
June 2013: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
M Moisan, M Lafargue, J Calderon, P Oses, A Ouattara
Pulmonary alveolar proteinosis (PAP), which was first described by Rosen in 1958, is a rare disease characterized by impaired surfactant metabolism that provokes the accumulation of proteinaceous material in the alveoli. PAP is usually an auto-immune disease though, less commonly, may be congenital or secondary to another underlying disorder, such as infection, an immunodeficiency or a haematological disease. A positive diagnosis can be made with the appearance of "crazy-paving" on a computed tomography scan, with a milky fluid bronchial aspiration...
April 2013: Annales Françaises D'anesthèsie et de Rèanimation
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