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surfactant INSURE

Vincent Rigo, Caroline Lefebvre, Isabelle Broux
: Less invasive surfactant therapies (LIST) use surfactant instillation through a thin tracheal catheter in spontaneously breathing infants. This review and meta-analysis investigates respiratory outcomes for preterm infants with respiratory distress syndrome treated with LIST rather than administration of surfactant through an endotracheal tube. Randomised controlled trial (RCT) full texts provided outcome data for bronchopulmonary dysplasia (BPD), death or BPD, early CPAP failure, invasive ventilation requirements and usual neonatal morbidities...
September 27, 2016: European Journal of Pediatrics
L Zhang, Y Qiu, B Yi, L Ni, L Zhang, Pulati Taxi, H Li, Q Zhang, W Wang, Z Liu, L Li, L Zhao, H Wang, B Sun
OBJECTIVES: We aimed to evaluate the efficacy of respiratory support and surfactant in incidence, management and outcome of neonatal hypoxemic respiratory failure (NRF) in Chinese emerging regional neonatal-perinatal care system in the era of universal health insurance policy. STUDY DESIGN: Clinical data of NRF were prospectively collected in 12 consecutive months from 2011 to 2012 in 12 neonatal intensive care units (NICU) in major cities of Northwest China. NRF was defined as hypoxemia requiring nasal continuous positive airway pressure (nCPAP) or intratracheal ventilation combined with surfactant for at least 24 h, with associated risk factors, mortality rate and major co-morbidities analyzed...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Anne Smits, Liesbeth Thewissen, Alexander Caicedo, Gunnar Naulaers, Karel Allegaert
OBJECTIVE: To define the effective dose for 50% of patients (ED50) of propofol for successful intubation and to determine the rate of successful extubation in those patients with planned intubation, surfactant administration, and immediate extubation (INSURE procedure). In addition, pharmacodynamic effects were assessed. STUDY DESIGN: Neonates (n = 50) treated with propofol for (semi-)elective endotracheal intubation were stratified in 8 strata by postmenstrual and postnatal age...
September 2, 2016: Journal of Pediatrics
Dimitrios Konstantelos, Jürgen Dinger, Sascha Ifflaender, Mario Rüdiger
BACKGROUND: Over the past years, research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution. METHODS: We performed a cross-sectional study of videos of preterm infants born by c-section. Videos were analyzed according to time point, duration and number of performed medical interventions. The study period occurred between January 2012 and December 2013...
2016: BMC Pregnancy and Childbirth
Tetsuya Isayama, Hiroko Iwami, Sarah McDonald, Joseph Beyene
IMPORTANCE: Various noninvasive ventilation strategies are used to prevent bronchopulmonary dysplasia (BPD) of preterm infants; however, the best mode is uncertain. OBJECTIVE: To compare 7 ventilation strategies for preterm infants including nasal continuous positive airway pressure (CPAP) alone, intubation and surfactant administration followed by immediate extubation (INSURE), less invasive surfactant administration (LISA), noninvasive intermittent positive pressure ventilation, nebulized surfactant administration, surfactant administration via laryngeal mask airway, and mechanical ventilation...
August 9, 2016: JAMA: the Journal of the American Medical Association
Tahereh Esmaeilnia, Fatemeh Nayeri, Roya Taheritafti, Mamak Shariat, Faezeh Moghimpour-Bijani
BACKGROUND: Respiratory distress syndrome (RDS) is one of the most common diseases in neonates admitted to NICU. For this important cause of morbidity and mortality in preterm neonates, several treatment methods have been used. To date, non-invasive methods are preferred due to fewer complications. OBJECTIVES: Herein, two non-invasive methods of ventilation support are compared: NCPAP vs. NIPPV. PATIENTS AND METHODS: This is a randomized clinical trial...
April 2016: Iranian Journal of Pediatrics
M J Sankar, N Gupta, K Jain, R Agarwal, V K Paul
Surfactant replacement therapy (SRT) has been shown to reduce mortality and air leaks in preterm neonates from high-income countries (HICs). The safety and efficacy of SRT in low- and middle- income countries (LMICs) have not been systematically evaluated. The major objectives of this review were to assess the (1) efficacy and safety, and (2) feasibility and cost effectiveness of SRT in LMIC settings. We searched the following databases-MEDLINE, CENTRAL, CINAHL, EMBASE and WHOLIS using the search terms 'surfactant' OR 'pulmonary surfactant'...
May 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Manal Mohmed Khowdiary, Nashwa S Mostafa
AIM OF THE STUDY: Synthesized CO (II) and Pt (II) of sulfadimethoxine. These compounds were tested for potential antitumor activity against two of human tumor cell lines, colon carcinoma cell line [Hct116], and breast carcinoma cell line MCF7. MATERIALS AND METHODS: The structures of the resulting compounds have been investigated by elemental, FT-IR and H 1 NMR analyzes to insure the purity and confirmed the structures of them. The surface properties studies and octanol/water partition coefficients, Po/w were measured...
January 2016: Journal of Cancer Research and Therapeutics
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
Ebtihal Ali, Mohamed Abdel Wahed, Zahraa Alsalami, Hasnaa Abouseif, Tania Gottschalk, Rasheda Rabbani, Ryan Zarychanski, Ahmed M Abou-Setta
CONTEXT: Surfactant is the principle treatment of respiratory distress syndrome, but the ideal method of its administration remains controversial. The intubation, surfactant administration and extubation (InSurE) method is proven to work but is invasive. The objective of this systematic review is to evaluate the efficacy and safety of the modalities of surfactant administration. METHODS: We searched MEDLINE, EMBASE and CENTRAL (inception to December 2015) for randomized trials comparing new modalities with InSurE method...
November 2016: Journal of Maternal-fetal & Neonatal Medicine
Jostein Grytten, Lars Monkerud, Irene Skau, Anne Eskild, Rune J Sørensen, Ola Didrik Saugstad
The aim of this study was to examine the effect that the introduction of new medical interventions at birth has had on mortality among newborn babies in Norway during the period 1967-2011. During this period, there has been a significant decline in mortality, in particular for low birth weight infants. We identified four interventions that together explained about 50% of the decline in early neonatal and infant mortality: ventilators, antenatal steroids, surfactant and insure. The analyses were performed on a large set of data, encompassing more than 1...
February 4, 2016: Health Economics
Masoud Dehdashtian, Arash Malakian, Mohammad Reza Aramesh, Ali Mazori, Mohammad Hasan Aletayeb, Afsaneh Shirani, Shiva Bashirnejad
BACKGROUND: In addition to surfactant deficiency, increase of lung fluid content and secretion of fluid derived from the blood participate in the pathogenesis of RDS in newborns. We hypothesized that the administration of salbutamol (β-agonist) to increase lung fluid absorption would decrease the INSURE failure rate in newborns with respiratory distress syndrome (RDS) treated with intratracheal surfactant. METHODS: Design Blinded, randomized clinical trial study...
2016: Italian Journal of Pediatrics
Christian L Hermansen, Anand Mahajan
Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common causes include transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension of the newborn, and delayed transition. Congenital heart defects, airway malformations, and inborn errors of metabolism are less common etiologies...
December 1, 2015: American Family Physician
Emel Okulu, Saadet Arsan, İlke Mungan Akın, Serdar Alan, Atila Kılıç, Begüm Atasay
We aimed to determine whether an early prophylactic INSURE strategy combined with early nasal continuous positive airway pressure (nCPAP) treatment could decrease the subsequent need for mechanical ventilation (MV) compared to the administration of surfactant prophylaxis later, at the 15th minute after birth, combined with early nCPAP. Infants born at <30 weeks' gestation were randomized to receive surfactant prophylaxis immediately or at the 15th minute after birth. All infants received 100 mg/kg poractant alpha, were ventilated with a T-piece resuscitator and were extubated to nCPAP if they had sufficient respiratory drive...
January 2015: Turkish Journal of Pediatrics
J Rodríguez-Fanjul, C Balcells Esponera, J Moreno Hernando, G Sarquella-Brugada
OBJECTIVES: The aim of this study is to assess the usefulness of lung ultrasound (LUS) to estimate the endotracheal tube (ETT) depth position during the Intubation-Surfactant-Extubation (INSURE) procedure. MATERIAL AND METHODS: The ETT insertion depth was estimated using the weight (insertion depth (cm)=weight (kg)+5.5). After intubation two independent neonatologists using bilateral auscultation or LUS checked the ETT depth. RESULTS: Twelve newborns with respiratory distress syndrome were included...
May 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
(no author information available yet)
OBJECTIVE: To investigate the status of admission and treatment of neonatal respiratory distress syndrome (RDS) in northwest regions in China. METHOD: Twenty hospitals (6 secondary hospitals, 2 tertiary grade B hospitals and 12 tertiary grade A hospitals) from 3 regions participated in the retrospective investigation. Data of infants with RDS and age ≤3 days admitted to neonatal intensive care units (NICUs) of participated hospitals from January 1, 2011 to December 31, 2011 were collected by using descriptive epidemiologic survey methodology...
May 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Tetsuya Isayama, Chatree Chai-Adisaksopha, Sarah D McDonald
IMPORTANCE: Controversy exists regarding which of the 2 major strategies currently used to prevent chronic lung disease (CLD) in preterm infants is optimal: noninvasive continuous positive airway pressure (NCPAP) or intubate-surfactant-extubate (INSURE). Preterm infants often require surfactant administration because of respiratory distress syndrome. OBJECTIVE: To evaluate whether early INSURE or NCPAP alone is more effective in preventing CLD, death, or both. DATA SOURCES: We searched the MEDLINE, EMBASE, Cochrane Controlled Trials Register, and Cumulative Index to Nursing and Allied Health Literature databases from their inception to January 2, 2015, along with conference proceedings and trial registrations...
August 2015: JAMA Pediatrics
Mats Blennow, Kajsa Bohlin
There is mounting evidence that early continuous positive airway pressure (CPAP) from birth is feasible and safe even in very preterm infants. However, many infants will develop respiratory distress syndrome (RDS) and require surfactant treatment. Combining a noninvasive ventilation approach with a strategy for surfactant administration is important to ensure optimal outcome, but questions remain about the optimal timing, mode of delivery and value of predictive tests for surfactant deficiency. Key findings in this review include the following: (1) a noninvasive ventilation strategy with CPAP from birth has a similar outcome to routine intubation in the delivery room; (2) prophylactic surfactant treatment has no advantage over early CPAP with selective surfactant administration; (3) surfactant during CPAP can be safely administered by rapid intubation-extubation (the INSURE method or via tracheal placement of a thin catheter), and (4) predictive tests for surfactant deficiency are being developed and might in future aid in directing surfactant treatment to infants at risk of developing severe RDS...
2015: Neonatology
Neeraj Gupta, Shiv Sajan Saini, Srinivas Murki, Praveen Kumar, Ashok Deorari
CONTEXT: Continuous Positive Airway Pressure (CPAP) is a cost-effective and minimal invasive respiratory support for the newborn. OBJECTIVE: To review the evidence related to various aspects of CPAP usage and its applicability for developing countries. EVIDENCE ACQUISITION: We conducted a literature search on PubMed, CENTRAL, and Cochrane Database of Systematic Reviews using the terms CPAP OR continuous positive airway pressure OR, non-invasive ventilation AND newborn OR neonate OR infant...
April 2015: Indian Pediatrics
Chung-Ming Chen
No abstract text is available yet for this article.
April 2015: Pediatrics and Neonatology
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