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Koh JW, Kim JW, Chang YP. Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants. Korean J Pediatr. 2018;61(10):315-321doi: 10.3345/kjp.2018.06296.
Koh, J. W., Kim, J. W., & Chang, Y. P. (2018). Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants. Korean journal of pediatrics, 61(10), 315-321. https://doi.org/10.3345/kjp.2018.06296
Koh, Ji Won, et al. "Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants." Korean journal of pediatrics vol. 61,10 (2018): 315-321. doi: https://doi.org/10.3345/kjp.2018.06296
Koh JW, Kim JW, Chang YP. Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants. Korean J Pediatr. 2018 Oct;61(10):315-321. doi: 10.3345/kjp.2018.06296. Epub 2018 Sep 16. PMID: 30304909; PMCID: PMC6212708.
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Korean J Pediatr. 2018 Oct;61(10):315-321. doi: 10.3345/kjp.2018.06296. Epub 2018 Sep 16.

Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants.

Korean journal of pediatrics

Ji Won Koh, Jong-Wan Kim, Young Pyo Chang

Affiliations

  1. Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea.
  2. Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Korea.

PMID: 30304909 PMCID: PMC6212708 DOI: 10.3345/kjp.2018.06296

Abstract

PURPOSE: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants.

METHODS: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal and neonatal characteristics were retrospectively reviewed, and major pulmonary outcomes such as duration of mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) plus death at 36-week postmenstrual age (PMA) were compared between INSURE (n=48) and prolonged MV groups (n=36). The factors associated with INSURE failure were determined.

RESULTS: Duration of MV and the occurrence of BPD at 36-week PMA were significantly lower in INSURE group than in prolonged MV group (P<0.05), but BPD plus death at 36-week PMA was not significantly different between the 2 groups. In a multivariate analysis, a reduced duration of MV was only significantly associated with INSURE (P=0.001). During the study period, duration of MV significantly decreased over time with an increasing rate of INSURE application (P<0.05), and BPD plus death at 36-week PMA also tended to decrease over time. A low arterial-alveolar oxygen tension ratio (a/APO2 ratio) was a significant predictor for INSURE failure (P=0.001).

CONCLUSION: INSURE was the noninvasive ventilation strategy in the treatment of RDS to reduce MV duration in extremely premature infants with gestational age less than 28 weeks.

Keywords: Endotracheal intubation; Extremely premature infants; Mechanical ventilation; Pulmonary surfactants; Respiratory distress syndrome

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