scholarly journals Guidelines for surfactant replacement therapy in neonates

2021 ◽  
Vol 26 (1) ◽  
pp. 35-41
Author(s):  
Eugene H Ng ◽  
Vibhuti Shah
Keyword(s):  
Clinical Practice ◽  
Laryngeal Mask Airway ◽  
Replacement Therapy ◽  
Distress Syndrome ◽  
Meconium Aspiration Syndrome ◽  
Limited Evidence ◽  
Meconium Aspiration ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Surfactant Administration

Abstract Surfactant replacement therapy (SRT) plays a pivotal role in the management of neonates with respiratory distress syndrome (RDS) because it improves survival and reduces respiratory morbidities. With the increasing use of noninvasive ventilation as the primary mode of respiratory support for preterm infants at delivery, prophylactic surfactant is no longer beneficial. For infants with worsening RDS, early rescue surfactant should be provided. While the strategy to intubate, give surfactant, and extubate (INSURE) has been widely accepted in clinical practice, newer methods of noninvasive surfactant administration, using thin catheter, laryngeal mask airway, or nebulization, are being adopted or investigated. Use of SRT as an adjunct for conditions other than RDS, such as meconium aspiration syndrome, may be effective based on limited evidence.

scholarly journals Evaluation of surfactant replacement therapy effects: A new potential role of lung ultrasound

2015 ◽  
Vol 143 (11-12) ◽  
pp. 669-675 ◽  
Author(s):  
Jovan Lovrenski ◽  
Erich Sorantin ◽  
Sanja Stojanovic ◽  
Aleksandra Doronjski ◽  
Aleksandra Lovrenski
Keyword(s):  
Replacement Therapy ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Grading System ◽  
Surfactant Replacement ◽  
Surfactant Replacement Therapy ◽  
Surfactant Administration ◽  
Us Findings

Introduction. Previous studies suggested that effects of the surfactant administration in preterm infants with respiratory distress syndrome cannot be followed by lung ultrasound (L-US). Objective. The aim of the paper is to evaluate the surfactant replacement therapy effects using a new, proposed grading system for L-US findings. Methods. We report the series of 12 preterm infants with clinical and radiographic signs of respiratory distress syndrome, in whom L-US examinations were performed prior to, and within the first 24 hours after surfactant administration. To evaluate the surfactant replacement therapy effects, we proposed a new grading system (1 to 6) for L-US findings at each examined lung area, based on the presence of normal finding, the amount of B-lines and subpleural consolidations. Results. All preterm infants had an improvement of L-US findings from one to four grades observed within the first 24 hours after surfactant administration, which has not been previously reported. The improvement of L-US findings was most commonly observed in anterior lung areas. Conclusion. L-US might enable an early detection of the surfactant replacement therapy effects. Further prospective studies are necessary to define the role of L-US in this field.

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