scholarly journals Continuous positive pressure ventilation combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Jing Miao ◽  
Haitao Xie ◽  
Yanping Zhang ◽  
Xiaohui Guo ◽  
Min Cui
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Neonatal Respiratory Distress Syndrome ◽  
Control Group ◽  
Observation Group ◽  
Blood Gas ◽  
Neonatal Respiratory Distress ◽  
Continuous Positive Pressure

Objective: To analyze the clinical effect of nasal continuous positive airway pressure (CPAP) combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: Eighty-two NRDS patients who received treatment from August 2017 to June 2019 in our hospital were selected and divided into a control group and an observation group using random number table, 41 in each group. The control group was treated with CPAP, and the observation group was treated with pulmonary surfactant injection besides CPAP. The therapeutic effect, blood gas index, mechanical ventilation parameters and occurrence of complications were compared between the two groups. Results: The total response rate of the observation group was 90.24%, which was significantly higher than 70.73% of the control group, and the difference had statistical significance (P<0.05). After treatment, the improvement of blood gas indexes of the observation group was better than that of the control group. The hospitalization time and duration of oxygen treatment of the observation group were shorter than those of the control group, and the hospitalization cost was higher than the control group (P<0.05). The difference of incidence of complications between the two groups was statistically significant (P<0.05). Conclusion: Endotracheal injection of pulmonary surfactant combined with CPAP in the treatment of NRDS can enhance the efficacy, promote the recovery of blood gas index, and reduce the parameters of mechanical ventilation and the incidence of complications, which is conducive to improving the respiratory function of the newborn. The therapy is worth application in the treatment of NRDS patients. doi: https://doi.org/10.12669/pjms.36.4.1963 How to cite this:Miao J, Xie H, Zhang Y, Guo X, Cui M. Continuous positive pressure ventilation combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1963 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Expression of Pulmonary Surfactant-Associated Protein B in Neonatal Respiratory Distress Syndrome

2013 ◽  
Vol 32 (2) ◽  
pp. 146-151
Author(s):  
Xiaojuan Yin ◽  
Yan Wang ◽  
Lu Xie ◽  
Xiangyong Kong ◽  
Chunzhi Wang ◽  
...  
Keyword(s):  
Protein Expression ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Mrna Expression ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Neonatal Respiratory Distress Syndrome ◽  
Control Group ◽  
Neonatal Respiratory Distress ◽  
Protein B

Summary Background: The aim of this study was to investigate the role of pulmonary surfactant-associated protein B (SP-B) expression in the pathogenesis of neonatal respiratory distress syndrome (RDS) via detecting the protein and mRNA expression of SP-B. Methods: A total of 60 unrelated neonates who died of RDS were chosen as the RDS group and then subgrouped into ≤32 weeks group, 32∼37 weeks group and ≥37 weeks group (n=20). Sixty neonates who died of other diseases were enrolled as controls and subdivided into 3 matched groups based on the gestational age. Western blot assay and RT-PCR were employed. Results: In the RDS group, SP-B protein expression was reduced or deficient in 8 neonates of which 6 had no SP-B protein expression. In the control group, only 1 had reduced SP-B protein expression. The reduced or deficient SP-B protein expression in 9 neonates of both groups was noted in the ≥37 weeks group. In the RDS group, the SP-B mRNA expression was significantly lower than that in the control group. In the ≤37 weeks group, SP-B mRNA expression was comparable between the RDS group and control group. In the 32∼37 weeks group, the SP-B mRNA expression in the RDS group was significantly reduced when compared with the control group. In the ≥37 weeks group, the SP-B mRNA expression in the RDS group was dramatically lower than that in the control group. Conclusions: Alteration of SP-B expression is present at transcriptional and translational levels. Reduction of SP-B mRNA and protein expression is involved in the pathogenesis of RDS.

scholarly journals Practical Considerations in the Selection and Use of Pulmonary Surfactant Therapy for Neonatal Respiratory Distress Syndrome in the Intensive Care Setting

2006 ◽  
Vol 11 (3) ◽  
pp. 161-168
Author(s):  
Karen E. Corff ◽  
Steve Greubel ◽  
Debra L. McCann ◽  
Richard Williams ◽  
Dwight L. Varner
Keyword(s):  
Adverse Effects ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Nurse Practitioners ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Response To Therapy ◽  
Lung Damage ◽  
Neonatal Respiratory Distress Syndrome ◽  
Neonatal Respiratory Distress

Pulmonary surfactant is the treatment of choice for neonatal respiratory distress syndrome, as it significantly reduces infant morbidity and mortality. Extensive clinical trials compare the surfactant products and their optimal usage, but often the practical administration issues are less frequently discussed. Herein, a panel of respiratory therapists and neonatal nurse practitioners share their experience regarding surfactant usage. According to the panelists, the primary criteria for surfactant selection are the ability to rapidly decrease ventilatory requirements toward extubation, a low incidence of adverse effects, cost-effectiveness, and ease of use. In most cases, surfactant is most efficacious when given as early as possible where indicated. The surfactant products differ in their storage, handling, preparation, and administration traits, and this may affect rapid dosing of the surfactant during acute treatment. During and after administration, optimal response to therapy depends on efficient management of ventilator settings, which requires vigilant monitoring of the infant. Common adverse effects include endotracheal tube reflux, bradycardia, and desaturation. Using a surfactant which requires a small dosing volume may decrease the incidence of these adverse effects. An emerging trend in clinical practice is the quick extubation of the infant to nasal continuous positive airway pressure after surfactant administration. This practice can reduce the need for ventilation and reduce the risk of ventilator-related lung damage. Nebulization of surfactant may be a future avenue of delivery, but further research is required to determine its precise role. The practical considerations summarized in this discussion may be useful for other clinicians in their own practice.

scholarly journals Application Value of a New Lung Ultrasound Scoring Method in Neonatal Respiratory Distress Syndrome Treatment 

2020 ◽  
Author(s):  
Qiu-xia Jiang ◽  
Li-jing Shi ◽  
Long-yuan Shen ◽  
Xiao-qing Li ◽  
Rong-sen Hung ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Neonatal Respiratory Distress Syndrome ◽  
Scoring Method ◽  
Neonatal Respiratory Distress ◽  
Pre Treatment

Abstract We studied a 14-zone lung ultrasound scoring method to quantify the efficiency of pulmonary surfactant treatment and to determine the timing of mechanical ventilation in neonates with neonatal respiratory distress syndrome. In this prospective study, we identified 88 neonates who received pulmonary surfactant replacement therapy. We measured surfactant efficiency using the 14-zone scoring method pre-treatment and at 12 h, 24 h, 48 h, and 72 h post-treatment. The ultrasound score was inversely associated with pulmonary surfactant treatment. We also identified 67 neonates on mechanical ventilation. We applied the scoring method when the infants met criteria for ventilator withdrawal. A comparison of pre-treatment to 12 h post-treatment showed that scoring method was significantly different (t = 4.08, P < 0.05); other scoring methods did not differ (P > 0.05). Thus, the scoring method performed better on withdrawal time. A score of 41.0 was defined as the threshold for risk of withdrawal failure with 92.36% sensitivity and 93.80% specificity, with an area under the curve of 0.955. Conclusion: The new 14-zone lung ultrasound scoring method improved scoring on the efficacy of pulmonary surfactant and had good diagnostic efficiency for timing the removal of mechanical ventilation in neonatal respiratory distress syndrome.

Two-Year Follow-up of Infants Enrolled in a Randomized Trial of Surfactant Replacement Therapy for Prevention of Neonatal Respiratory Distress Syndrome

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 543-547
Author(s):  
Michael S. Dunn ◽  
Andrew T. Shennan ◽  
Elizabeth M. Hoskins ◽  
Kathryn Lennox ◽  
Goran Enhorning
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neonatal Respiratory Distress Syndrome ◽  
Control Group ◽  
Short Term ◽  
Surfactant Replacement Therapy ◽  
Neonatal Respiratory Distress ◽  
Term Benefit

A randomized clinical trial of the use of bovine surfactant for the prevention of neonatal respiratory distress syndrome was completed at our Institution in 1984 (Pediatrics 1985;76:145-153). All infants entering the trial were enrolled in our follow-up clinic and seen at regular intervals for assessment of growth and development, neurologic and sensory status, and incidence of respiratory disease and allergic conditions. Infants have now been followed-up for at least 2 years. Of those infants for whom follow-up is complete, two of 32 (6.3%) surfactant-treated infants died, five (15.6%) had major neurodevelopmental handicaps, and five had minor neurodevelopmental handicaps. In the control group, eight of 33 (24%) infants died, whereas only two (6.1%) survived with major neurodevelopmental handicaps, and four (12.1%) were left with minor handicaps. Except for an increased neonatal death rate in the control group, other differences were not statistically significant. The groups were also comparable in terms of the incidence of late respiratory or allergic disease as assessed by history. Treatment with bovine surfactant at birth of premature infants at high risk for respiratory distress syndrome appears to be safe and of short-term benefit, although no decrease in neurodevelopmental handicap at 2 years' follow-up can be demonstrated.

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