Lung Recruitment Improves the Efficacy of Intubation-Surfactant-Extubation Treatment for Respiratory Distress Syndrome in Preterm Neonates, A Randomized Controlled Trial

2021 ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
MinYi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Primary Outcome ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Lung Recruitment ◽  
Preterm Neonates ◽  
Control Group ◽  
Complications And Mortality

Abstract Background: Lung recruitment is a maneuver in preterm neonates at birth, which may decrease the length of intubation. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome.Methods: A total of 184 preterm neonates with respiratory distress syndrome from 2017 to 2019 were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O for 15 seconds) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes include the duration of intubation, noninvasive ventilation, total oxygen therapy, hospitalization, and other complications.Results: Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates need for MV within 72 h after extubation (23% vs. 38%, P=0.025) and pulmonary surfactant administration, as well as shorter the MV duration. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk for need for MV than the lung recruitment group (OR: 2.17, 95% CI: 1.13-4.18; P=0.021). In the mothers with hypertension, the infants presented a 2.41-time higher risk for requiring MV as compared with those of mothers with normotension (OR: 2.41, 95% CI: 1.15-5.05; P=0.020). Conclusion: These data suggested that lung recruitment plus INSURE can reduce the need for MV within 72 hours after extubation without increasing the incidence of complications and mortality.

scholarly journals Lung recruitment improves the efficacy of intubation-surfactant-extubation treatment for respiratory distress syndrome in preterm neonates, a randomized controlled trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
Minyi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Lung Recruitment ◽  
Preterm Neonates ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Significant Difference

Abstract Background Lung recruitment is a maneuver used to decrease the length of intubation in preterm neonates. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome. Methods From 2017 to 2019, 184 preterm neonates (gestational age 24–32 weeks) with respiratory distress syndrome were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O, 15 s) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes included duration of MV, noninvasive ventilation, total oxygen therapy, hospitalization time, and complications. Results Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates requiring MV within 72 h after extubation (23% vs. 38%, P = 0.025) and pulmonary surfactant administration, as well as a shorter MV duration. There was no significant difference in the incidences of complications (all P > 0.05) and in-hospital mortality (2% vs. 4%, P = 0.4) between the lung recruitment group and control group. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk of requiring MV than the lung recruitment group (AOR: 2.17, 95% CI: 1.13–4.18; P = 0.021). Compared with infants with a normotensive mother, infants with a hypertensive mother have a 2.41-time higher risk of requiring MV (AOR: 2.41, 95% CI: 1.15–5.05; P = 0.020). Conclusion Lung recruitment plus INSURE can reduce the need for MV within 72 h after extubation and did not increase the incidence of complications and mortality. Trial registration Chinese Clinical Trial Registry ChiCTR1800020125, retrospectively registered on December 15, 2018.

Phototherapy Effect on the Incidence of Patent Ductus Arteriosus in Premature Infants: Prevention With Chest Shielding

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Warren Rosenfeld ◽  
Shashi Sadhev ◽  
Verlaine Brunot ◽  
Ramesh Jhaveri ◽  
Ignacio Zabaleta ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Control Group ◽  
Patent Ductus

Patent ductus arteriosus is common among premature neonates, especially those with birth weights less than 1,500 g. In vitro, room light inhibits the contraction of immature piglet's ductal rings. Because phototherapy is used frequently from the first days of life to treat jaundice in preterm neonates, we compared the occurrence of patent ductus arteriosus among premature infants exposed to this intense light source with those whose chests were shielded. Seventy-four babies with respiratory distress syndrome were randomly assigned to either a treatment group (chest shielded with aluminum foil while on phototherapy, 36 babies) or control group (no shield, 38 babies). All were on radiant warmers, received mechanical ventilation for respiratory distress syndrome, and phototherapy (Air Shields model PTU 78-1) from day 1 of life. Irradiance was maintained at >4.0 µW/cm2/nm in all cases. Although both groups had similar birth weights, gestational ages, severity of respiratory distress syndrome, intravenous fluid intake, and duration of phototherapy, the incidence of patent ductus arteriosus was significantly less in the shield group (shield 11/36 v No shield 23/38; P = .009). Patent ductus arteriosus murmurs developed in shielded patients at a later date, they required less vigorous treatment (ie, indomethacin), and they had shorter hospitalizations (74 v 85 days; P < .05). The significant reduction of patent ductus arteriosus with shielding suggests that phototherapy may play a role in the occurrence of patent ductus arteriosus in premature infants. Shielding may be a practical method to decrease this common complication should this initial observation be confirmed.

Role of lung ultrasound in the assessment of recruitment maneuvers in ventilated preterm neonates with respiratory distress syndrome and its correlation with tracheal IL-6 levels: A randomized controlled trial

2020 ◽  
pp. 1-6
Author(s):  
N.M.A. Shady ◽  
H.A.S. Awad ◽  
D.R. Kamel ◽  
E.M. Fouda ◽  
N.T. Ahmed ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Controlled Trial ◽  
Controlled Study ◽  
Preterm Neonates ◽  
Invasive Ventilation ◽  
Randomized Controlled ◽  
Group I

BACKGROUND: This study’s aim is to evaluate lung ultrasound (LUS) efficacy in detecting opening and closing lung pressures and its correlation with the tracheal interleukin 6 (IL-6) level. METHOD: This single-blinded randomized controlled study was done at Ain Shams University Children’s Hospital neonatal intensive care units, Egypt. It consists of 44 mechanically ventilated preterm neonates with Respiratory Distress Syndrome (RDS). Initial LUS assessment was done followed by randomization to one of 2 groups; group I: 22 patients underwent LUS guided RM and group II: 22 patients underwent non-ultrasound guided RM. Tracheal IL-6 level was measured before and after RM in both groups. RESULTS: The LUS scores showed a sensitivity of 86.7% , specificity of 62.10% and accuracy of 70.45% at the cut-off point >B1 grade. After RM, there was a higher percentage of changes in mean airway pressure (p = 0.03), FiO2 (p = 0.01), PaO2/FiO2 ratio (p = 0.01), and IL-6 (p <  0.01) in group I. The duration of oxygen requirement (6 vs.13.5 days, p = 0.01), invasive ventilation (3 vs.5.5 days, p = 0.03), non-invasive ventilation (2.5 vs. 5 days, p = 0.02) and NICU stay (21.5 vs. 42.5 days, p = 0.03) was less in group I. A positive correlation between reaeration score and the duration of O2 requirement (p = 0.002), duration of invasive ventilation (p = 0.001), NICU length of stay (p = 0.002) and negative correlation with PaO2/FiO2 ratio before RM (p = 0.012). The best cut-off point for the reaeration score is >21 with a sensitivity of 75% , specificity of 71.43% and area under the curve of 78.1% . CONCLUSION: LUS-guided RM achieved earlier lowest FiO2, shorter O2 dependency, lesser NICU stay and marked decrease in lung inflammation by decreasing atelectotrauma and shortening the duration of invasive ventilation.

scholarly journals Assessment of 5-Year Outcomes of Life Satisfaction in Acute Respiratory Distress Syndrome Survivors After Rehabilitation Programs: A Prospective, Multicenter, Randomized Controlled Trial

2021 ◽  
Author(s):  
Farshid Rahimi-Bashar ◽  
Mahmood Salesi ◽  
Keivan Gohari-Moghadam ◽  
Mohamad Amin Pourhoseingholi ◽  
Amir Vahedian_Azimi
Keyword(s):  
Life Satisfaction ◽  
Acute Respiratory Distress Syndrome ◽  
Pulmonary Function ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Control Group ◽  
Multicenter Randomized Controlled Trial ◽  
Empowerment Model

Abstract The use of rehabilitation program for survivors of Acute Respiratory Distress Syndrome (ARDS) could be one of the important and fundamental steps to improve the pulmonary function and health related quality of life (HRQoL) of patients. This study was carried out to evaluate the effect of two rehabilitation techniques (Family-Based Empowerment Model (FECM)/Continuing Care Model (CCM), or both of them) on pulmonary function and HRQoL in ARDS survivor. From December 2009 to October 2014, ARDS survivors from mixed medical-surgical ICUs at four academic teaching hospitals in Tehran, Iran, randomly assigned to one of three intervention groups (A, B or C) or a control group (D). Pre- and post-interventions, pulmonary functions and HRQoL status of patients in all groups were collected 48 times through clinical measurements and various questionnaires during 5 years of follow-up. Significantly improvement was seen in the intervention groups compared to the control group, and the greatest benefit was observed in patients that received mixed of FCEM and CCM rehabilitation techniques. Co-administration of FCEM and CCM can improve pulmonary function as well as the life satisfaction of ARDS survivors. As a result, the execution of the empowerment model by nurses is recommended for ARDS survivors and the participation of their families at the same time. Trial registration: NCT02787720 (ClinicalTrial.gov, 01/06/2016).

Study of Respiratory Distress Syndrome (RDS) in preterm neonates

2012 ◽  
Vol 3 (2) ◽  
pp. 218-220
Author(s):  
PANKTI D DESAI ◽  
◽  
HETAL D VORA ◽  
S H MANSURI S H MANSURI
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Preterm Neonates
Sign in / Sign up

Export Citation Format

Share Document