Relation of asymmetric dimethylarginine with pulmonary morbidities in neonatal respiratory distress syndrome

2021 ◽  
pp. 1-7
Author(s):  
N.T. Abed ◽  
O.M. Abdelhaie ◽  
E.R.A. Almonaem ◽  
A.I. Mansour
Keyword(s):  
Nitric Oxide ◽  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Elevated Serum ◽  
Preterm Neonates ◽  
Adma Level ◽  
Surfactant Treatment

BACKGROUND: Asymmetric Dimethyl Arginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) is important in different diseases characterized by decreased nitric oxide (NO) availability. We aimed to assess the serum ADMA level in preterm infants suffering from respiratory distress syndrome (RDS) and its relationship with pulmonary outcomes. METHODS: This prospective study included 50 preterm neonates suffering from RDS aging≤32 weeks and weighing≤1500  gm. Serum ADMA levels were estimated in the 1st and 28th day of life by ELISA, and its correlation with surfactant requirement, duration of ventilation, and development of BPD was assessed. RESULTS: Fifty preterm infants with RDS were included, 30 infants were treated with surfactant within 12 hours after birth, the 1stday ADMA level was higher significantly in infants who required surfactant treatment than infants without surfactant treatment, At 36 weeks postmenstrual age, 16 infants were diagnosed with BPD, the 28th day ADMA level was significantly higher in infants with BPD than others without BPD. 1st-day ADMA level was significantly correlated with days on mechanical ventilation but there were no significant correlations between 1st day ADMA and days on CPAP and days on supplemental O2. CONCLUSION: Elevated serum ADMA level in preterm neonates with RDS estimated in the 1st and 28th day of life is a good predictor for pulmonary morbidities such as surfactant requirement, duration of mechanical ventilation, and development of BPD.

Inhaled nitric oxide in very preterm infants with severe respiratory distress syndrome

2006 ◽  
Vol 95 (9) ◽  
pp. 1116-1123 ◽  
Author(s):  
Carlo Dani ◽  
Giovanna Bertini ◽  
Marco Pezzati ◽  
Luca Filippi ◽  
Alessandra Cecchi ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Inhaled Nitric Oxide ◽  
Severe Respiratory Distress ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Severe Respiratory Distress Syndrome

INSURE (INtubate, SURfactant and Extubate) method in preterm infants with respiratory distress syndrome: a retrospective study

2020 ◽  
Author(s):  
Mohamed Mubarak Shaik Kidur Mohideen ◽  
Deepika Wagh ◽  
Sam Athikarisamy
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
P Value ◽  
Severe Respiratory Distress ◽  
Surfactant Administration

Abstract Background: Preterm infants with severe respiratory distress syndrome (RDS) are usually managed with endotracheal intubation and surfactant administration followed by mechanical ventilation however this has immediate and long-term complications. Hence, INSURE (Intubate, surfactant administration and extubate) method combined with continuous positive airway pressure (CPAP) support has been accepted as an alternative method in eligible infants. Aim of this study is to look at our experience of administering INSURE and to look at the factors predisposing to the failure of INSURE. Methods: A retrospective chart review was done of all the babies who were born in a tertiary hospital between 1 st January 2014 to 31 st December 2015 (2 years) and received surfactant through INSURE method. Infants requiring reintubation and mechanical ventilation within 3 days post INSURE are considered as INSURE failure for our study purpose. Results: Eighty-five infants were included in the review with gestational age (GA) ranging from 26 +3 to 35 +5 weeks and birth weight ranging from 680 to 3340 grams. Of these, 22 infants (26%) had INSURE failure. INSURE failure rate was higher in infants born <30 weeks gestation (40%). Higher FiO2 requirement prior to INSURE (mean FIO 2 0.5 vs 0.3, P value <0.001) and preeclampsia in mothers of infants < 30 weeks of GA (P value 0.027) were strongly associated with INSURE failure. No mortality was noted in either group. Conclusion: We found that INSURE method may be useful in preventing the need for mechanical ventilation in late preterm infants with RDS. However, this method may be less successful in preterm infants with lower GA (<30 weeks) and higher FiO2 requirement (≥0.5). More prospective studies are needed to assess the effectiveness of INSURE method.

Five-year single center experience on surfactant treatment in preterm infants with respiratory distress syndrome: LISA vs INSURE

2019 ◽  
Vol 135 ◽  
pp. 32-36
Author(s):  
Mehmet Buyuktiryaki ◽  
Tugba Alarcon-Martinez ◽  
Gulsum Kadioglu Simsek ◽  
Fuat Emre Canpolat ◽  
Cuneyt Tayman ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Single Center ◽  
Surfactant Treatment ◽  
Single Center Experience

scholarly journals A Comparative Pharmacoeconomic Assessment of Two Surfactants for the Prevention of Respiratory Distress Syndrome

2006 ◽  
Vol 11 (1) ◽  
pp. 43-54 ◽  
Author(s):  
Joette M. Gdovin ◽  
Fernando Moya ◽  
Tejal Vishalpura ◽  
Amy Grogg
Keyword(s):  
Mechanical Ventilation ◽  
Cost Effectiveness ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Resource Utilization ◽  
Distress Syndrome ◽  
Healthcare Resource ◽  
Pharmacoeconomic Analysis ◽  
Healthcare Resource Utilization

OBJECTIVE The use of exogenous surfactants among preterm infants for the prevention and treatment of respiratory distress syndrome (RDS) has led to economic and cost-effectiveness evaluations of these products. Lucinactant (Surfaxin), a novel, peptide-based, synthetic surfactant, has been shown to significantly reduce RDS-related mortality, compared with the most commonly prescribed animal-derived surfactant, beractant (Survanta). Infants who survive expend significant healthcare resources; therefore, the impact of improved survival through 1-year corrected age was evaluated in a prospectively defined pharmacoeconomic analysis. The objectives of this study were to estimate the healthcare resource utilization, economic impact, and cost-effectiveness of lucinactant versus beractant for the prevention of RDS among surviving very low birth weight (VLBW) preterm infants weighing 600 to 1250 grams. METHODS A decision-analytic model was developed to compare the healthcare resource utilization, economic impact, and cost-effectiveness of lucinactant versus beractant. RESULTS Infants who received lucinactant had fewer neonatal intensive care unit (NICU) days and fewer NICU days on mechanical ventilation compared with infants who received beractant. Total healthcare costs for the initial stay in the NICU were lower by $8,803 among infants who received lucinactant compared with infants who received beractant. The incremental cost per life saved was $40,309 for lucinactant compared with beractant. CONCLUSIONS Administration of lucinactant to surviving VLBW preterm infants resulted in fewer NICU days and fewer NICU days on mechanical ventilation compared with beractant. Fewer NICU days translates into lower total costs among infants who received lucinactant. This comprehensive pharmacoeconomic analysis indicates that lucinactant is a cost-effective therapy for the prevention of RDS among preterm infants.

scholarly journals Study Of The Outcome Of Early And Late Rescue Surfactant Administration In Preterm Babies

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Jayachandra Naidu T ◽  
Kireeti AS ◽  
Lokesh B ◽  
Shankar Reddy Dudala
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Surfactant Therapy ◽  
Preterm Neonates ◽  
P Value ◽  
Surfactant Replacement Therapy ◽  
Preterm Babies ◽  
Surfactant Administration

Introduction: Respiratory Distress Syndrome (RDS) is a common cause of mortality and morbidity in preterm. It is the commonest indication for ventilation in neonates in India. Surfactant Replacement Therapy (SRT) for RDS is a major breakthrough that has revolutionized the survival of premature infants worldwide. Randomized controlled trials have also demonstrated that prophylactic or early surfactant therapy compared with delayed surfactant treatment results in improved outcomes for preterm infants at high risk. Objective: To assess the outcome of early and late rescue surfactant administration by InSuRE (Intubation, Surfactant and Rapid Extubation) technic in managing preterm neonates with respiratory distress syndrome (RDS). Methodology: Study design: Prospective analytical study. Sample size: 144 preterm babies between 28-34 weeks of GA. Setting: Level III NICU at SVRR Government General Hospital, Tirupati, AP. Study Period: 1 year (Sep 2013 to Aug 2014). Method: All preterm babies between 28-34 weeks with respiratory distress were given surfactant with InSuRE technic immediately and categorized into early and late rescue group depending on the time of surfactant therapy i.e. within 2 hrs. of life and between 2-24 hrs. of life respectively. Results: In early rescue group there is significant reduction in mortality and lessen the need of mechanical ventilation with p value <0.05. Conclusion: Early routine surfactant administration within 2 hrs. of life as compared to late selective administration significantly reduced the need mechanical ventilation within 7th day of life and mortality among preterm with respiratory distress syndrome.

scholarly journals Novel Approaches to Surfactant Administration

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Samir Gupta ◽  
Steven M. Donn
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Noninvasive Ventilation ◽  
Clinical Evidence ◽  
Distress Syndrome ◽  
Surfactant Replacement Therapy ◽  
Surfactant Administration ◽  
Novel Approaches

Surfactant replacement therapy has been the mainstay of treatment for preterm infants with respiratory distress syndrome for more than twenty years. For the most part, surfactant is administered intratracheally, followed by mechanical ventilation. In recent years, the growing interest in noninvasive ventilation has led to novel approaches of administration. This paper will review these techniques and the associated clinical evidence.

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