AARC Clinical Practice Guideline. Surfactant Replacement Therapy: 2013

Abstract Background NICE Guideline NG107, “Renal replacement therapy and conservative management” (Renal replacement therapy and conservative management (NG107); 2018:1–33) was published in October 2018 and replaced the existing NICE guideline CG125, “Chronic Kidney Disease (Stage 5): peritoneal dialysis” (Chronic kidney disease (stage 5): peritoneal dialysis | Guidance | NICE; 2011) and NICE Technology Appraisal TA48, “Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure”(Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure (Technology appraisal guideline TA48); 2002) The aim of the NICE guideline (NG107) was to provide guidance on renal replacement therapy (RRT), including dialysis, transplant and conservative care, for adults and children with CKD Stages 4 and 5. The guideline is extremely welcomed by the Renal Association and it offers huge value to patients, clinicians, commissioners and key stakeholders. It overlaps and enhances current guidance published by the Renal Association including “Haemodialysis” (Clinical practice guideline: Haemodialysis; 2019) which was updated in 2019 after the publication of the NICE guideline, “Peritoneal Dialysis in Adults and Children” (Clinical practice guideline: peritoneal Dialysis in adults and children; 2017) and “Planning, Initiation & withdrawal of Renal Replacement Therapy” (Clinical practice guideline: planning, initiation and withdrawal of renal replacement therapy; 2014) (at present there are no plans to update this guideline). There are several strengths to NICE guideline NG107 and we agree with and support the vast majority of recommendation statements in the guideline. This summary from the Renal Association discusses some of the key highlights, controversies, gaps in knowledge and challenges in implementation. Where there is disagreement with a NICE guideline statement, we have highlighted this and a new suggested statement has been written.

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Renal Association Clinical Practice Guideline on Planning, Initiating and Withdrawal of Renal Replacement Therapy

Nephron Clinical Practice ◽

10.1159/000328069 ◽

2011 ◽

Vol 118 (s1) ◽

pp. c189-c208 ◽

Cited By ~ 15

Author(s):

Ken Farrington ◽

Graham Warwick

Keyword(s):

Clinical Practice ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Clinical Practice Guideline ◽

Practice Guideline

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Guidelines for surfactant replacement therapy in neonates

Paediatrics & Child Health ◽

10.1093/pch/pxaa116 ◽

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.

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