Surfaktantbehandling af nyfödte börn i continuous positive airway pressure-behandling
Engelsk titel: Surfactant treatment of newborn infants receiving continuous positive airway pressure treatment
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Författare:
Andersen T
;
Holm HS
;
Kamper J
Email: hspangsberg@hotmail.com
Språk: Dan
Antal referenser: 10
Dokumenttyp:
Artikel
UI-nummer: 06101189
Sammanfattning
Introduction: The purpose of this study was to examine the efficiency of a single dose of fast-acting exogenous surfactant (Curosurf ®) given to premature babies with progressive respiratory insufficiency. Curosurf was given as early rescue therapy during a brief intubation (INSURE method: INtubation-SURfactant-Extubation) during treatment with nasal Continuous Positive Airway Pressure (CPAP). Materials and methods: Retrospective study of 115 premature infants with respiratory distress syndrome born and treated at Odense University Hospital during the years 1999 to 2004. The criterion for surfactant treatment was a decrease in the arterial/alveolar oxygen tension ratio (or corresponding values for the fraction of inspired oxygen) below 0.36 in infants with gestational age (GA) < 30 weeks and 0.22 in more mature infants. Results: The primary end point was survival during the first week of life without mechanical ventilation. This end point was reached by 51% of the infants with GA < 30 weeks. However, the effect proved to be GA-dependent, increasing from 22% in infants with a GA of 24-25 weeks to 86% in week 29. Seventy percent survived to be discharged. In infants with GA > 29 weeks the effect was 87%, and all survived. Conclusion: The effect of surfactant therapy administered per the INSURE method is GA-dependent, and the method works best after GA week 25. The question is whether earlier therapy will increase its efficiency or the method has reached its limit.