Oscillatory mechanics at birth for identifying infants requiring surfactant: a prospective, observational trial.
Breathing mechanics
Nasal continuous positive airway pressure
Neonatal respiratory distress syndrome
Premature infants
Pulmonary surfactant
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
20 Dec 2021
20 Dec 2021
Historique:
received:
02
09
2021
accepted:
25
11
2021
entrez:
21
12
2021
pubmed:
22
12
2021
medline:
19
3
2022
Statut:
epublish
Résumé
Current criteria for surfactant administration assume that hypoxia is a direct marker of lung-volume de-recruitment. We first introduced an early, non-invasive assessment of lung mechanics by the Forced Oscillation Technique (FOT) and evaluated its role in predicting the need for surfactant therapy. To evaluate whether lung reactance (Xrs) assessment by FOT within 2 h of birth identifies infants who would need surfactant within 24 h; to eventually determine Xrs performance and a cut-off value for early detection of infants requiring surfactant. We conducted a prospective, observational, non-randomized study in our tertiary NICU in Milan. Eligible infants were born between 27 endotracheal intubation at birth, major malformations participation in other interventional trials, parental consent denied. We assessed Xrs during nasal CPAP at 5 cmH We enrolled 61 infants, with a median [IQR] gestational age of 31.9 [30.3; 32.9] weeks and birth weight 1490 [1230; 1816] g; 2 infants were excluded from the analysis for set-up malfunctioning. 14/59 infants received surfactant within 24 h. Xrs predicted surfactant need with a cut-off - 33.4 cmH Xrs assessed within 2 h of life predicts surfactant need and respiratory support duration in preterm infants. The possible role of Xrs in improving the individualization of respiratory management in preterm infants deserves further investigation.
Sections du résumé
BACKGROUND
BACKGROUND
Current criteria for surfactant administration assume that hypoxia is a direct marker of lung-volume de-recruitment. We first introduced an early, non-invasive assessment of lung mechanics by the Forced Oscillation Technique (FOT) and evaluated its role in predicting the need for surfactant therapy.
OBJECTIVES
OBJECTIVE
To evaluate whether lung reactance (Xrs) assessment by FOT within 2 h of birth identifies infants who would need surfactant within 24 h; to eventually determine Xrs performance and a cut-off value for early detection of infants requiring surfactant.
METHODS
METHODS
We conducted a prospective, observational, non-randomized study in our tertiary NICU in Milan. Eligible infants were born between 27
EXCLUSION CRITERIA
METHODS
endotracheal intubation at birth, major malformations participation in other interventional trials, parental consent denied. We assessed Xrs during nasal CPAP at 5 cmH
RESULTS
RESULTS
We enrolled 61 infants, with a median [IQR] gestational age of 31.9 [30.3; 32.9] weeks and birth weight 1490 [1230; 1816] g; 2 infants were excluded from the analysis for set-up malfunctioning. 14/59 infants received surfactant within 24 h. Xrs predicted surfactant need with a cut-off - 33.4 cmH
CONCLUSION
CONCLUSIONS
Xrs assessed within 2 h of life predicts surfactant need and respiratory support duration in preterm infants. The possible role of Xrs in improving the individualization of respiratory management in preterm infants deserves further investigation.
Identifiants
pubmed: 34930247
doi: 10.1186/s12931-021-01906-6
pii: 10.1186/s12931-021-01906-6
pmc: PMC8686669
doi:
Substances chimiques
Pulmonary Surfactants
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
314Informations de copyright
© 2021. The Author(s).
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