Less invasive surfactant administration versus endotracheal surfactant instillation followed by limited peak pressure ventilation in preterm infants with respiratory distress syndrome in China: study protocol for a randomized controlled trial

Zhu, Jiajun; Bao, Yingying; Du, Lizhong; Huang, Huafei; Lv, Qin; Jiang, Yejun; Yu-xuan, Dai; Chen, Zhijun; Shi, Jingyun; Shi, Yongyan; Yang, Chuangzhong; Mao, Hua; Jiang, Hong; Sun, Yang; Sun, Xin

doi:10.1186/s13063-020-04390-3

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…These strategies may be considered as sub-optimal since they may cause lung de-recruitment or overexpansion. Studies are ongoing in these fields [36,37].…”

Section: Discussionmentioning

confidence: 99%

A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units

Moretti,

Gizzi,

Gagliardi

et al. 2024

Children

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(1) Background: Our survey aimed to gather information on respiratory care in Neonatal Intensive Care Units (NICUs) in the European and Mediterranean region. (2) Methods: Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs. The adherence to the “European consensus guidelines on the management of respiratory distress syndrome” was assessed for comparison. (3) Results: The response rate was 75% (397/528 units). In most Delivery Rooms (DRs), full resuscitation is given from 22 to 23 weeks gestational age. A T-piece device with facial masks or short binasal prongs are commonly used for respiratory stabilization. Initial FiO2 is set as per guidelines. Most units use heated humidified gases to prevent heat loss. SpO2 and ECG monitoring are largely performed. Surfactant in the DR is preferentially given through Intubation-Surfactant-Extubation (INSURE) or Less-Invasive-Surfactant-Administration (LISA) techniques. DR caffeine is widespread. In the NICUs, most of the non-invasive modes used are nasal CPAP and nasal intermittent positive-pressure ventilation. Volume-targeted, synchronized intermittent positive-pressure ventilation is the preferred invasive mode to treat acute respiratory distress. Pulmonary recruitment maneuvers are common approaches. During NICU stay, surfactant administration is primarily guided by FiO2 and SpO2/FiO2 ratio, and it is mostly performed through LISA or INSURE. Steroids are used to facilitate extubation and prevent bronchopulmonary dysplasia. (4) Conclusions: Overall, clinical practices are in line with the 2022 European Guidelines, but there are some divergences. These data will allow stakeholders to make comparisons and to identify opportunities for improvement.

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“…These strategies may be considered as sub-optimal since they may cause lung de-recruitment or overexpansion. Studies are ongoing in these fields [36,37].…”

Section: Discussionmentioning

confidence: 99%

A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units

Moretti,

Gizzi,

Gagliardi

et al. 2024

Children

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“…The following are pre-defined criteria used to guide extraction and withdrawal: (1) weaning from CMV: RR < 30 beats/min, PIP < 16 cmH 2 O, PEEP < 5 cmH 2 O, and FiO2 < 30%, (2) weaning from HFV: MAP < 8 cm H2O, and FiO2 < 0.30 ( 19 ). In brief, extubation may be attempted when the infant on mechanical ventilation remains clinically stable with adequate spontaneous respiratory effort and FiO2 ≤ 0.30 for 6 h, followed by appropriate non-invasive ventilation or oxygen therapy support, with the specific criteria as described above ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Safety and efficacy of a novel double-lumen tracheal tube in neonates with RDS: A prospective cohort study

Du²,

Yang³

et al. 2022

Front. Pediatr.

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BackgroundThe purpose of this study was to assess the safety and efficacy of a new double-lumen tracheal tube for neonates, with a conventional tracheal tube as a control.MethodNewborns with respiratory distress syndrome (RDS) requiring endotracheal intubation admitted to the tertiary neonatal intensive care unit (NICU) of Qujing Maternal and Child Healthcare Hospital in Yunnan Province between March 2021 and May 2022 were enrolled in this prospective cohort study. Outcome indicators related to effectiveness included mainly the number of intubations, duration of ventilation, duration of oxygenation, and length of stay; safety indicators included any clinical adverse effects during and after intubation. Appropriate stratified and subgroup analyses were performed according to the purpose of intubation, gestational age, and whether the drug was administered via endotracheal tube.ResultA total of 101 neonates were included and divided into two groups based on the choice of tracheal tube: the conventional (n = 50) and new (n = 51) tracheal tube groups. There was no statistical difference between the two groups in terms of adverse effects during and after intubation (p > 0.05). In neonates who were mechanically ventilated without endotracheal surfactant therapy or newborns receiving InSurE technique followed by non-invasive ventilation, no significant differences were found between the two groups regarding any of the efficacy indicators (p > 0.05). However, for neonates on invasive mechanical ventilation, the new tracheal tube allowed for a significant reduction in the duration of mechanical ventilation (96.50[74.00, 144.00] vs. 121.00[96.00, 196.50] hours, p = 0.037) and total ventilation (205.71 ± 80.24 vs. 277.56 ± 117.84 h, p = 0.027), when used as a route for endotracheal drug delivery. Further analysis was performed according to gestational age for newborns requiring intratracheal surfactant administration during mechanical ventilation, and the data showed that for preterm infants, the new tracheal tube not only shortened the duration of mechanical ventilation (101.75 ± 39.72 vs. 155.50 ± 51.49 h, p = 0.026) and total ventilation (216.00 ± 81.60 vs. 351.50 ± 113.79 h, p = 0.010), but also demonstrated significant advantages in reducing the duration of oxygen therapy (9.75 ± 6.02 vs. 17.33 ± 8.43 days, p = 0.042); however, there was no statistical difference in efficacy outcomes between the two groups in full-term infants (p > 0.05).ConclusionThe efficacy and safety of this new tracheal tube are promising in neonates with RDS, especially those requiring surfactant administration via a tracheal tube during mechanical ventilation. Given the limitations of this study, however, the clinical feasibility of this catheter needs to be further confirmed in prospective randomized trials with larger sample sizes.Clinical Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=122073

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Effect of the occurrence state of magnesium in talc on the adsorption of Pb(II)

Xie

Zhang

Zhong

et al. 2021

Journal of Alloys and Compounds

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Less invasive surfactant administration versus endotracheal surfactant instillation followed by limited peak pressure ventilation in preterm infants with respiratory distress syndrome in China: study protocol for a randomized controlled trial

Cited by 6 publications

References 21 publications

A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units

A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units

Safety and efficacy of a novel double-lumen tracheal tube in neonates with RDS: A prospective cohort study

Effect of the occurrence state of magnesium in talc on the adsorption of Pb(II)

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