Randomized Trial of Early Bubble Continuous Positive Airway Pressure for Very Low Birth Weight Infants

Tapia, José Luís; Urzúa, Soledad; Bancalari, Aldo; Meritano, Javier; Torres, Gabriela; Fabres, Jorge; Toro, Claudia A; Rivera, Fabiola; Céspedes, Elizabeth; Burgos, Jaime F; Mariani, Gonzalo; Roldan, Liliana; Silvera, Fernando; Gonzalez, Agustina; Domínguez, Angélica

doi:10.1016/j.jpeds.2011.12.054

Cited by 90 publications

(56 citation statements)

References 23 publications

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“…También se ha demostrado que el tiempo de ventilación mecánica se reduce con el uso de esteroides prenatales 14 y la administración temprana del surfactante 15 que también contribuyen de forma importante a disminuir la presentación la enfermedad de membrana hialina 16 . El inicio del soporte con presión positiva continua en la vía aérea (CPAP), también reduce la necesidad de ventilación mecánica invasiva sin aumentar la morbimortalidad en el infante con bajo peso al nacer 17,18 .…”

Section: Discussionunclassified

Características de pacientes ingresados a la unidad de cuidado intensivo neonatal en la Clínica Universidad de La Sabana

et al. 2016

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RESUMENIntroducción: Es pertinente conocer las características de los pacientes que ingresan a las unidades de cuidado intensivo neonatal para que las acciones en salud respondan a sus necesidades particulares. Objetivo: Caracterizar los pacientes que ingresaron a la Unidad de Cuidado Intensivo Neonatal (UCIN) de la Clínica de la Universidad de La Sabana de enero a diciembre del 2012. Materiales y Métodos: estudio retrospectivo con n=206 neonatos que ingresaron a la UCIN de la Clínica Universidad de La Sabana en el 2012, se revisaron las historias clínicas de los pacientes ingresados para identificar sus características, se calcularon frecuencias relativas y absolutas; y para las variables cuantitativas se describieron medidas de tendencia central y dispersión. Resultados: el 56,3% eran hombres, el promedio de edad gestacional de 36,5 semanas (SD 3,3 semanas), el peso promedio fue de 2625,9 g (SD 757,5 g). La mediana de los días de estancia fue de 4 (IQR: 2 a 9). El principal diagnóstico fue ictericia neonatal en (21,8%), el 22% de los pacientes requirieron ventilación mecánica (VM). La media de la edad gestacional y del peso en pacientes con requerimientos de VM fue de 32.7 semanas (SD: 3,7 semanas) y 1883 g (SD: 779 g) respectivamente, comparado con 37,6 semanas (SD: 2,2 semanas) y 2840 g (SD: 601 g) en los que no requirieron VM. Conclusiones: características como bajo peso al nacer, edad gestacional temprana y el uso de surfactante, se asociaron con el requerimiento de VM, adicionalmente la mortalidad calculada fue del 2,8%.Palabras clave: Enfermedades del prematuro; enfermedades del recién nacido; peso al nacer; Cuidado Intensivo Neonatal. ABSTRACT Introduction: It is relevant to know the characteristics of patients who enter to neonatal intensive care units in order to learn how to respond to their specific conditions and which health actions can be applied for their particular needs. Objective: The aim of this study is describe patients admitted at Clinica Universidad de La Sabana (Neonatal Intensive Care -NIC) from January to December 2012. Materials and Methods: Retrospective study with n=206 neonates admitted to the NIC at Clinica Universidad de La Sabana in 2012, medical records of patients admitted were reviewed to identify its characteristics, as well absolute and relative frequencies were calculated. In terms of quantitative variables, they were measured with central tendency and dispersion. Results: 56.3% of patients were men, the average gestational age was 36.5 weeks (SD 3.3 weeks), the average weight was 2625 gr (SD 757.5 gr).The median days of stay was 4 (IQR:2-9). The main diagnosis was neonatal icterus (21.8%); 22% of patient's required mechanical ventilation (MV). The mean gestational age and weight in patients with VM requirements was 32.7 weeks (SD: 3.7 weeks) and 1883 gr (SD: 779 gr) respectively. Contrasted with the gestational age and weight of newborns that not requiring VM was 37.6 weeks (SD 2.2 weeks) and 2840 gr (SD: 601 gr). Conclusions: Low birth weight, early gestational age and ...

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Section: Discussionunclassified

Características de pacientes ingresados a la unidad de cuidado intensivo neonatal en la Clínica Universidad de La Sabana

et al. 2016

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“…The neonates who required surfactant was 16.9% (10.14-26.77%), and who met with mortality was 6.5% (10.14-26.77%) ( Table 7). 15 This study also shows that 39% of babies weighing 1000-1499 g showed effective results. Similar study done by Bassiouny et al showed infants with RDS, treated with nCPAP, incidence of CPAP failure was 39% and significant improvement of RDS was seen.…”

Section: Resultsmentioning

confidence: 52%

Outcome of preterm babies with respiratory distress syndrome on nasal CPAP

Sunil

Girish

Bhuyan

2017

Int J Contemp Pediatr

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INTRODUCTIONRespiratory Distress Syndrome (RDS) is the commonest cause of respiratory distress in preterm infants. Deficiency of pulmonary surfactant is one of the most important factors contributing to the development of respiratory RDS. In immature lungs, the elevated surface tension resulting from surfactant deficiency leads to alveolar collapse at the end of expiration, atelectasis, uneven inflation and regional alveolar over distension. If untreated, this will result in epithelial injury and pulmonary edema which further interfere with surfactant function, producing the clinical picture of RDS. The main risk for RDS is prematurity. Other factors that increases the risk of RDS are perinatal asphyxia, maternal diabetes, lack of labour, absence of antenatal steroid administration to the mother and male gender. In preterm infants with respiratory distress syndrome (RDS), the application of continuous positive airway pressure (CPAP) is associated with benefits in terms of reduced respiratory failure and reduced mortality. ABSTRACTBackground: Continuous positive airway pressure (CPAP) has become a useful modality in management of respiratory distress in preterm babies. Nasal CPAP was found to be safe and effective means of treating mild and moderate RDS and apnoea of prematurity; Continuous Positive Airway Pressure (CPAP) is a cost-effective and minimal invasive respiratory support for the newborn. The aim of the study was to assess whether the introduction of continuous positive airway pressure (CPAP) results in improved respiratory outcomes in preterm neonates ≤36 weeks of gestation in KIMS hospital. Methods: The study was an observational clinical study, undertaken in KIMS hospital, Bangalore, Karnataka, between November 2015 to October 2016. All babies born ≤36 weeks of gestational age with respiratory distress were included in this study. Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between two or more groups and Non-parametric setting for Qualitative data analysis Results: Seventy-seven premature newborn babies with ≤36 weeks of gestation were included in the study and were put on nasal CPAP. The incidence of CPAP failure was 22.1% (95% CI 14.27-32.54%). The proportion of neonates who required surfactant was 16.9% (10.14-26.77%) and the proportion of children who met with mortality was 6.5% (10.14-26.77%) in this study. Conclusions: Early institution of CPAP in the management of RDS in premature neonates can significantly reduce the need for mechanical ventilation (MV) and surfactant therapy.

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“…New delivery room management and early NIV support significantly contributed to a sensible decay in the need for MV support. [23][24][25][26][27][28] Thus, further perspectives for neonatologists involve the assessment of different NIV strategies in terms of availability, effectiveness, and failure.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Ventilation Strategies for Early Treatment of RDS in Preterm Infants: An RCT

Salvo¹,

Lista

Lupo

et al. 2015

Pediatrics

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BACKGROUND AND OBJECTIVES: There is evidence that new methods of noninvasive ventilation (NIV) support have significantly changed respiratory distress syndrome (RDS) management in preterm infants. Further perspectives for neonatologists involve the assessment of different NIV strategies in terms of availability, effectiveness, and failure. This study evaluates the efficacy of 2 different NIV strategies for RDS treatment in very low birth weight (VLBW) infants: nasal synchronized intermittent positive pressure ventilation (NSIPPV), which is a modality of conventional ventilation with intermittent peak inspiratory pressure, and bilevel continuous positive airway pressure (BiPAP), not synchronized, with 2 alternate levels of continuous positive airway pressure. METHODS:We conducted a 2-center randomized control study in 124 VLBW infants (,1500 g and ,32 weeks of gestational age) with RDS who received NIV support (NSIPPV, n = 62; BiPAP, n = 62) within 2 hours of birth. We evaluated the performance of NIV strategies by selected primary outcomes (failure rate and duration of ventilation) and secondary outcomes. RESULTS:The number of failures and duration of ventilation support did not differ between NSIPPV and BiPAP strategies (P . .05 for both). Moreover, no differences between groups were found regarding secondary outcomes (P . .05 for all).CONCLUSIONS: The present data show no statistically significant differences between NSIPPV and BiPAP strategies in terms of duration of ventilation and failures, suggesting that both NIV techniques are effective in the early treatment of RDS in VLBW infants. Further randomized investigations on wider populations are needed to evaluate the effect of NIV techniques on long-term outcomes.

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Randomized Trial of Early Bubble Continuous Positive Airway Pressure for Very Low Birth Weight Infants

Cited by 90 publications

References 23 publications

Características de pacientes ingresados a la unidad de cuidado intensivo neonatal en la Clínica Universidad de La Sabana

Características de pacientes ingresados a la unidad de cuidado intensivo neonatal en la Clínica Universidad de La Sabana

Outcome of preterm babies with respiratory distress syndrome on nasal CPAP

Noninvasive Ventilation Strategies for Early Treatment of RDS in Preterm Infants: An RCT

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