Early surfactant replacement guided by lung ultrasound in preterm newborns with RDS: the ULTRASURF randomised controlled trial
Por:
Rodriguez-Fanjul J, Jordán-García I, Balaguer-Gargallo M, Batista-Muñoz A, Ramon M and Bobillo-Perez S
Publicada:
1 dic 2020
Ahead of Print:
1 jul 2020
Categoría:
Pediatrics, perinatology and child health
Resumen:
This study aimed to investigate whether using lung ultrasound (LUS) scores in premature newborns with respiratory distress syndrome (RDS) allows for earlier surfactant therapy (within the first 3 h of life) than using FiO(2)criteria. This was a randomised, non-blinded clinical trial conducted in a neonatal intensive care unit. The inclusion criteria were newborns with a gestational age of <= 32 weeks and RDS. Patients meeting the inclusion criteria were randomly assigned to two groups: the ultrasound group, administered surfactant based on LUS score and/or FiO(2)threshold, and the control group, guided by FiO(2)only. Fifty-six patients were included. The ultrasound group received surfactant earlier (1 h of life vs. 6 h,p< 0.001), with lower FiO(2)(25% vs. 30%,p= 0.016) and lower CO2(48 vs. 54,p= 0.011). After surfactant treatment, newborns in the ultrasound group presented a greater SpO(2)(p= 0.001) and SpO(2)/FiO(2)ratio (p= 0.012).
Conclusions: LUS score allowed an earlier surfactant therapy, reduced oxygen exposure early in life and a better oxygenation after the treatment. This early surfactant replacement may lead to reduced oxygen exposure.What is Known:center dot Lung ultrasound scores predict the need for surfactant therapy in premature newborns.What is New:center dot This study shows that using lung ultrasound scores improves the timeliness of surfactant replacement compared with using FiO(2)alone.
Filiaciones:
Rodriguez-Fanjul J:
Neonatal Intensive Care Unit, Paediatrics Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.
Jordán-García I:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Paediatric Infectious Diseases Research Group, Institut de Recerca Hospital Sant Joan de Déu, CIBERESP, Barcelona, Spain
Balaguer-Gargallo M:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Batista-Muñoz A:
Neonatal Intensive Care Unit, Paediatrics Department, Hospital Joan XXIII, Tarragona, Spain
Ramon M:
Neonatal Intensive Care Unit, Paediatrics Department, Hospital Joan XXIII, Tarragona, Spain
Bobillo-Perez S:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Disorders of Immunity and Respiration of the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Green Submitted, Bronze
|