Prophylactic or early selective surfactant combined with nCPAP in very preterm infants.
Details
Serval ID
serval:BIB_E9B5E48B3550
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prophylactic or early selective surfactant combined with nCPAP in very preterm infants.
Journal
Pediatrics
Working group(s)
CURPAP Study Group
Contributor(s)
Stranak Z., Berka I., Melichar J., Pesvová A., Kolárová R., Kordos P., Wierdermanová H., Kokstein Z., Basek P., Maly J., Ticha E., Martinelli S., Restelli R., Juren T., FukovFucíková H., Kucera M., Macko J., Rajchlová V., Tesarová B., Vyoralova S., Gizzi C., Agostino R., Mosca FA., Colnaghi MR., Condó V., Matassa PG., Kantor L., Suláková S., Vránová I., Simeoni U., Andres V., Arnaud F., Boubred F., Grosse C., Lacroze V., Ligi I., Millet V., Tagliabue P., Ventura ML., Furlan F., Biban P., Soffiati M., Santuz P., Cerny M., Brabec R., Fisárková B., Hícová L., Kozák V., Zunová J., Barrio C., Caserío Carbonero S., Alonso Díaz C., Rodríguez López J., Moral Pumarega MT. , López Sastre J., Arias RP., Fernández B., Fernández Colomer B., Coto G., Ibáñez A., Ramos A., Santiago J., Calvo A., Sandri F., Demaria F., Mescoli G., Faldella G., Ancora G., Maranella E., Saliba E., Chantepie-Bigot S., Chemin A., Favreau A., Follet-Bouhamed C., Henrot A., Areias A., Pombeiro J., Valido A., Nascimento O., Nona J., Santos I., Riverola A., Alvarez J., Camprubi M., Conde N., Iglesias Platas I., Rinaldi G., Maffei G., Magaldi R., Popolo G., Rinaldi M., Aujard Y., Arsac M., Baud O., Bauvin I., Farnoux C.
ISSN
1098-4275 (Electronic)
ISSN-L
0031-4005
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
125
Number
6
Pages
e1402-e1409
Language
english
Notes
Publication types: Clinical Trial, Phase IV ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
OBJECTIVE: Early surfactant followed by extubation to nasal continuous positive airway pressure (nCPAP) compared with later surfactant and mechanical ventilation (MV) reduce the need for MV, air leaks, and bronchopulmonary dysplasia. This randomized, controlled trial investigated whether prophylactic surfactant followed by nCPAP compared with early nCPAP application with early selective surfactant would reduce the need for MV in the first 5 days of life.
METHODS: A total of 208 inborn infants who were born at 25 to 28 weeks' gestation and were not intubated at birth were randomly assigned to prophylactic surfactant or nCPAP within 30 minutes of birth. Outcomes were assessed within the first 5 days of life and until death or discharge of the infants from hospital.
RESULTS: Thirty-three (31.4%) infants in the prophylactic surfactant group needed MV in the first 5 days of life compared with 34 (33.0%) in the nCPAP group (risk ratio: 0.95 [95% confidence interval: 0.64-1.41]; P = .80). Death and type of survival at 28 days of life and 36 weeks' postmenstrual age and incidence of main morbidities of prematurity (secondary outcomes) were similar in the 2 groups. A total of 78.1% of infants in the prophylactic surfactant group and 78.6% in the nCPAP group survived in room air at 36 weeks' postmenstrual age.
CONCLUSIONS: Prophylactic surfactant was not superior to nCPAP and early selective surfactant in decreasing the need for MV in the first 5 days of life and the incidence of main morbidities of prematurity in spontaneously breathing very preterm infants on nCPAP.
METHODS: A total of 208 inborn infants who were born at 25 to 28 weeks' gestation and were not intubated at birth were randomly assigned to prophylactic surfactant or nCPAP within 30 minutes of birth. Outcomes were assessed within the first 5 days of life and until death or discharge of the infants from hospital.
RESULTS: Thirty-three (31.4%) infants in the prophylactic surfactant group needed MV in the first 5 days of life compared with 34 (33.0%) in the nCPAP group (risk ratio: 0.95 [95% confidence interval: 0.64-1.41]; P = .80). Death and type of survival at 28 days of life and 36 weeks' postmenstrual age and incidence of main morbidities of prematurity (secondary outcomes) were similar in the 2 groups. A total of 78.1% of infants in the prophylactic surfactant group and 78.6% in the nCPAP group survived in room air at 36 weeks' postmenstrual age.
CONCLUSIONS: Prophylactic surfactant was not superior to nCPAP and early selective surfactant in decreasing the need for MV in the first 5 days of life and the incidence of main morbidities of prematurity in spontaneously breathing very preterm infants on nCPAP.
Keywords
Bronchopulmonary Dysplasia/prevention & control, Continuous Positive Airway Pressure, Humans, Infant, Newborn, Infant, Premature, Pulmonary Surfactants/therapeutic use
Pubmed
Web of science
Create date
22/02/2015 11:49
Last modification date
20/08/2019 17:12
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