Details

Autor(en) / Beteiligte

• Finer, Neil N
• Carlo, Waldemar A
• Walsh, Michele C
• Rich, Wade
• Gantz, Marie G
• Laptook, Abbot R
• Yoder, Bradley A
• Faix, Roger G
• Das, Abhik
• Poole, W Kenneth
• Donovan, Edward F
• Newman, Nancy S
• Ambalavanan, Namasivayam
• Frantz, 3rd, Ivan D
• Buchter, Susie
• Sánchez, Pablo J
• Kennedy, Kathleen A
• Laroia, Nirupama
• Poindexter, Brenda B
• Cotten, C Michael
• Van Meurs, Krisa P
• Duara, Shahnaz
• Narendran, Vivek
• Sood, Beena G
• O'Shea, T Michael
• Bell, Edward F
• Bhandari, Vineet
• Watterberg, Kristi L
• Higgins, Rosemary D

Titel

Early CPAP versus Surfactant in Extremely Preterm Infants

Ist Teil von

• The New England journal of medicine, 2010-05, Vol.362 (21), p.1970-1979

Ort / Verlag

Waltham, MA: Massachusetts Medical Society

Erscheinungsjahr

2010

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• In this part of a randomized, 2-by-2 factorial trial involving extremely preterm infants, use of intubation and surfactant treatment (within 1 hour after birth) was compared with initiation of continuous positive airway pressure (CPAP) in the delivery room and subsequent use of a protocol-driven limited ventilation strategy. The rate of death or bronchopulmonary dysplasia (the primary outcome) did not differ significantly between the groups; the CPAP group required intubation less frequently and for fewer days than did the surfactant group. These results support consideration of CPAP as an alternative to intubation and surfactant in preterm infants. Use of intubation and surfactant treatment was compared with initiation of CPAP in the delivery room. The rate of death or bronchopulmonary dysplasia did not differ significantly between the groups. The CPAP group required intubation less frequently and for fewer days than did the surfactant group. It has been shown that surfactant treatment at less than 2 hours of life significantly decreases the rates of death, air leak, and death or bronchopulmonary dysplasia in preterm infants. 1 , 2 Overall, prophylactic treatment with surfactant has not been shown to significantly reduce the risk of bronchopulmonary dysplasia alone, whereas studies comparing early with later rescue use of surfactant have shown that there is a decreased risk of chronic lung disease with early use. 2 Several studies have shown that the use of surfactant does not have a significant effect on the risk of subsequent neurodevelopmental impairment, 3 although a recent follow-up . . .