Reininger Ann, Khalak Rubia, Kendig James W, Ryan Rita M, Stevens Timothy P, Reubens Linda, D'Angio Carl T
Strong Children's Research Center, University of Rochester, Rochester, NY 14642, USA.
J Perinatol. 2005 Nov;25(11):703-8. doi: 10.1038/sj.jp.7211381.
To assess, among premature infants with early respiratory distress syndrome (RDS), the effect of one dose of intratracheally administered surfactant followed by extubation to nasal continuous positive airway pressure (NCPAP) on subsequent mechanical ventilation (MV), when compared with NCPAP alone.
Randomized, blinded trial in infants 29 to 35 weeks' gestation with mild-to-moderate RDS requiring supplemental oxygen and NCPAP. Infants were randomized to intubation, surfactant treatment, and immediate extubation (surfactant group N=52), or to no intervention (control group N=53). All infants were subsequently managed with NCPAP.
Need for later MV was 70% in the control group and 50% in the surfactant group. Surfactant group subjects had lower inspired oxygen fraction (FiO(2)) after study intervention and were less likely to require subsequent surfactant. Overall surfactant use, duration of O(2) therapy, length of stay, and bronchopulmonary dysplasia were unaffected.
Among premature infants with mild-to-moderate RDS, transient intubation for surfactant administration reduces later MV.
评估在患有早期呼吸窘迫综合征（RDS）的早产儿中，与单纯使用鼻持续气道正压通气（NCPAP）相比，一剂气管内注入表面活性剂后拔管改为NCPAP对后续机械通气（MV）的影响。
对妊娠29至35周、患有轻度至中度RDS且需要补充氧气和NCPAP的婴儿进行随机、盲法试验。婴儿被随机分为插管、表面活性剂治疗并立即拔管组（表面活性剂组，N = 52）或不进行干预组（对照组，N = 53）。所有婴儿随后均采用NCPAP进行管理。
对照组后期需要MV的比例为70%，表面活性剂组为50%。研究干预后，表面活性剂组受试者的吸入氧分数（FiO₂）较低，且后续需要表面活性剂的可能性较小。总体表面活性剂使用、氧疗持续时间、住院时间和支气管肺发育不良均未受影响。
在患有轻度至中度RDS的早产儿中，短暂插管给予表面活性剂可减少后期MV。
