Dani C, Berti E, Barp J
Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):19-20.
The INSURE (Intubation-surfactant-extubation) method has been found to reduce the need for MV, the duration of respiratory support, and the need for surfactant in preterm infants with respiratory distress syndrome (RDS). However, this method fails in some patients. We demonstrated that a birth weight <750 g, pO2/FiO2 <218, and a/ApO2 < 0.44 at the first blood gas analysis were independent risk factor for INSURE failure in infants with gestational age <30 weeks. Moreover, we demonstrated that INSURE treatment can be repeated being the respiratory outcome similar in infants treated with single or multiple INSURE procedures. Thus, it is possible that the multiple INSURE strategy might decrease the failure rate of INSURE and increase its effectiveness in preventing the need for mechanical ventilation (MV).
INSURE（插管-表面活性剂-拔管）方法已被发现可减少呼吸窘迫综合征（RDS）早产儿对机械通气（MV）的需求、呼吸支持的持续时间以及对表面活性剂的需求。然而，该方法在一些患者中并不成功。我们证明，出生体重<750g、首次血气分析时的pO2/FiO2<218以及a/ApO2<0.44是胎龄<30周婴儿INSURE失败的独立危险因素。此外，我们证明INSURE治疗可以重复进行，单次或多次INSURE治疗的婴儿呼吸结局相似。因此，多次INSURE策略有可能降低INSURE的失败率，并提高其预防机械通气（MV）需求的有效性。
