Department of Pediatrics, McMaster University, Hamilton, Ontario and Mutah University, Karak, Jordan.
J Perinatol. 2012 Apr;32(4):270-5. doi: 10.1038/jp.2011.89. Epub 2011 Jul 7.
The objective of this study was to evaluate the occurrence of adverse effects during surfactant delivery, using a standardized protocol for administration and management of complications.
The protocol was developed, implemented and used for 6 months. Vital signs and ventilatory parameters were prospectively recorded during the procedure. Infants were classified into three groups, based on the occurrence and severity of complications: no, minor or major.
A total of 39 infants received surfactant and 19 presented some complication: 11 minor and 8 major. Six of the major complications were episodes of severe airway obstruction (SAO) and five occurred in extreme low birth weight (ELBW) infants that had more severe lung disease before surfactant delivery. Two cases of persistent pulmonary hypertension occurred in infants with birth weight>1000 g.
This study identified a high rate of SAO and provides data to support changes in the protocol, which should include faster and more robust increases in positive inspiratory pressures in ELBW infants presenting with SAO.
本研究旨在使用标准化的表面活性剂给药和并发症管理方案评估在输送表面活性剂过程中出现的不良反应。
该方案已开发、实施并使用了 6 个月。在操作过程中，对生命体征和通气参数进行了前瞻性记录。根据并发症的发生和严重程度，将婴儿分为三组：无、轻度或重度。
共有 39 名婴儿接受了表面活性剂治疗，19 名婴儿出现了一些并发症：11 名轻度并发症和 8 名重度并发症。6 例严重气道阻塞（SAO）发生在重度低出生体重（ELBW）婴儿中，这些婴儿在接受表面活性剂治疗前肺部疾病更为严重。2 例持续性肺动脉高压发生在出生体重>1000 克的婴儿中。
本研究发现严重气道阻塞的发生率较高，并提供了数据支持对方案进行更改，该方案应包括在出现严重气道阻塞的 ELBW 婴儿中更快、更强有力地增加吸气正压。
