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使用ProSealTM喉罩气道进行表面活性剂给药治疗早产儿呼吸窘迫综合征。

ProSealTM laryngeal mask airway for surfactant administration in the treatment of respiratory distress syndrome in a premature infant.

作者信息

Barbosa Rosilu Ferreira, Marcatto Juliana de Oliveira, Silva Ana Cristina Simões E, Silva Yerkes Pereira E

出版信息

Rev Bras Ter Intensiva. 2012 Jun;24(2):207-10.

Abstract

The administration of surfactant via tracheal cannula with mechanical ventilation is the conventional treatment for infant respiratory distress syndrome. Hemodynamic and respiratory changes due to tracheal intubation and the need for premedication justify the search for less invasive alternatives of surfactant administration. The objective of this study was to describe the use of the ProSealTM laryngeal mask airway as an option for the treatment of respiratory distress syndrome in a premature infant born at 31 weeks of gestation, at 1335 g, with respiratory difficulty after the first hour of life and exhibiting the clinical and radiologic features of respiratory distress syndrome. The surfactant was administered with the use of the ProSealTM laryngeal mask airway at 3.5 hours of life. It was well tolerated, with no need for tracheal intubation. Normal gasometry and radiologic improvement were observed after three and six hours of administration. Oxygen administration was suspended after eight days, with no comorbidities at discharge. The laryngeal mask airway seems to be a painless and less invasive alternative to treat respiratory distress syndrome and may reduce the need for tracheal intubation and mechanical ventilation. The efficacy and advantages of this route of treatment should be confirmed in a study of an adequate sample.

摘要

经气管插管并机械通气给予表面活性剂是治疗婴儿呼吸窘迫综合征的传统方法。气管插管引起的血流动力学和呼吸变化以及术前用药的必要性促使人们寻找侵入性较小的表面活性剂给药替代方法。本研究的目的是描述使用ProSealTM喉罩气道作为治疗一名孕31周出生、体重1335克的早产儿呼吸窘迫综合征的一种选择,该早产儿出生后1小时出现呼吸困难,并表现出呼吸窘迫综合征的临床和放射学特征。在出生3.5小时时使用ProSealTM喉罩气道给予表面活性剂。耐受性良好,无需气管插管。给药3小时和6小时后观察到血气分析正常且放射学改善。8天后停止吸氧,出院时无合并症。喉罩气道似乎是治疗呼吸窘迫综合征的一种无痛且侵入性较小的替代方法,可能减少气管插管和机械通气的需求。这种治疗途径的疗效和优势应在足够样本的研究中得到证实。

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