Aguar Marta, Nuñez Antonio, Cubells Elena, Cernada Maria, Dargaville Peter A, Vento Maximo
University & Polytechnic Hospital La Fe, Valencia, Spain; Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
Early Hum Dev. 2014 Sep;90 Suppl 2:S57-9. doi: 10.1016/S0378-3782(14)50015-1.
Traditional treatment of respiratory distress syndrome in preterm infants consisted of early intubation, mechanical ventilation and intra-tracheal administration of exogenous surfactant. Recently, non-invasive ventilation, which has shown some advantages in short- and long-term outcomes, has gained popularity for the initial management of respiratory insufficiency in preterm infants. However, non-invasive ventilation from the outset poses difficulties in relation to administration of exogenous surfactant. The customary INSURE technique requires tracheal intubation, surfactant administration, and rapid extubation, but the latter is not always possible. As a more elegant approach, several minimally invasive techniques of delivering surfactant have been developed for babies spontaneously breathing on CPAP. The most extensively studied have been those in which the trachea is briefly catheterized with a nasogastric tube or vascular catheter, and exogenous surfactant is administered. Although results seem promising they are not yet conclusive, and further studies will be needed to answer a number of outstanding questions.
早产儿呼吸窘迫综合征的传统治疗方法包括早期插管、机械通气以及气管内给予外源性表面活性物质。近来，无创通气在短期和长期预后方面显示出一些优势，已在早产儿呼吸功能不全的初始管理中得到广泛应用。然而，从一开始，无创通气在外源性表面活性物质的给药方面就存在困难。传统的INSURE技术需要气管插管、给予表面活性物质并迅速拔管，但后者并非总是可行。作为一种更巧妙的方法，已经开发出几种用于在持续气道正压通气（CPAP）下自主呼吸婴儿的微创表面活性物质给药技术。研究最广泛的是那些通过鼻胃管或血管导管短暂插入气管并给予外源性表面活性物质的技术。尽管结果似乎很有前景，但尚未得出定论，还需要进一步研究来回答一些悬而未决的问题。
