Tomar Rampal Singh, Ghuliani Ranjit, Yadav Dinesh
Department of Pediatrics, Base Hospital, Delhi Cantt, New Delhi, 110010, India.
Indian J Pediatr. 2017 Apr;84(4):257-261. doi: 10.1007/s12098-016-2278-9. Epub 2017 Jan 3.
To assess the outcome of a modified method of Minimally Invasive Surfactant Therapy (MIST) therapy where an orogastric tube was used for tracheal catherization to deliver surfactant in preterm newborns less than 34 wk of gestation with respiratory distress syndrome (RDS).
A single centre, prospective observational study was conducted to enroll eligible inborn preterm neonates with gestation age more than 24 wk but less than 34 wk and suffering from RDS to receive surfactant using MIST. Results were compared with a historical cohort of preterms who received surfactant with InSurE (Intubate, Surfactant, Extubate) technique.
Sixty four cases in the modified MIST group were compared with a historic cohort of 68 cases in the InSurE group. There were no differences in the requirement of intubation and mechanical ventilation (MV) in the first 72 h but the duration of MV and continuous positive airway pressure (CPAP) were significantly less in modified MIST group. Other neonatal morbidities and mortality rates were similar in either of the groups.
The modified MIST technique is an effective method for the treatment of RDS in preterms with better clinical efficacy and comparable outcomes than the more invasive InSurE procedure and deserves further evaluation.
评估改良微创表面活性剂疗法（MIST）的疗效，该疗法通过经口胃管进行气管插管，为孕周小于34周且患有呼吸窘迫综合征（RDS）的早产新生儿输送表面活性剂。
开展一项单中心前瞻性观察性研究，纳入符合条件的胎龄大于24周但小于34周且患有RDS的早产新生儿，采用MIST疗法接受表面活性剂治疗。将结果与一组采用InSurE（插管、表面活性剂、拔管）技术接受表面活性剂治疗的早产历史队列进行比较。
改良MIST组的64例病例与InSurE组的68例历史队列病例进行了比较。两组在最初72小时内的插管和机械通气（MV）需求无差异，但改良MIST组的MV和持续气道正压通气（CPAP）持续时间显著更短。两组的其他新生儿发病率和死亡率相似。
改良MIST技术是治疗早产新生儿RDS的有效方法，临床疗效优于侵入性更强的InSurE程序，且结果相当，值得进一步评估。
