Neonatal-Perinatal Medicine, Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA,
Neonatal-Perinatal Medicine, Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
Neonatology. 2019;115(4):411-422. doi: 10.1159/000497328. Epub 2019 Apr 11.
Traditionally, surfactant has been administered to preterm infants with respiratory distress syndrome via an endotracheal tube and in conjunction with mechanical ventilation. However, negative consequences of mechanical ventilation such as pneumothorax and bronchopulmonary dysplasia are well known. In order to provide the benefits of surfactant administration without the negative effects of mechanical ventilation, several methods of less invasive surfactant administration have been developed. These methods include InSurE (intubate, surfactant, extubate), pharyngeal administration, laryngeal mask administration, aerosolized surfactant administration, and thin catheter administration (TCA). Of these, TCA has been studied most extensively and holds the most promise as a less invasive and effective mode of surfactant administration to preterm infants. Further studies will aid in determining which patients would benefit most from less invasive surfactant administration.
传统上，表面活性剂通过气管内管和机械通气给予有呼吸窘迫综合征的早产儿。然而，机械通气的负面后果，如气胸和支气管肺发育不良，是众所周知的。为了在没有机械通气的负面影响的情况下提供表面活性剂治疗的益处，已经开发了几种微创表面活性剂给药方法。这些方法包括 InSurE（插管、表面活性剂、拔管）、咽给药、喉罩给药、雾化表面活性剂给药和细导管给药（TCA）。在这些方法中，TCA 研究得最广泛，作为一种微创、有效的早产儿表面活性剂给药方式，最有前途。进一步的研究将有助于确定哪些患者最受益于微创表面活性剂给药。
