Özkan Hasan, Erdeve Ömer, Kutman H Gözde Kanmaz
Division of Neonatology, Department of Pediatrics, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey.
Division of Neonatology, Department of Pediatrics, Ankara University, Faculty of Medicine, Ankara, Turkey.
Turk Pediatri Ars. 2018 Dec 25;53(Suppl 1):S45-S54. doi: 10.5152/TurkPediatriArs.2018.01806. eCollection 2018.
Respiratory distress syndrome is the leading cause of respiratory failure in preterm infants. The incidence and severity of respiratory distress syndrome are inversely related to the gestational age of the newborn. The major underlying pathophysiologic mechanisms are surfactant deficiency and anatomic, structural immaturity of the lung. Recent improvements such as antenatal steroid treatment to enhance pulmonary maturity, appropriate resuscitation facilitated by placental transfusion and immediate use of continuous positive airway pressure for alveolar recruitment, early rescue administration of surfactant, ventilation with gentler modes to minimize damage to the immature lungs, and the other supportive therapies have significantly decreased respiratory distress syndrome-related morbidity and mortality. This guideline was addressed to overview the mentioned improvements in order to standardize respiratory distress syndrome management in neonatal intensive care units in Turkey.
呼吸窘迫综合征是早产儿呼吸衰竭的主要原因。呼吸窘迫综合征的发病率和严重程度与新生儿的胎龄呈负相关。主要的潜在病理生理机制是表面活性物质缺乏以及肺的解剖学、结构不成熟。近期的一些改进措施,如产前使用类固醇激素治疗以促进肺成熟、通过胎盘输血进行适当复苏并立即使用持续气道正压通气来扩张肺泡、早期抢救性给予表面活性物质、采用更温和的通气模式以尽量减少对未成熟肺的损伤以及其他支持性治疗,已显著降低了与呼吸窘迫综合征相关的发病率和死亡率。本指南旨在概述上述改进措施,以便规范土耳其新生儿重症监护病房中呼吸窘迫综合征的管理。