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评估在患有呼吸窘迫综合征的早产新生儿临床病程中,除表面活性剂外气管内使用沙丁胺醇的效果。

Evaluation of intratracheal salbutamol effects in addition to surfactant in the clinical course of premature neonates with respiratory distress syndrome.

作者信息

Goudarzi Razieh Moazami, Badiee Zohreh, Sadeghnia Alireza, Barekatain Behzad

机构信息

Department of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Hormozgan, Iran.

Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences and Child Growth and Development Center, Isfahan, Iran.

出版信息

J Res Med Sci. 2023 Jun 28;28:53. doi: 10.4103/jrms.jrms_548_22. eCollection 2023.

Abstract

BACKGROUND

In addition to surfactant deficiency, secretion of fluid from blood to the lungs and increase in the fluid content of the lung play significant roles in the pathogenesis of respiratory distress syndrome (RDS). Thus, we aimed to evaluate the effect of salbutamol (a beta-agonist) on fluid clearance from the lungs in neonates with RDS.

MATERIALS AND METHODS

This randomized controlled clinical trial included 82 neonates with RDS admitted to the neonatal intensive care units of Alzahra and Shahid Beheshti Hospitals of Isfahan University of Medical Science from 2017 to 2018. Patients were recruited through convenience sampling. They were randomized into two groups, using simple randomization: 42 were only treated with intra-tracheal surfactant (control group) and 40 with intra-tracheal surfactant plus salbutamol (intervention group). The two groups were compared regarding intubation surfactant administration and extubation (INSURE) failure, duration of nasal continuous positive airway pressure, intubation, oxygen therapy, morbidity, and mortality.

RESULTS

INSURE failure leading to mechanical ventilation occurred in 3 neonates in the control group and 2 in the intervention group ( = 0.680). Mean hospital length of stay did not differ significantly between groups ( = 0.230). Comparison of controls with the intervention group regarding complications and the incidence of morbidities revealed no statistically significant difference ( > 0.05).

CONCLUSION

Findings of this study were not in favor of the routine use of salbutamol in neonates with RDS as it did not improve the course of the disease among newborns.

摘要

背景

除表面活性剂缺乏外,血液中液体向肺内的分泌以及肺内液体含量的增加在呼吸窘迫综合征(RDS)的发病机制中起重要作用。因此,我们旨在评估沙丁胺醇(一种β受体激动剂)对患有RDS的新生儿肺内液体清除的影响。

材料与方法

这项随机对照临床试验纳入了2017年至2018年在伊斯法罕医科大学阿尔扎赫拉医院和沙希德·贝赫什提医院新生儿重症监护病房收治的82例RDS新生儿。通过便利抽样招募患者。采用简单随机化将他们分为两组:42例仅接受气管内表面活性剂治疗(对照组),40例接受气管内表面活性剂加沙丁胺醇治疗(干预组)。比较两组在插管表面活性剂给药和拔管(INSURE)失败、鼻持续气道正压通气持续时间、插管、氧疗、发病率和死亡率方面的情况。

结果

对照组有3例新生儿发生导致机械通气的INSURE失败,干预组有2例(P = 0.680)。两组的平均住院时间差异无统计学意义(P = 0.230)。比较对照组和干预组在并发症和发病率方面的情况,未发现统计学上的显著差异(P>0.05)。

结论

本研究结果不支持在患有RDS的新生儿中常规使用沙丁胺醇,因为它并未改善新生儿的疾病进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f2/10366974/648caa757da9/JRMS-28-53-g001.jpg

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