van Kaam Anton H, Niemarkt Hendrik J, Onland Wes
Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Department of Neonatology, Maxima Medical Center, De Run 4600, 5504 DB, Veldhoven, the Netherlands.
Semin Fetal Neonatal Med. 2023 Dec;28(6):101495. doi: 10.1016/j.siny.2023.101495. Epub 2023 Nov 22.
The introduction of exogenous surfactant in the 1980s has resulted in an improved survival of very preterm infants with respiratory distress syndrome (RDS). Randomized controlled trials conducted before 2000 have shown that the magnitude of this beneficial effect strongly depends on the timing of surfactant treatment, i.e. the earlier surfactant is administered after birth the better. However, the initial mode of respiratory support in infants with RDS has changed dramatically over the last decades, moving from invasive to non-invasive support. Furthermore, new, less invasive techniques to administer surfactant have been introduced to match this non-invasive approach. This review summarizes the evidence on how these practice changes impacted the effect of surfactant timing on mortality and morbidity in preterm infants with RDS.
20世纪80年代外源性表面活性剂的引入，使患有呼吸窘迫综合征（RDS）的极早产儿的存活率得到了提高。2000年前进行的随机对照试验表明，这种有益效果的程度很大程度上取决于表面活性剂治疗的时机，即出生后越早给予表面活性剂效果越好。然而，在过去几十年中，RDS婴儿的初始呼吸支持模式发生了巨大变化，从侵入性支持转变为非侵入性支持。此外，为了配合这种非侵入性方法，已经引入了新的、侵入性较小的表面活性剂给药技术。本综述总结了关于这些实践变化如何影响表面活性剂给药时机对RDS早产儿死亡率和发病率的影响的证据。
