Laryngeal Mask Airway for Surfactant Administration in Neonates: A Randomized, Controlled Trial.
J Pediatr
; 193: 40-46.e1, 2018 02.
Article
en En
| MEDLINE
| ID: mdl-29174079
ABSTRACT
OBJECTIVE:
To determine if preterm infants with moderate respiratory distress syndrome on continuous positive airway pressure (CPAP) who received surfactant via a laryngeal mask airway (LMA) would have a decreased rate of intubation and mechanical ventilation compared with those on CPAP who did not receive surfactant. STUDYDESIGN:
In this prospective, multicenter, randomized controlled trial, 103 premature infants 280/7-356/7 weeks gestation, ≥1250 g and ≤36 hours old on CPAP requiring fraction of inspired oxygen 0.30-0.40 were assigned to receive surfactant administered through an LMA then placed back on CPAP (LMA group) or maintained on CPAP with no surfactant administered (control group). The primary outcome was treatment failure necessitating intubation and mechanical ventilation in the first 7 days of life.RESULTS:
Surfactant administration through an LMA (n = 50) significantly decreased the rate of intubation and mechanical ventilation compared with controls (n = 53) 38% vs 64%, respectively, OR 0.30 (95% CI 0.13, 0.70), P = .006, number needed to treat 4). There were no serious adverse events associated with placement of the LMA or surfactant administration.CONCLUSIONS:
In premature neonates with moderate respiratory distress syndrome, surfactant administered through an LMA decreased the rate of intubation and mechanical ventilation. This intervention may have significant impact on clinical care in both high and low resource settings. TRIAL REGISTRATION ClinicalTrials.gov NCT01116921.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Síndrome de Dificultad Respiratoria del Recién Nacido
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Surfactantes Pulmonares
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Máscaras Laríngeas
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Presión de las Vías Aéreas Positiva Contínua
Tipo de estudio:
Clinical_trials
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Observational_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Revista:
J Pediatr
Año:
2018
Tipo del documento:
Article