ArticleIntensive care medicine2010
Surfactant use based on the oxygenation response to lung recruitment during HFOV in VLBW infants.
Article in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Lung Recruitment Strategies During High Frequency Oscillatory Ventilation in Preterm Lambs.Frontiers in pediatrics · 2018Article
- [Clinical effects of different ways of mechanical ventilation combined with pulmonary surfactant in treatment of acute lung injury/acute respiratory distress syndrome in neonates: a comparative analysis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2016Article
- Use of therapeutic surfactant lavage in a preterm infant with massive pulmonary hemorrhage.Clinics and practice · 2012Article
- Year in review in Intensive Care Medicine 2010: III. ARDS and ALI, mechanical ventilation, noninvasive ventilation, weaning, endotracheal intubation, lung ultrasound and paediatrics.Intensive care medicine · 2011Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeEarly lung recruitment (ELR) during high-frequency oscillatory ventilation (HFOV) in combination with prophylactic surfactant use has been reported to reduce mortality, improve respiratory outcomes, and reduce the need for repeated surfactant dosing, suggesting that surfactant might be used more selectively in very low birth weight (VLBW) infants on HFOV than generally recommended. We report our first experience from such a selective early rescue use of surfactant in VLBW infants on HFOV.
methodsAfter a deliberate ELR maneuver and "optimal" continuous distending pressure (CDP) finding during HFOV, used as primary ventilation mode for VLBW infants with respiratory distress syndrome (RDS), surfactant was only given when an unsatisfactory oxygenation response to lung recruitment (as defined by CDP x FiO(2) > 5) was observed.
resultsOut of 144 VLBW infants on HFOV, 84 (58.3%) received surfactant and 60 (41.7%) did not. Duration of required oxygen supplementation (37.4 +/- 44.9 vs. 46.2 +/- 35.4 days; P = 0.031) and respiratory support (i.e., n-CPAP and/or mechanical ventilation; 22.3 +/- 19.3 vs. 38.2 +/- 24.3 days; P = 0.001) was shorter for infants who did not receive surfactant than for those who did. The incidence and severity of bronchopulmonary dysplasia was similar in both groups, and there was no difference in survival rates between groups. Subgroup analysis for infants of less than 28 weeks of gestation revealed similar results.
conclusionsFirst intention HFOV combined with an early attempt at lung volume optimization might allow surfactants to be used more selectively (in relation to disease severity) in VLBW infants presenting with RDS at birth without negatively influencing the outcome.
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