Author/Authors :
-، - نويسنده Neonatologist, Pediatrics Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Mirnia, Kayvan , -، - نويسنده Assistant Prof. of Neonatology, Dept. of Pediatrics, Tabriz University of Medical Sciences, Director of Dept. of Neonatal Health, Ministry of Health & Medical Education, Tabriz ,Iran Heidarzadeh, Mohammad , -، - نويسنده Associated Prof. of Neonatology, Dept. of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran Hoseini, Mohammad Bagher , -، - نويسنده Assistant prof. of Neonatology, Isfahan University of Medical Sciences, Isfahan, Iran Sadeghnia, Alireza , -، - نويسنده Master of maternal and neonatal health science, Master of public Health (SDH), Dept. of Neonatal Health, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran Akrami, Forouzan , -، - نويسنده Assistant prof. of Neonatology, Boosher University of Medical Sciences, Boosher,Iran Balila, Masomeh , -، - نويسنده PHD of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran Ghojazadeh, Morteza , -، - نويسنده MSC of NICU, Tabriz University of Medical Sciences, Tabriz, Iran Shafai, Fatemeh , -، - نويسنده MSC of NICU, Tabriz University of Medical Sciences, Tabriz, Iran Rezaei, Fatemeh
Abstract :
Introduction Respiratory distress syndrome (RDS) is a current cause of morbidity in premature infants resulted from surfactant deficiency. The primary aim of this randomized study was to describe the feasibility of early administration of surfactant via a thin catheter during spontaneous breathing (TEC) and compare its outcomes with the InSurE (Intubate, Surfactant, Extubate) procedure Materials and Methods Premature infants with RDS, who were ≤ 32 weeks old and stabilized with nasal continuous positive airway pressure (nCPAP), were randomized to receive surfactant either by the TEC or InSurE technique. Tracheal instillation of 200 mg/kg Curosorf via 5-F catheter during spontaneous breathing under nCPAP was performed in the intervention group (n=38). In the InSurE group (n=40), infants were intubated, received positive pressure ventilation for 30 seconds after surfactant instillation, and placed on nCPAP immediately Results Necrotizing enterocolitis rate was significantly lower in TEC group, than InSurE group, [p<0.02, RR=0.49, CI=%95(0.39_0.62)]. But rate of other morbidities did not significant difference between two groups. Although Mechanical ventilation duration did not significant different between two groups (p=0.2), but Total CPAP duration was shorter in TEC group, significantly [P<0.01, RR=8.2, CI=%95 (-37.9_-4.8)]. Need for O2 supplement and mean of total hospital duration was also lower in TEC group, but was not significant, statistically Conclusion The TEC technique is feasible for the treatment of respiratory distress syndrome in infants with very low birth weight and decreases total nCPAP duration, significantly. But Judgment of substitution TEC instead of InSurE as a routine technique need to more studies.
