dc.contributor.author |
Tapia, J.L. |
|
dc.contributor.author |
Urzua, S. |
|
dc.contributor.author |
Bancalari, A. |
|
dc.contributor.author |
Meritano, J. |
|
dc.contributor.author |
Torres, G. |
|
dc.contributor.author |
Fabres, J. |
|
dc.contributor.author |
Toro, C.A. |
|
dc.contributor.author |
Rivera, F. |
|
dc.contributor.author |
Cespedes, E. |
|
dc.contributor.author |
Burgos, J.F. |
|
dc.contributor.author |
Mariani, G. |
|
dc.contributor.author |
Roldan, L. |
|
dc.contributor.author |
Silvera, F. |
|
dc.contributor.author |
Gonzalez, Agustina |
|
dc.contributor.author |
Dominguez, A. |
|
dc.date.accessioned |
2022-01-18T19:26:47Z |
|
dc.date.available |
2022-01-18T19:26:47Z |
|
dc.date.issued |
2012 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/10878 |
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dc.description.abstract |
Objective: To determine whether very low birth weight infants (VLBWIs), initially supported with continuous positive airway pressure (CPAP) and then selectively treated with the INSURE (intubation, surfactant, and extubation to CPAP; CPAP/INSURE) protocol, need less mechanical ventilation than those supported with supplemental oxygen, surfactant, and mechanical ventilation if required (Oxygen/mechanical ventilation [MV]). Study design: In a multicenter randomized controlled trial, spontaneously breathing VLBWIs weighing 800-1500 g were allocated to receive either therapy. In the CPAP/INSURE group, if respiratory distress syndrome (RDS) did not occur, CPAP was discontinued after 3-6 hours. If RDS developed and the fraction of inspired oxygen (FiO 2) was >0.35, the INSURE protocol was indicated. Failure criteria included FiO2 >0.60, severe apnea or respiratory acidosis, and receipt of more than 2 doses of surfactant. In the Oxygen/MV group, in the presence of RDS, supplemental oxygen without CPAP was given, and if FiO 2 was >0.35, surfactant and mechanical ventilation were provided. Results: A total of 256 patients were randomized to either the CPAP/INSURE group (n = 131) or the Oxygen/MV group (n = 125). The need for mechanical ventilation was lower in the CPAP/INSURE group (29.8% vs 50.4%; P =.001), as was the use of surfactant (27.5% vs 46.4%; P =.002). There were no differences in death, pneumothorax, bronchopulmonary dysplasia, and other complications of prematurity between the 2 groups. Conclusion: CPAP and early selective INSURE reduced the need for mechanical ventilation and surfactant in VLBWIs without increasing morbidity and death. These results may be particularly relevant for resource-limited regions. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Elsevier |
|
dc.relation.ispartofseries |
Journal of Pediatrics |
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dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
female |
en_US |
dc.subject |
article |
en_US |
dc.subject |
controlled study |
en_US |
dc.subject |
major clinical study |
en_US |
dc.subject |
priority journal |
en_US |
dc.subject |
morbidity |
en_US |
dc.subject |
mortality |
en_US |
dc.subject |
infant |
en_US |
dc.subject |
oxygen |
en_US |
dc.subject |
multicenter study |
en_US |
dc.subject |
randomized controlled trial |
en_US |
dc.subject |
artificial ventilation |
en_US |
dc.subject |
positive end expiratory pressure |
en_US |
dc.subject |
prematurity |
en_US |
dc.subject |
treatment outcome |
en_US |
dc.subject |
clinical assessment |
en_US |
dc.subject |
bradycardia |
en_US |
dc.subject |
steroid |
en_US |
dc.subject |
oxygen therapy |
en_US |
dc.subject |
steroid therapy |
en_US |
dc.subject |
clinical protocol |
en_US |
dc.subject |
oxygen supply |
en_US |
dc.subject |
very low birth weight |
en_US |
dc.subject |
apnea |
en_US |
dc.subject |
endotracheal intubation |
en_US |
dc.subject |
extubation |
en_US |
dc.subject |
fraction of inspired oxygen |
en_US |
dc.subject |
inspiratory capacity |
en_US |
dc.subject |
lung dysplasia |
en_US |
dc.subject |
lung surfactant |
en_US |
dc.subject |
neonatal respiratory distress syndrome |
en_US |
dc.subject |
peak inspiratory flow |
en_US |
dc.subject |
pneumothorax |
en_US |
dc.title |
Randomized trial of early bubble continuous positive airway pressure for very low birth weight infants |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1016/j.jpeds.2011.12.054 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.02.03 |
|
dc.relation.issn |
1097-6833 |
|