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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 | |
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 | |
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 |
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