World journal of pediatrics : WJP · 2016
Respiratory management of extremely low birth weight infants: survey of neonatal specialists.
СтатьяНазвание и аннотация: Перевод в очереди
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Parat Sumesh, Mhanna Maroun Jean
Аннотация
BACKGROUND: To investigate strategies used for the management of respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants.
METHODS: A survey of neonatal specialists working in US academic institutions with fellowship training programs.
RESULTS: Eighty percent (72/89) of the identified academic institutions had at least one physician who responded to the survey. Among respondents, 85% (171/201) agreed or strongly agreed to use continuous positive airway pressure (CPAP) initially for the management of RDS, and the majority agreed or strongly agreed to use a fraction of inspired oxygen (FiO2) ≥0.4 and a mean airway pressure (MAP) ≥10 cm H2O as a criteria for surfactant therapy; and 73% (146/200) sometimes or always used caffeine to prevent BPD. Only 25% (50/202) sometimes or almost always used steroids to prevent or treat BPD. Identified indications to use steroids were 3 or more extubation failures or inability to extubate beyond 8 weeks of age.
CONCLUSIONS: Variability in treatment strategies of ELBW is common among neonatal specialists. However, the majority of the respondents agreed or strongly agreed to use early CPAP for the management of RDS, consider a FiO2 ≥0.4 and a MAP ≥10 cm H2O as criteria for surfactant therapy, and sometimes or almost always used caffeine to prevent BPD. Steroids continue to have a role in the management of BPD in infants who are difficult to extubate.
METHODS: A survey of neonatal specialists working in US academic institutions with fellowship training programs.
RESULTS: Eighty percent (72/89) of the identified academic institutions had at least one physician who responded to the survey. Among respondents, 85% (171/201) agreed or strongly agreed to use continuous positive airway pressure (CPAP) initially for the management of RDS, and the majority agreed or strongly agreed to use a fraction of inspired oxygen (FiO2) ≥0.4 and a mean airway pressure (MAP) ≥10 cm H2O as a criteria for surfactant therapy; and 73% (146/200) sometimes or always used caffeine to prevent BPD. Only 25% (50/202) sometimes or almost always used steroids to prevent or treat BPD. Identified indications to use steroids were 3 or more extubation failures or inability to extubate beyond 8 weeks of age.
CONCLUSIONS: Variability in treatment strategies of ELBW is common among neonatal specialists. However, the majority of the respondents agreed or strongly agreed to use early CPAP for the management of RDS, consider a FiO2 ≥0.4 and a MAP ≥10 cm H2O as criteria for surfactant therapy, and sometimes or almost always used caffeine to prevent BPD. Steroids continue to have a role in the management of BPD in infants who are difficult to extubate.
Предметные рубрики MeSH
Academic Medical CentersAttitude of Health PersonnelBronchopulmonary DysplasiaContinuous Positive Airway PressureCross-Sectional StudiesFemaleHumansInfant, Extremely Low Birth WeightInfant, NewbornMaleNeonatologistsPractice Patterns, Physicians'PrognosisPulmonary SurfactantsReference ValuesRespiratory Distress Syndrome, NewbornRisk AssessmentSurveys and QuestionnairesSurvival RateUnited States