Journal of tropical pediatrics · 2019
Lung Lavage with Dilute Surfactant vs. Bolus Surfactant for Meconium Aspiration Syndrome.
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Arayici Sema, Sari Fatma Nur, Kadioglu Simsek Gulsum, Yarci Erbu, Alyamac Dizdar Evrim, Uras Nurdan, Canpolat Fuat Emre, Oguz Serife Suna
Аннотация
OBJECTIVE: To compare the effectiveness of lung lavage with surfactant vs. bolus surfactant treatment in meconium aspiration syndrome (MAS).
PATIENTS AND METHODS: This randomized controlled trial included newborns ventilated with MAS. In lavage group (n = 17) 30 ml/kg of diluted porcine surfactant was instilled into the lung. In bolus group (n = 16) porcine surfactant (100 mg/kg) was administered as bolus. Respiratory outcomes and mortality were compared between groups.
RESULTS: Duration of respiratory support was found to be similar between lavage and bolus groups (3 vs. 3.5 days, p = 0.36). Death or requirement for extracorporeal membrane oxygenation (ECMO) was 12% vs. 6%; respectively (RR: 2, 95% CI 0.16-24.48; p = 1.0). Duration of oxygen therapy, high-frequency ventilation or inhaled nitric oxide requirement did not differ among the groups.
CONCLUSION: Lung lavage did not show any advantage over bolus therapy on duration of respiratory support. The incidence of pneumothorax and surfactant re-administration decreased nonsignificantly in lavage group.
CLINICAL TRIAL REGISTRATION: We registered the trial to ClinicalTrials.gov (http://clinicaltrials.gov) under identifier NCT02041546.
REGISTRY NAME: Lung Lavage With Dilute Poractant Alfa for Meconium Aspiration Syndrome.
PATIENTS AND METHODS: This randomized controlled trial included newborns ventilated with MAS. In lavage group (n = 17) 30 ml/kg of diluted porcine surfactant was instilled into the lung. In bolus group (n = 16) porcine surfactant (100 mg/kg) was administered as bolus. Respiratory outcomes and mortality were compared between groups.
RESULTS: Duration of respiratory support was found to be similar between lavage and bolus groups (3 vs. 3.5 days, p = 0.36). Death or requirement for extracorporeal membrane oxygenation (ECMO) was 12% vs. 6%; respectively (RR: 2, 95% CI 0.16-24.48; p = 1.0). Duration of oxygen therapy, high-frequency ventilation or inhaled nitric oxide requirement did not differ among the groups.
CONCLUSION: Lung lavage did not show any advantage over bolus therapy on duration of respiratory support. The incidence of pneumothorax and surfactant re-administration decreased nonsignificantly in lavage group.
CLINICAL TRIAL REGISTRATION: We registered the trial to ClinicalTrials.gov (http://clinicaltrials.gov) under identifier NCT02041546.
REGISTRY NAME: Lung Lavage With Dilute Poractant Alfa for Meconium Aspiration Syndrome.