期刊
EUROPEAN JOURNAL OF PEDIATRICS
卷 179, 期 12, 页码 1913-1920出版社
SPRINGER
DOI: 10.1007/s00431-020-03744-y
关键词
Lung ultrasound; Respiratory distress syndrome; Premature newborns; Surfactant
类别
This study aimed to investigate whether using lung ultrasound (LUS) scores in premature newborns with respiratory distress syndrome (RDS) allows for earlier surfactant therapy (within the first 3 h of life) than using FiO(2)criteria. This was a randomised, non-blinded clinical trial conducted in a neonatal intensive care unit. The inclusion criteria were newborns with a gestational age of <= 32 weeks and RDS. Patients meeting the inclusion criteria were randomly assigned to two groups: the ultrasound group, administered surfactant based on LUS score and/or FiO(2)threshold, and the control group, guided by FiO(2)only. Fifty-six patients were included. The ultrasound group received surfactant earlier (1 h of life vs. 6 h,p< 0.001), with lower FiO(2)(25% vs. 30%,p= 0.016) and lower CO2(48 vs. 54,p= 0.011). After surfactant treatment, newborns in the ultrasound group presented a greater SpO(2)(p= 0.001) and SpO(2)/FiO(2)ratio (p= 0.012). Conclusions: LUS score allowed an earlier surfactant therapy, reduced oxygen exposure early in life and a better oxygenation after the treatment. This early surfactant replacement may lead to reduced oxygen exposure.What is Known:center dot Lung ultrasound scores predict the need for surfactant therapy in premature newborns.What is New:center dot This study shows that using lung ultrasound scores improves the timeliness of surfactant replacement compared with using FiO(2)alone.
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