A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates,
Abstract Objective: To compare the short-term efficacy of surfactant administration by laryngeal mask airway versus endotracheal tube. Methods: Preterm infants (28-35 weeks of gestational age), weighing 1 kg or more, with respiratory distress syndrome, requiring nasal continuous positive airway pr...
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| Format: | Article |
| Language: | English |
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Elsevier
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| Series: | Jornal de Pediatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572017000400343&lng=en&tlng=en |
| _version_ | 1811217839169732608 |
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| author | Rosilu F. Barbosa Ana C. Simões e Silva Yerkes P. Silva |
| author_facet | Rosilu F. Barbosa Ana C. Simões e Silva Yerkes P. Silva |
| author_sort | Rosilu F. Barbosa |
| collection | DOAJ |
| description | Abstract Objective: To compare the short-term efficacy of surfactant administration by laryngeal mask airway versus endotracheal tube. Methods: Preterm infants (28-35 weeks of gestational age), weighing 1 kg or more, with respiratory distress syndrome, requiring nasal continuous positive airway pressure, with increased respiratory effort and/or fraction of inspired oxygen (FiO2) ≥ 0.40 to maintain oxygen saturation 91-95%, were randomized to receive surfactant by LMA following nCPAP or by ETT following mechanical ventilation (MV). The primary outcome was a clinical response defined as FiO2 ≤ 0.30 three hours after surfactant. Secondary outcomes for LMA group were: need of surfactant retreatment during the first 24 h, MV requirement, and presence of surfactant in gastric content. Results: Forty-eight patients were randomized; 26 in the LMA group and 22 in the ETT group. Six of 26 patients (23%) in the LMA group and five of 22 patients (22.7%) in the ETT group did not meet the primary outcome (p = 0.977). Fourteen (53.8%) of the LMA patients were not intubated nor ventilated; 12 (46.1%) were ventilated: for surfactant failure (23%), for nCPAP failure (11.5%), and for late complications (11.5%). Groups were similar regarding prenatal status, birth conditions, and adverse events. No significant gastric content was found in 61.5% of the LMA patients. Oxygen and second dose surfactant requirements, arterial/alveolar ratio, and morbidities were similar among groups. Conclusions: Surfactant administration by LMA showed short-term efficacy, with similar supplementary oxygen need compared to surfactant by ETT, and lower MV requirement. Further studies with larger sample size are necessary to confirm these results. |
| first_indexed | 2024-04-12T07:01:23Z |
| format | Article |
| id | doaj.art-d5aaa001d4134e65bd3edc5c1f5ae3da |
| institution | Directory Open Access Journal |
| issn | 1678-4782 |
| language | English |
| last_indexed | 2024-04-12T07:01:23Z |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-d5aaa001d4134e65bd3edc5c1f5ae3da2022-12-22T03:43:00ZengElsevierJornal de Pediatria1678-478293434335010.1016/j.jped.2016.08.007S0021-75572017000400343A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates,Rosilu F. BarbosaAna C. Simões e SilvaYerkes P. SilvaAbstract Objective: To compare the short-term efficacy of surfactant administration by laryngeal mask airway versus endotracheal tube. Methods: Preterm infants (28-35 weeks of gestational age), weighing 1 kg or more, with respiratory distress syndrome, requiring nasal continuous positive airway pressure, with increased respiratory effort and/or fraction of inspired oxygen (FiO2) ≥ 0.40 to maintain oxygen saturation 91-95%, were randomized to receive surfactant by LMA following nCPAP or by ETT following mechanical ventilation (MV). The primary outcome was a clinical response defined as FiO2 ≤ 0.30 three hours after surfactant. Secondary outcomes for LMA group were: need of surfactant retreatment during the first 24 h, MV requirement, and presence of surfactant in gastric content. Results: Forty-eight patients were randomized; 26 in the LMA group and 22 in the ETT group. Six of 26 patients (23%) in the LMA group and five of 22 patients (22.7%) in the ETT group did not meet the primary outcome (p = 0.977). Fourteen (53.8%) of the LMA patients were not intubated nor ventilated; 12 (46.1%) were ventilated: for surfactant failure (23%), for nCPAP failure (11.5%), and for late complications (11.5%). Groups were similar regarding prenatal status, birth conditions, and adverse events. No significant gastric content was found in 61.5% of the LMA patients. Oxygen and second dose surfactant requirements, arterial/alveolar ratio, and morbidities were similar among groups. Conclusions: Surfactant administration by LMA showed short-term efficacy, with similar supplementary oxygen need compared to surfactant by ETT, and lower MV requirement. Further studies with larger sample size are necessary to confirm these results.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572017000400343&lng=en&tlng=enLaryngeal mask airwayPreterm infantPulmonary surfactant |
| spellingShingle | Rosilu F. Barbosa Ana C. Simões e Silva Yerkes P. Silva A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, Jornal de Pediatria Laryngeal mask airway Preterm infant Pulmonary surfactant |
| title | A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, |
| title_full | A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, |
| title_fullStr | A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, |
| title_full_unstemmed | A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, |
| title_short | A randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates, |
| title_sort | randomized controlled trial of the laryngeal mask airway for surfactant administration in neonates |
| topic | Laryngeal mask airway Preterm infant Pulmonary surfactant |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572017000400343&lng=en&tlng=en |
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