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Oxygen requirement and surfactant therapy in preterm infants after delivery
Author(s) -
Toriyama Mihiro,
Ishiguro Akio,
Motojima Yukiko,
Yamana Keiji,
Sobajima Hisanori,
Tamura Masanori
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12435
Subject(s) - medicine , surfactant therapy , pulmonary surfactant , respiratory distress , neonatal respiratory distress syndrome , gestation , observational study , fraction of inspired oxygen , anesthesia , pediatrics , intensive care medicine , mechanical ventilation , gestational age , pregnancy , genetics , physics , biology , thermodynamics
Abstract Background Several reports have shown the beneficial effects of early or prophylactic surfactant therapy for preterm infants, who often develop respiratory distress syndrome. No report, however, has addressed which infants should receive surfactant therapy in the delivery room. Therefore, the aim of this study was to assess the validity of identifying infants who need surfactant therapy based on fraction of inspiratory oxygen ( FiO 2 ) requirement in the delivery room. Methods In this observational, retrospective study, FiO 2 given in the delivery room, use of surfactant therapy, stable microbubble test ( SMT ) results, and changes in FiO 2 both before and after surfactant therapy were reviewed in infants born at <33 weeks' gestation. Results Overall, 170 infants were included. Forty infants were given oxygen with FiO 2 ≥0.6, and all received surfactant therapy. Of these 40 infants, FiO 2 could be reduced in 36 (90%) by an average of 0.46 after surfactant therapy. SMT was done in 22 of 40 infants, and surfactant insufficiency was suspected in 20 (91%). In contrast, 81 of 102 infants (79%) with FiO 2 <0.4 did not need surfactant therapy within 48 h after birth. Conclusions Preterm infants who need FiO 2 ≥0.6 in the delivery room appear to be at high risk of surfactant insufficiency and would benefit from surfactant. Surfactant therapy would provide a more effective resuscitation method for preterm infants, and thus a larger prospective study is needed to confirm these results.