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- Title
Comparison of two strategies for surfactant prophylaxis in very premature infants: a multicenter randomized trial.
- Authors
Kendig, J W; Ryan, R M; Sinkin, R A; Maniscalco, W M; Notter, R H; Guillet, R; Cox, C; Dweck, H S; Horgan, M J; Reubens, L J; Risemberg, H; Phelps, D L
- Abstract
Previous trials of surfactant therapy in premature infants have demonstrated a survival advantage associated with prophylactic therapy as an immediate bolus, compared with the rescue treatment of established respiratory distress syndrome. The optimal strategy for prophylactic therapy, however, remains controversial. When administered as an endotracheal bolus immediately after delivery, surfactant mixes with the absorbing fetal lung fluid and may reach the alveoli before the onset of lung injury. This approach, however, causes a brief delay in the initiation of standard neonatal resuscitation, including positive pressure ventilation, and is associated with a risk for surfactant delivery into the right main stem bronchus or esophagus. As an alternative approach, surfactant prophylaxis may be administered in small aliquots soon after resuscitation and confirmation of endotracheal tube position. Although this strategy has substantial logistical advantages in clinical practice, its efficacy has not been established.
- Publication
Pediatrics, 1998, Vol 101, Issue 6, p1006
- ISSN
1098-4275
- Publication type
Journal Article
- DOI
10.1542/peds.101.6.1006