Prevention of bronchopulmonary dysplasia by administration of bovine superoxide dismutase in preterm infants with respiratory distress syndrome
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Bronchopulmonary Dysplasia
Abstract Early nasal continuous positive airway pressure (nCPAP) or early surfactant therapy with early extubation onto nCPAP rather than continued mechanical ventilation has been adopted by many centres, particularly in Scandinavia, as part of the treatment of newborns with respiratory distress syndrome. It has been suggested that bronchopulmonary dysplasia is less of a problem in centres adopting such a policy. Results from randomized trials suggest prophylactic or early nCPAP may reduce bronchopulmonary dysplasia (BPD), but further studies are required to determine the relative contributions of an early lung recruitment policy, early surfactant administration and nCPAP in reducing BPD. In addition, the optimum method of generating and delivering CPAP needs to be determined. Conclusion: The efficacy of nCPAP in improving long‐term respiratory outcomes needs to be compared with the newer ventilator techniques with the optimum and timing of delivery of surfactant administration.
Bronchopulmonary Dysplasia
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The aim of this pilot study was to determine Clara cell protein (CC16) concentration in bronchoalveolar lavages (BAL) fluid from full-term and preterm (<37 weeks' gestational age) neonates requiring respiratory support, having symptoms of neonatal respiratory distress syndrome, and at risk of bronchopulmonary dysplasia (BPD). We hypothesized that CC16 may be predictive of BPD diagnosis regardless of gestational age. BAL fluid CC16 was measured by ELISA at birth and at day 7 of life. Both groups that developed BPD showed significantly decreased BAL fluid CC16 levels compared to those infants that did not develop the disease. CC16 positively correlated with diagnosis of BPD and negatively with the severity of the disease. These results suggest that BAL fluid CC16 levels may have a diagnostic value at day 7 for BPD in both term and preterm infants. This study demonstrates the potential utility of BAL fluid CC16 levels as a biomarker for BPD in term infants.
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Aims: We determined the association between short-term neonatal morbidities, such as bronchopulmonary dysplasia (BPD) and intraventricular hemorrhage (IVH), and Ureaplasma spp. in amniotic fluid, placental and amniotic mem-brane of preterm infants.
Bronchopulmonary Dysplasia
Ureaplasma urealyticum
Ureaplasma
Periventricular leukomalacia
Neonatology
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Background: Respiratory distress syndrome (RDS), is the single most important cause of morbidity and mortality in preterm infants.In infants with progressive respiratory insufficiency, intermittent positive pressure ventilation (IPPV) with surfactant has been the usual treatment, but it is invasive, potentially resulting in airway and lung injury.Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of respiratory distress syndrome, as well as for the prevention of apnoea, and in weaning from IPPV. Objective: To evaluate the effect of different types of CPAP in treatment of preterm neonates with respiratory distress syndrome in Al-Azhar (Assiut) university hospital neonatal intensive care unit (NICU).Patients and methods: This was a prospective study, conducted at Al-Azhar (Assiut) university hospital NICU.The study included 60 preterm neonates with respiratory distress syndrome divided into 3 groups: (1 st group); 20 cases on nasal CPAP; (2 nd group); 20 cases on nasopharyngeal CPAP and (3 rd group); 20 cases on mask CPAP from March 2021 to November 2021. Results:The results of our study showed significant difference between the three groups regarding complications, nasal irritation and problems in fixation as it occur in (10%, 10%, 85%) respectively of cases in mask group and (90%, 85%, 85%) respectively in nasal group and (90%, 0%,0%) respectively in nasopharyngeal group with p value < 0.001 in all.There was also a significant difference between the three groups regarding to response to treatment with P value < 0.04.Conclusions: CPAP is one of the effective treatments of RDS leading to significant improvement of outcome, reducing hospital stay and the need for invasive mechanical ventilation with its harmful adverse effects and thus the case fatality rate of RDS cases and so the overall mortality rate of the NICU.
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To verify if preterm neonates transferred between tertiary referral centers have worse outcomes than matched untransferred infants.Cohort study with a historically matched control group.Two tertiary-level neonatal ICUs.Seventy-five neonates per group.Transfer between tertiary-level neonatal ICUs carried out by a fully equipped transportation team.We measured in-hospital mortality, frequency of intraventricular hemorrhage greater than 2nd grade, periventricular leukomalacia, necrotizing enterocolitis greater than or equal to grade 2, bronchopulmonary dysplasia, composite outcomes (in-hospital mortality/bronchopulmonary dysplasia, in-hospital mortality/intraventricular hemorrhage > 2nd grade, and bronchopulmonary dysplasia/periventricular leukomalacia/intraventricular hemorrhage > 2nd grade), length of neonatal ICU stay, weight at discharge, and time spent on ventilatory support. Seventy-five similar (except for antenatal steroids administration) neonates were enrolled in each cohort. Cohorts did not differ in mortality, bronchopulmonary dysplasia, intraventricular hemorrhage greater than 2nd grade, periventricular leukomalacia, necrotizing enterocolitis greater than or equal to grade 2, any composite outcomes, neonatal ICU stay, weight at discharge, and duration of respiratory support. Results were unchanged adjusting for antenatal steroids.Neonatal transfer between tertiary-level centers does not impact on clinical outcomes, if performed under optimal conditions.
Bronchopulmonary Dysplasia
Periventricular leukomalacia
Necrotizing Enterocolitis
Pulmonary hemorrhage
Tertiary referral hospital
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Bronchopulmonary Dysplasia
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Abstract: There is growing interest in the use of noninvasive methods of providing respiratory support to preterm infants, especially those born at the limits of viability. This paper relates to the use of noninvasive forms of respiratory support, which could be used to treat preterm infants with respiratory distress syndrome (RDS). Evidence is reviewed from clinical trials that have evaluated the use of continuous positive airway pressure (CPAP), nasal intermittent positive airway pressure (NIPPV), and high flow nasal cannulae (HFNC). Keywords: CPAP, NIPPV, RDS, preterm
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To the Editor We have several concerns about the sham intervention and the control of factors related to bronchopulmonary dysplasia in the recent study1 of minimally invasive surfactant therapy vs sham treatment in preterm infants with respiratory distress syndrome.
Bronchopulmonary Dysplasia
Surfactant therapy
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To evaluate whether nasal continuous positive airway pressure (N-CPAP) could be an alternative to ventilator treatment in infants with severe respiratory distress syndrome (RDS) after surfactant treatment, we performed the trial on 15 newborn babies with birth weight > or = 1500 g. All babies were put on N-CPAP as soon as the diagnosis of RDS was established. The N-CPAP system that we used in this study consisted of no ventilator. When FiO2 > or = 0.7 was required for maintaining PaO2 > 50 mmHg, surfactant treatment was decided. After the tracheal instillation of surfactant (120 mg/kg body weight), the babies were randomly assigned into 2 groups. In the ventilator group (n = 7), the babies were connected to mechanical ventilation following surfactant instillation. In the N-CPAP group (n = 8), the babies were extubated immediately after instillation of surfactant and were connected to N-CPAP. There was a marked improvement in the ratio of arterial PO2 to alveolar PO2 (a/A PO2) immediately following surfactant treatment and the effect was sustained during the study period of 72 hours in both groups. No significant differences in a/A PO2 were noted in 2 groups. There was a significantly higher PaCO2 in the N-CPAP group than in the ventilator group. PaCO2 declined significantly in the ventilator group 8 hours after surfactant treatment. A delayed decline in PaCO2 until 48 hours after surfactant instillation in the N-CPAP group was noted.(ABSTRACT TRUNCATED AT 250 WORDS)
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