OBJECTIVES: Our aim was to identify the clinical characteristics which could distinguish infants who can be managed with INSURE (intubatio-surfactant-extubation) method for preventing mechanical ventilation (MV) and which could predict INSURE success or failure. METHODS: Inborn infants with gestational age <30 weeks were Infants were categorised into three groups: (1) infants who needed MV in the delivery room; (2) infants spontaneously breathing who were treated only with NCPAP; (3) infants who were treated with INSURE method. RESULTS: We studied 125 infants: 30 (24%) required MV, 75 (60%) received INSURE treatment, and 20 (16%) were treated with NCPAP. Sixty-eight (91%) infants were successfully treated with the INSURE method. Infants in the success group had less severe RDS and less occurrence of sepsis and pneumothorax, lower mortality, and shorter duration of stay in the NICU than infants in the failure group. A birth weight <750 g, pO(2)/FiO(2) <218, and a/ApO(2) <0.44 at the first blood gas analysis were independent risk factor for INSURE failure. CONCLUSIONS: The INSURE method can be applied to the majority of extremely preterm infants and is followed by a high percentage of success.
OBJECTIVES: Our aim was to identify the clinical characteristics which could distinguish infants who can be managed with INSURE (intubatio-surfactant-extubation) method for preventing mechanical ventilation (MV) and which could predict INSURE success or failure. METHODS: Inborn infants with gestational age <30 weeks were Infants were categorised into three groups: (1) infants who needed MV in the delivery room; (2) infants spontaneously breathing who were treated only with NCPAP; (3) infants who were treated with INSURE method. RESULTS: We studied 125 infants: 30 (24%) required MV, 75 (60%) received INSURE treatment, and 20 (16%) were treated with NCPAP. Sixty-eight (91%) infants were successfully treated with the INSURE method. Infants in the success group had less severe RDS and less occurrence of sepsis and pneumothorax, lower mortality, and shorter duration of stay in the NICU than infants in the failure group. A birth weight <750 g, pO(2)/FiO(2) <218, and a/ApO(2) <0.44 at the first blood gas analysis were independent risk factor for INSURE failure. CONCLUSIONS: The INSURE method can be applied to the majority of extremely preterm infants and is followed by a high percentage of success.
Authors: Carlos G Guardia; Fernando R Moya; Sunil Sinha; Phillip D Simmons; Robert Segal; Jay S Greenspan Journal: J Pediatr Pharmacol Ther Date: 2012-07
Authors: Genevieve Taylor; Wesley Jackson; Christoph P Hornik; Alec Koss; Sreekar Mantena; Kenya Homsley; Blair Gattis; Menefese Kudumu-Clavell; Reese Clark; P Brian Smith; Matthew M Laughon Journal: J Pediatr Date: 2018-12-21 Impact factor: 6.314
Authors: Maria Livia Ognean; Silvia-Maria Stoicescu; Oana Boantă; Leonard Năstase; Carmen Gliga; Manuela Cucerea Journal: J Crit Care Med (Targu Mures) Date: 2016-05-09