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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Prophylactic or early selective surfactant combined with nCPAP in very preterm infants.
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Prophylactic or early selective surfactant combined with nCPAP in very preterm infants.

机译：预防性或早期选择性表面活性剂与nCPAP结合用于早产儿。

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OBJECTIVE: Early surfactant followed by extubation to nasal continuous positive airway pressure (nCPAP) compared with later surfactant and mechanical ventilation (MV) reduce the need for MV, air leaks, and bronchopulmonary dysplasia. This randomized, controlled trial investigated whether prophylactic surfactant followed by nCPAP compared with early nCPAP application with early selective surfactant would reduce the need for MV in the first 5 days of life. METHODS: A total of 208 inborn infants who were born at 25 to 28 weeks' gestation and were not intubated at birth were randomly assigned to prophylactic surfactant or nCPAP within 30 minutes of birth. Outcomes were assessed within the first 5 days of life and until death or discharge of the infants from hospital. RESULTS: Thirty-three (31.4%) infants in the prophylactic surfactant group needed MV in the first 5 days of life compared with 34 (33.0%) in the nCPAP group (risk ratio: 0.95 [95% confidence interval: 0.64-1.41]; P = .80). Death and type of survival at 28 days of life and 36 weeks' postmenstrual age and incidence of main morbidities of prematurity (secondary outcomes) were similar in the 2 groups. A total of 78.1% of infants in the prophylactic surfactant group and 78.6% in the nCPAP group survived in room air at 36 weeks' postmenstrual age. CONCLUSIONS: Prophylactic surfactant was not superior to nCPAP and early selective surfactant in decreasing the need for MV in the first 5 days of life and the incidence of main morbidities of prematurity in spontaneously breathing very preterm infants on nCPAP.
机译：目的：与早期表面活性剂和机械通气（MV）相比，早期表面活性剂随后拔管至鼻腔持续气道正压通气（nCPAP）减少了对MV，漏气和支气管肺发育不良的需要。这项随机对照试验研究了预防性表面活性剂后加nCPAP，与早期nCPAP和早期选择性表面活性剂的应用相比，是否可以减少生命头5天对MV的需求。方法：将208名在25至28周妊娠时出生且未在出生时未插管的婴儿随机分配到出生后30分钟内使用预防性表面活性剂或nCPAP。在生命的头5天内评估结果，直到婴儿死亡或出院为止。结果：预防性表面活性剂组的33例婴儿在出生后前5天需要MV，而nCPAP组的34例（33.0％）需要MV（风险比：0.95 [95％可信区间：0.64-1.41] ; P = .80）。两组的寿命和寿命分别为28天和36周，以及早产的主要发病率（继发结局）的发生率相似。预防性表面活性剂组中的78.1％的婴儿和nCPAP组中的78.6％的婴儿在月经后36周在室内空气中存活。结论：自发性呼吸非常早产的nCPAP婴儿在预防生命的前5天对MV的需求以及早期早产的主要发病率方面，预防性表面活性剂并不优于nCPAP和早期选择性表面活性剂。

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