Comparison of the clinical effects of different ventilation modes combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome / 中国小儿急救医学

Objective To compare the clinical efficacy and the complications of two ventilation modes in the premature infants with neonatal respiratory distress syndrome(NRDS).Two different noninva-sive ventilation methods,synchronized nasal intermittent positive pressure ventilation(SNIPPV) and nasal continuous positive airway pressure(NCPAP) combined with Curosurf were used in the treatment of patients with NRDS.Methods A retrospective study was conducted in 46 infants with NRDS admitted to our hospi-tal during January 2016 to December 2017. The subjects were divided into SNIPPV group(n =24) and NCPAP group(n =22),respectively combined with Curosurf treatment. PaO2,PaCO2,oxygenation index (OI)(PaO2/FiO2),duration of oxygen therapy,noninvasive ventilation time,reintubation cases for the use of pulmonary surfactant,starting time of feeding,length of hospital stay,incidence of abdominal distention, intracranial hemorrhage,air leakage and other complications were compared between the two groups before and after treatment.Results After treatment,the blood gas indexes of PaO2and OI at 24 h both in the two groups were significantly higher than those before the treatment(P<0.05).After treatment,PaCO2was lower in both SNIPPV group and NCPAP group,but there was no statistical difference between the two groups(P>0.05).The OI at 24 h[(219 ± 23)mmHg,1 mmHg=0.133 kPa] was significantly higher in SNIPPV group than that in NCPAP group[(199 ± 26)mmHg](P<0.05).There was no difference in PaO2,PaCO2and OI between the two groups before treatment.Duration of oxygen therapy,starting time of feeding,the time of using noninvasive ventilation,length of hospital stay were shorter in SNIPPV group[(82.8 ± 11.7)h vs. (107.6 ± 20.3)h,(32.0 ± 8.0)h vs.(47.0 ± 7.2)h,(62.3 ± 10.8)h vs.(99.6 ± 17.1)h,(12.0 ± 3.5)d vs.(15.0 ± 3.8)d] than those in NCPAP group,the differences were statistically significant(P <0.05). Reintubation cases for the use of pulmonary surfactant and the incidence rate of abdominal distension, intracranial hemorrhage,air leakage showed no statistical significance between the two groups(P>0.05). Conclusion SNIPPV and NCPAP combined with Curosurf treatment have similar clinical effects in premature infants with NRDS. While SNIPPV can reduce the starting time of feeding,the time of using noninvasive ventilation,duration of oxygen therapy,length of hospital stay in the patients with NRDS,and the clinical effect is more significant.

Influence of intratracheal instillation of curosurf on right ventricular function in neonatal respiratory distress syndrome / 中国生化药物杂志

Objective To investigate the effect of intratracheal instillation of curosurf on neonatal respiratory distress syndrome ( NRDS ) in children with right ventricular function.Methods 52 patients with NRDS were retrospectively selected and divided into two groups according to different treatment.The patients in the conventional group were treated with nasal airway ventilation.Based on the conventional group, the curosurf group was taken with curosurf.26 cases were in each group.The blood gas index (PaCO2, PaO2, pH), inflammatory reaction (TNF-α, IL-10), SF of the two groups were compared, the complications and curative effect of the two groups before and after treatment were taken for statistics.Results There was no significant difference in pH value between the two groups at each time point.The PaO2 expression levels in the curosurf group at different time points after treatment were significantly lower than the conventional group (P<0.05).The levels of TNF-αand IL-10 in the curosurf group were more stable than those in the control group at different time points after treatment (P<0.05), and the degree of SF increasing at different time points were higher (P<0.05).The total effective rate 80.77% of the curosurf group was significantly higher than that of the conventional group 61.54%(P<0.05).The total complication rate 19.24% had no significant differences with the conventional group 23.08%.Conclusion Intratracheal instillation of CsA in the treatment of NRDS has the advantages of simple operation, little side effect, rapid recovery of blood gas index and inflammatory factors, so it is a feasible method for clinical treatment of NRDS.

Clinical Efficacy and Nursing Points of Curosurf Combined with NCPAP on Neonatal Respiratory Failure / 昆明医科大学学报

Objective To discuss the clinical efficacy and nursing points of Curosurf combined with nasal continuous positive airway pressure (NCPAP) on children with neonatal respiratory failure.Methods Children with neonatal respiratory failure were randomly divided into the control group and the treatment group. Children in control group were treated with NCPAP and in treatment group were given Curosurf combined with NCPAP. The blood gas indexes and clinical efficacy were recorded and analyzed before and after treatment.Results The total effective rate in treatment group (88.89%) was significantly higher than that in control group (77.78%) after treatment for 48 hours ( <0.05) . Compared with children in control group, the blood gas indexes of children in treatment group were significantly higher after treatment ( <0.05) . Conclusion The methods of Curosurf combined with NCPAP and careful nursing can significantly improve clinical efficacy in the treatment of neonatal respiratory failure.

Comparison of Curosurf(R) versus Surfacten(R) in the Treatment of Respiratory Distress Syndrome

PURPOSE: The goal of this study was to compare the effects of treatment of newborn babies with two different surfactants, Curosurf(R) and Surfacten(R). METHODS: We retrospectively reviewed the medical records from 2007 to 2009 and divided the patients into two groups: those who received Curosurf(R) (n=20) and those who received Surfacten(R) (n=21). We compared the groups for sex, gestational age (GA), birth weight, type of delivery, apgar score, maternal history, age at treatment, bronchopulmonary dysplasia (BPD), administration indomethacin for patent ductus arteriosus(PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), retinopathy of prematurity (ROP), pulmonary hemorrhage (PH), pneumothorax (PTX), duration of ventilation, need for oxygen, and administration. RESULTS: The demographic and clinical variables were similar in both groups. The gestational age for Curosurf(R) and Surfacten(R) were 32.7+/-3.1 and, 30.5+/-4.3 weeks, respectively (P=0.08). Six newborns in the Curosurf(R) group and 8 in the Surfacten(R) group developed BPD (P=0.59). No significant differences were noted for NEC, IVH, PVL, ROP, PH, PTX between the two groups (IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX P=0.34). The mean duration of ventilation was 16.8 days with Curosurf(R) and 23.7 days with Surfacten(R), but these differences were not statistically significant (P=0.43). The differences in duration of need for oxygen and administration were also not statistically significant (P=0.92, 0.91, respectively). CONCLUSION: This study indicated no significant differences between Curosurf(R) and Surfacten(R). However, because of its convenience and the merit of minimal touching of the babies, the use of Curosurf(R) is recommended.

Application of Curosurf in children with hyaline membrane disease and the nursing measures / 中国实用护理杂志

Objective To investigate the effect of curosurf in treatment of children with hyaline membrane disease and the nursing. Methods 56 cases of children patients with hyaline membrane disease from June 2008 to June 2010 admitted to neonatal wards were selected. The control group (26 cases)treated with mechanical ventilation alone and corresponding conventional care, on this basis, the treatment group (30 cases) was treated with curosurf and give systemic nursing intervention. Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate, death rate, PaO2 and PaCO2 before and after treatment were observed in two groups. Results Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate in the treatment group was significantly lower than that in the control group; PaO2 and PaCO2 amelioration in the treatment group was better than the control group. Conclusions Children with hyaline membrane disease should be treated with curosurf and given systemic nursing intervention as early as possible, it can rapidly improve the symptoms of hypoxia, reduce complications, decrease mortality, accelerate the recovery of disease.

Comparison of the Therapeutic Effects of Curosurf(R) and Newfactan(R) in Respiratory Distress Syndrome

PURPOSE: The aim of this study was to compare the clinical effects of modified porcine (Curosurf(R)) and bovine (Newfactan(R)) surfactants in the treatment of neonatal respiratory distress syndrome. METHODS: Between April 2004 and December 2006, 65 neonates (birth weight < or =2,500 g and gestational age < or =35 weeks) with neonatal respiratory distress syndrome were treated in our neonatal intensive care unit with surfactant. Thirty-one neonates received Curosurf(R) and 34 neonates received Newfactan(R). The neonates were not enrolled if they had major congenital anomalies or meconium aspiration syndrome. We compared the changes in respiratory parameters after surfactant instillation, the incidences of acute and chronic complications, and the mortality between the two treatment groups. RESULTS: Neonatal and maternal demographic characteristics were not different between the groups. The patterns of change in the respiratory parameters after surfactant instillation were not statistically different between the groups. The incidences of surfactant reinstillation and acute complications, such as pneumothorax, patent ductus arteriosus, pulmonary hemorrhage, and grade 3-4 intraventricular hemorrhage, were not different between the neonates who received Curosurf(R) and the neonates who received Newfactan(R). There were no statistically significant differences in the duration of mechanical ventilation, oxygen therapy, hospitalization, prevalence of bronchopulmonary dysplasia, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, and mortality between the groups. CONCLUSION: In the present comparative study, no significant differences in the clinical effects of Curosurf(R) and Newfactan(R) were observed.

Comparison of in vitro Surface Physical Properties of Four Artificial Exogenous Pulmonary Surfactant Preparations

PURPOSE: We conducted this study to compare the surface physical properties of four commercial preparations of artificial exogenous pulmonary surfactants in vitro which have been used in both the prevention and treatment of respiratory distress syndrome in newborn infants. METHODS: We tested four surfactants : a) Surfacten (Tokyo Tanabe, Japan) and Newfactan (Yuhan, Korea) : reconstituted bovine lung extract, b) Curosurf (Cheisi, Italy) : porcine lung mince; chloroform-methanol extract; liquid-gel chromatography, and c) Exosurf (Wellcome, USA), synthetic surfactant composed of colfosceril, palmitate, hexadecanol, and tyloxapol. We measured the surface adsorption rate, spreading rate, and surface tension(ST)-area diagram by using modified Wilhelmy balance and minimum(min-ST) and maximum ST(max-ST) by Pulsating Bubble Surfactometer. RESULTS: The adsorption rate of Surfacten is less than 30mN/m and those of Newfactan, Curosurf, and Exosurf are more than 30mN/m. The spreading rate of Surfaten and Newfactan are less than 30mN/m, and those of Curosurf and Exosurf are more than 30mN/m. The min-ST of Surfacten and Newfacten are less than 10mN/m, and those of Curosurf and Exosurf are more than 10mN/m. According to high performance of surface physical activities, which are compared with in vitro criteria of effective artificial surfactant, they are as follows; Surfacten>Newfactan>Curosurf>Exosurf. CONCLUSION: There are some differences between the surface physical properties of the four surfactant preparations. The natural surfactants appear to be superior to synthetic surfactant in vitro. Among the natural surfactants, Surfacten showed the best surface physical activities of spreading, adsorption and ST-lowering properties.