Protocolo de seguimiento para el recién nacido menor de 1.500 g o menor de 32 semanas de edad gestación / Follow-up protocol for newborns of birthweight less than 1500 g or less than 32 weeks gestation

La mortalidad de los niños nacidos con peso menor de 1.500 g o con una edad gestacional menor de 32 semanas (<1.500 < 32) ha disminuido significativamente en las últimas décadas. Dado el mayor riesgo de discapacidad de estos niños, el seguimiento tras el alta hospitalaria se considera muy necesario. En este documento, el Grupo de Seguimiento de la Sociedad Española de Neonatología, en colaboración con la Asociación Española de Pediatría de Atención Primaria, propone un protocolo de seguimiento específico para los < 1.500 < 32, cuyo objetivo es estandarizar las actividades y evaluaciones según los criterios de buena práctica

The mortality of children with a birthweight of less than 1500 g or with a gestational age of less than 32 weeks (<1500 < 32) has decreased significantly in the last 20 years or so. Given the higher risk of disability in these children, follow-up after hospital discharge is considered essential. In this document, the Follow-Up Group of the Spanish Society of Neonatology, in collaboration with the Spanish Society of Paediatric Primary Care, propose a follow-up protocol specific for the < 1500 < 32, which has as its aim to standardise the activities and evaluations according to good practice criteria

[Follow-up protocol for newborns of birthweight less than 1500 g or less than 32 weeks gestation]. / Protocolo de seguimiento para el recién nacido menor de 1.500 g o menor de 32 semanas de edad gestación.

The mortality of children with a birthweight of less than 1500g or with a gestational age of less than 32 weeks (<1500<32) has decreased significantly in the last 20 years or so. Given the higher risk of disability in these children, follow-up after hospital discharge is considered essential. In this document, the Follow-Up Group of the Spanish Society of Neonatology, in collaboration with the Spanish Society of Paediatric Primary Care, propose a follow-up protocol specific for the<1500<32, which has as its aim to standardise the activities and evaluations according to good practice criteria.

Acute and sustained effects of lucinactant versus poractant-alpha on pulmonary gas exchange and mechanics in premature lambs with respiratory distress syndrome.

BACKGROUND: Animal-derived, protein-containing surfactants seem to be superior to protein-free surfactants. Lucinactant, a synthetic surfactant containing a surfactant protein-B peptide analog, has been shown to be effective in animal models and phase II clinical trials. To date, lucinactant has not been compared with an animal-derived surfactant in a premature animal model. OBJECTIVE: The objective was to compare the acute and sustained effects of lucinactant among premature lambs with respiratory distress syndrome (RDS) with the effects of a natural porcine surfactant (poractant-alpha). METHODS: After 5 minutes of mechanical ventilation twin premature lambs were assigned randomly to the lucinactant group (30 mg/mL, 5.8 mL/kg) or the poractant-alpha group (80 mg/mL, 2.2 mL/kg). Heart rate, systemic arterial pressure, arterial pH, blood gas values, and lung mechanics were recorded for 12 hours. RESULTS: Baseline fetal pH values were similar for the 2 groups (pH 7.27). After 5 minutes of mechanical ventilation, severe RDS developed (pH: <7.08; Paco2: >80 mm Hg; Pao2: <40 mm Hg; dynamic compliance: <0.08 mL/cm H2O per kg). After surfactant instillation, similar improvements in gas exchange and lung mechanics were observed for the lucinactant and poractant-alpha groups at 1 hour (pH: 7.3 +/- 0.1 vs 7.4 +/- 0.1; Paco2: 8 +/- 18 mm Hg vs 40 +/- 8 mm Hg; Pao2: 167 +/- 52 mm Hg vs 259 +/- 51 mm Hg; dynamic compliance: 0.3 +/- 0.1 mL/cm H2O per kg vs 0.3 +/- 0.1 mL/cm H2O per kg). The improvements in lung function were sustained, with no differences between groups. Cardiovascular profiles remained stable in both groups. CONCLUSIONS: Among preterm lambs with severe RDS, lucinactant produced improvements in gas exchange and lung mechanics similar to those observed with a porcine-derived surfactant.