Yıl: 2021 Cilt: 17 Sayı: 1 Sayfa Aralığı: 1 - 6 Metin Dili: İngilizce DOI: 10.5222/BMJ.2021.35744 İndeks Tarihi: 20-05-2021

Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial

Öz:
Objective: Surfactant administration is usually performed by endotracheal intubation under mechanical ventilation. Less invasive surfactant administration (LISA) technique has became widespread in recent years, in order to prevent the risk of barotrauma and volutrauma caused by mechanical ventilation and intubation. The aim of this prospective study is to evaluate the effectiveness of surfactant administration via a thin catheter during spontaneous breathing on NIPPV and to compare with INSURE method.Method: Seventy-eight preterm infants who were born at university hospital with less than 34 weeks of gestational age and who received surfactant therapy were enrolled. The intratracheal administration of poractant alfa (CUROSURF®) was performed using umbilical catheters in LISA group (n= 42). INSURE group had 36 infants who were intubated, received surfactant then extubated and placed on NIPPV.Results: There were no statistically significant differences between two groups in terms of intubation in the first 72 hours and re-administration of surfactant, the duration of NIPPV and the occurence of pneumothorax, pulmonary hemorrhage, patent ductus arteriosus, intraventricular hemorrhage, early onset neonatal sepsis, necrotising enterocolitis, bronchopulmonary dsyplasia and mortality (p>0.05). The pCO2 values decreased faster in LISA group when compared to INSURE group and this difference was statistically significant (p<0.05).Conclusions: LISA procedure under NIPPV seems to provide better pCO2 levels and does not increased the mortality and morbidity due to technique. Although the results seem to be promising, we need further investigations and larger series.
Anahtar Kelime:

Preterm Bebeklerde Nazal Aralıklı Pozitif Basınçlı Ventilasyon (NIPPV) Desteği kullanılarak LISA ile INSURE Tekniğinin Karşılaştırılması: Randomize Kontrollü Bir Çalışma

Öz:
Amaç: Sürfaktan uygulaması genellikle mekanik ventilasyon altında endotrakeal entübasyon ile yapılır. Mekanik ventilasyon ve entübasyonun neden olduğu barotravma ve volutravma riskini önlemek için son yıllarda daha az invaziv sürfaktan uygulama teknikleri yaygınlaşmıştır. Bu prospektif çalışmanın amacı, NIPPV'de spontan solunum sırasında ince bir kateter yoluyla sürfaktan uygulamasının etkinliğini değerlendirmek ve INSURE yöntemiyle karşılaştırmaktır.Yöntem: Kocaeli Üniversitesi Hastanesi'nde 34 haftadan küçük doğan ve sürfaktan tedavisine ihtiyaç duyan yetmiş sekiz preterm bebek çalışmaya dahil edildi. LISA grubunda spontan solunum sırasında laringoskopi altında göbek kateterleri kullanılarak sürfaktanın trakeal uygulaması (n = 42) yapıldı. INSURE grubundaki bebekler entübe edildi, 200 mg / kg sürfaktan uygulamasındıktan sonra 30 saniye boyunca pozitif basınçlı ventilasyon(n=36) uygulandı. Daha sonra ekstübe edildi ve hemen NIPPV'ye alındı.Bulgular: İki grup arasında ilk 72 saatte entübasyon ihtiyacı ve sürfaktanın tekrar uygulanması, NIPPV süresi, pnömotoraks, pulmoner kanama, patent duktus arteriozus insidansı, intraventriküler kanama, erken sepsis, nekrotizan enterokolit, bronkopulmoner displazi ve mortalite oranları arasında fark yoktu. Parsiyel karbondioksit değerleri LISA grubunda InSurE grubuna göre daha hızlı düştü ve bu istatistiksel olarak anlamlıydı.Sonuçlar: LISA entübasyon gerektirmez, ayrıca uygulanması basit ve kolaydır. Sonuçlar umut verici gibi görünse de, daha fazla araştırmaya ve daha geniş serilere ihtiyacımız var.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA AKCAY N, kılıçbay f, Oğuz D, GÜNLEMEZ A, Gökalp A, Arısoy A (2021). Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. , 1 - 6. 10.5222/BMJ.2021.35744
Chicago AKCAY NIHAL,kılıçbay fatih,Oğuz Demet,GÜNLEMEZ AYLA,Gökalp Ayşe Sevim,Arısoy Ayşe Engin Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. (2021): 1 - 6. 10.5222/BMJ.2021.35744
MLA AKCAY NIHAL,kılıçbay fatih,Oğuz Demet,GÜNLEMEZ AYLA,Gökalp Ayşe Sevim,Arısoy Ayşe Engin Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. , 2021, ss.1 - 6. 10.5222/BMJ.2021.35744
AMA AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. . 2021; 1 - 6. 10.5222/BMJ.2021.35744
Vancouver AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. . 2021; 1 - 6. 10.5222/BMJ.2021.35744
IEEE AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A "Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial." , ss.1 - 6, 2021. 10.5222/BMJ.2021.35744
ISNAD AKCAY, NIHAL vd. "Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial". (2021), 1-6. https://doi.org/10.5222/BMJ.2021.35744
APA AKCAY N, kılıçbay f, Oğuz D, GÜNLEMEZ A, Gökalp A, Arısoy A (2021). Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. Bakırköy Tıp Dergisi, 17(1), 1 - 6. 10.5222/BMJ.2021.35744
Chicago AKCAY NIHAL,kılıçbay fatih,Oğuz Demet,GÜNLEMEZ AYLA,Gökalp Ayşe Sevim,Arısoy Ayşe Engin Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. Bakırköy Tıp Dergisi 17, no.1 (2021): 1 - 6. 10.5222/BMJ.2021.35744
MLA AKCAY NIHAL,kılıçbay fatih,Oğuz Demet,GÜNLEMEZ AYLA,Gökalp Ayşe Sevim,Arısoy Ayşe Engin Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. Bakırköy Tıp Dergisi, vol.17, no.1, 2021, ss.1 - 6. 10.5222/BMJ.2021.35744
AMA AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. Bakırköy Tıp Dergisi. 2021; 17(1): 1 - 6. 10.5222/BMJ.2021.35744
Vancouver AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial. Bakırköy Tıp Dergisi. 2021; 17(1): 1 - 6. 10.5222/BMJ.2021.35744
IEEE AKCAY N,kılıçbay f,Oğuz D,GÜNLEMEZ A,Gökalp A,Arısoy A "Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial." Bakırköy Tıp Dergisi, 17, ss.1 - 6, 2021. 10.5222/BMJ.2021.35744
ISNAD AKCAY, NIHAL vd. "Comparison of LISA vs INSURE Technique Using Nasal Intermittent Positive Pressure Ventilation (NIPPV) Support In Preterm Infants: A Randomized Controlled Trial". Bakırköy Tıp Dergisi 17/1 (2021), 1-6. https://doi.org/10.5222/BMJ.2021.35744