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001-es BibID:BIBFORM111995
Első szerző:Balázs Gergely (csecsemő- és gyermekgyógyász, neonatológus)
Cím:Comparison of flexible nasogastric tube and semi-rigid catheter during less invasive surfactant administration / Gergely Balázs, Ivett Pecsi, Csilla Feher, Nora Katona, Tunde Kotorman, Balazs Kovacs-Paszthy, Mariann Marki, Istvan Pataki, Magdolna Riszter, Timea Rozsa, Gusztav Belteki, Tamas Kovacs, Gyorgy Balla, Andras Balajthy
Dátum:2023
ISSN:2724-5780
Megjegyzések:BACKGROUND: Various flexible and semi-rigid catheter techniques have been reported for surfactant delivery during less invasive surfactant administration (LISA) in preterm infants. Data on the effect of catheter selection on procedural success rates and adverse events are limited. Our objective was to compare the rates of success and adverse events of LISA performed with nasogastric tube and semi-rigid catheter. METHODS: This was a post-hoc analysis of data from a quality improvement project. LISA was performed according to the standardized local protocol. Baseline characteristics, data on performance of LISA, degree of difficulty in laryngoscopy and vital parameters after the initiation of LISA were collected and outcomes were compared between groups. RESULTS: Fifty-six infants were included (21 with nasogastric tube, and 35 with semi-rigid catheter). Procedure success rate (defined as a single LISA attempt resulting in intratracheal administration of the planned dose of surfactant), incidence of adverse events, heart rate and oxygen saturation values and outcomes did not differ significantly between the two groups. When using a nasogastric tube for LISA, a significantly higher fraction of inspired oxygen was needed in the 3rd (0.62 vs. 0.48, P=0.024), 4th (0.61 vs. 0.37, P<0.001) and 5th minute (0.48 vs. 0.37, P=0.001) to maintain normal oxygen saturations. CONCLUSIONS: Use of the semi-rigid catheter was associated with better oxygenation during and shortly after the procedure. Our results may help neonatal units to develop local guidelines.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Minerva Pediatrics. - [Epub ahead of print] (2023). -
További szerzők:Pécsi Ivett Fehér Csilla Katona Nóra Kotormán Tünde Kovács-Pászthy Balázs Márki Mariann (1987-) (csecsemő- és gyermekgyógyász) Pataki István (1975-) (csecsemő és gyermekgyógyász, neonatológus) Riszter Magdolna (1973-) (csecsemő és gyermekgyógyász, neonatológus) Rózsa Tímea (1985-) (csecsemő- és gyermekgyógyász) Bélteki Gusztáv (1970-) (csecsemő és gyermekgyógyász, neonatológus) Kovács Tamás Balla György (1953-) (csecsemő és gyermekgyógyász, neonatológus) Balajthy András (1988-) (általános orvos)
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001-es BibID:BIBFORM101443
035-os BibID:(WoS)000787144100001 (Scopus)85128863628
Első szerző:Balázs Gergely (csecsemő- és gyermekgyógyász, neonatológus)
Cím:Incidence, predictors of success and outcome of LISA in very preterm infants / Balazs Gergely, Balajthy Andras, Riszter Magdolna, Kovacs Tamas, Szabo Tamas, Belteki Gusztav, Balla Gyorgy
Dátum:2022
ISSN:8755-6863
Megjegyzések:Objectives The aim of this study was to examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA, and to compare neonatal outcomes between the LISA failure group and the group of infants who were successfully treated with LISA. Design A retrospective cohort study. Patients Infants born at less than 33 weeks of gestation (n = 158) and treated with LISA for respiratory distress syndrome. Results LISA was successful in 86 cases (54.4%); 72 preterm infants (45.6%) needed additional surfactant therapy and/or mechanical ventilation in the first 72 h (LISA failure). In a multivariate logistic regression analysis, six independent predictors of LISA success were identified: core temperature at the time of admission (adjusted odds ratio (OR): 3.56), dose of poractant alfa (<200 mg/kg; adjusted OR: 0.254), elevated C-reactive protein (>10 mg/L) at 24 h of life (adjusted OR: 0.28), highest respiratory severity score (RSS) during the first hour of life or at the time of LISA (adjusted OR: 0.463), maternal age (adjusted OR: 0.923), and birth weight (adjusted OR: 1.003). The receiver operating curve created by using the identified factors indicates good predictive power with an area under the curve of 0.85. LISA failure was associated with a substantially higher risk of complications. Conclusion LISA success can be predicted by variables available before the intervention. Failure of LISA is relatively frequent event in very preterm infants and is associated with adverse outcomes. Prevention of hypothermia during early stabilization and appropriate dosing of surfactant may increase LISA success rates and improve patient outcome.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
respiratory distress syndrome in premature infants
continuous positive airway pressure
surfactant
Megjelenés:Pediatric Pulmonology. - 57 : 7 (2022), p. 1751-1759. -
További szerzők:Balajthy András (1988-) (általános orvos) Riszter Magdolna (1973-) (csecsemő és gyermekgyógyász, neonatológus) Kovács Tamás (1970-) (csecsemő és gyermekgyógyász, neonatológus) Szabó Tamás (1968-) (gyermekgyógyász) Bélteki Gusztáv (1970-) (csecsemő és gyermekgyógyász, neonatológus) Balla György (1953-) (csecsemő és gyermekgyógyász, neonatológus)
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Intézményi repozitóriumban (DEA) tárolt változat
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