The use of surfactant for respiratory distress syndrome by minimally invasive technique in a neonatal unit in Belo Horizonte
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Abstract
Introduction: Hyaline membrane disease (HDM), also known as respiratory distress syndrome (RDS) and, nowadays, just referred to as surfactant deficiency, is the most common cause of respiratory distress in preterm infants, correlating with structural lung immaturity and function. Objectives: Describe the experience of the minimally invasive surfactant technique (MIST) in newborns (NB) with respiratory distress syndrome (RDS) and to evaluate the results of the services
protocol, defining possible points for improvement. Methods: A cross sectional study carried out with data from the unit between June 2018 and February 2020. Newborns submitted to the MIST technique were included (Premature infants younger than 32 weeks with SDR: FiO2 > 30% to maintain saturation between 90-95% on CPAP). NBs who progressed to death and transfers were excluded. Results: Surfactant was administered in doses of 100 to 200 mg/kg, and 47.4% of newborns received it within the first 6 hours of life and 11.8% within the first 2
hours. The analgesia used was non-pharmacological with 25% glucose. No significant adverse effects were observed, with surfactant reflux being the main one. All newborns submitted to MIST at less than 28 weeks developed bronchopulmonary dysplasia (BPD), 54.5% of which were mild and 45.5% were moderate to severe. In the NB > 28 weeks, 53.5% developed BPD, however, 84.6% had a mild form and only 15.4% had a moderate to severe form. Conclusion: MIST was considered a safe practice in the care of premature newborns, with indicators of the success of the protocol implemented.
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