MIST SURVIVAL TRAINER 0.2 HOW TO

There is no clear evidence that one mode of continuous positive airway pressure delivery is superior to others. Non-invasive respiratory support has been shown to improve short-term respiratory outcome but the impact on long-term respiratory health needs more evidence. This review aims to highlight the evidence base behind some of these advancements and resultant controversies. This has resulted in substantial change in the typical patient population in neonatal intensive care units as well as availability of newer respiratory strategies. With this in mind, in the present review several quantitative and qualitative biological tests to assess the surfactant status in RDS neonates are introduced as potential candidates for the early prediction of SRT requirement, summarising the state-of-the-art in the evaluation of surfactant activity.Īdvances in neonatal respiratory support have resulted in increasing survival of infants at the limits of viability. Since surfactant replacement therapy (SRT) seems to be more effective if it is initiated within the first three hours of life, the use of a reliable bench-to-bedside biological test able to predict as soon as possible the necessity of SRT will help to optimise individualised therapies and personalise the actual collective strategy used to treat RDS neonates. However, these oxygenation thresholds do not fully take into consideration the lung physiopathology and mechanics as well as the lung surfactant biology of RDS neonates. The administration of surfactant should be reserved only for babies with respiratory distress syndrome (RDS) with increased oxygen requirement, according to different thresholds of FiO2. We verified feasibility and safety of ENSURE in a cross-sectional observational study enrolling 57 preterm neonates.Īccording to both European and American Guidelines, preterm neonates have to be treated early by nasal continuous positive air pressure (CPAP) in the delivery room. We called it ENSURE (Enhanced INSURE) and clarified crucial points of the original technique, in light of the current knowledge. We here describe a modern way to perform INSURE, based on the current knowledge and technology.INSURE technique has been originally described many years ago without considering modern principles of neonatal respiratory care and the available state-of-the-art technology. There is no consensus about the optimal methodįor surfactant administration.Conclusion: ENSURE can be used as a reference technique in clinical practice, teaching and research. We performed a cross-sectional observational study enrolling 57 preterm neonates describing ENSURE feasibility and safety. We offer ENSURE (Enhanced INSURE) as an updated and standardised technique for surfactant administration, clarifying crucial issues of the original method by applying current state-of-the-art concepts of respiratory care.

Thus, our aim is to formally describe a modern way to perform INSURE, based on the current knowledge and technology, to increase its feasibility and patients’ safety. Since the first INSURE description, our knowledge in respiratory care has largely progressed, but the technique has not been updated according to current evidence-based practice. The intubation-surfactant-extubation (INSURE) procedure has not been fully described, and important details, such as duration and mode of ventilation, remain unclear, leading to significant clinical practice variations and influencing its suitability and feasibility. There is no firm consensus about the optimal technique for the administration of exogenous surfactant in preterm neonates, and different techniques may be equally effective. We offer a comprehensive, evidence-based review of the clinical data on LISA, their biases and the lack of physiopathology background.

MIST SURVIVAL TRAINER 0.2 HOW TO

We urge the conduction of high-quality studies to understand how to choose and titrate analgesia/sedation and optimize surfactant administration in preterm neonates. The available data from these trials only allow to conclude that LISA is better than prolonged, unrestricted invasive ventilation with loosely described parameters, a mode of respiratory support that should be anyway avoided in preterm infants. Moreover, LISA has been investigated in clinical trials without previous translational data and these trials are affected by significant flaws. LISA lacks biological and pathophysiological background justifying its potential benefits. We believe that the clinical potential of LISA techniques is currently overestimated. Over the last 10 years, new techniques to administer surfactant have been promoted, based on their presumed lesser invasiveness and they have been generally called LISA (less invasive surfactant administration).

Mist survival trainer 0.2