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学科主题: 临床医学
题名:
Treatment of severe meconium aspiration syndrome with porcine surfactant: A multicentre, randomized, controlled trial
作者: Huang, QW; Zhang, YM; Song, SM; Wu, L; Xu, YM; Zhou, XY; Du, LZ; Sun, MY; Shi, LP; Li, KH; Fan, XM; Guo, ZC; Wang, Y; Jiang, YJ; Song, GW; Gan, XZ; Chen, C; Shao, XM; Zhang, XD; Qian, LL; Sun, B; Gu, J; Yang, XL; Xiao, ZH; Ding, XC; Lin, ZL; Gu, XQ; Han, SP; Wang, DH; Zhu, JX; Sun, JH; Chen, HM; Shen, YH; Li, ST; Wu, MY; Yang, JF; Chinese Collaborat Study Grp Neonatal Resp Dis
关键词: Meconium aspiration syndrome ; pulmonary surfactants ; term or near-term neonates ; respiratory therapy
刊名: ACTA PAEDIATRICA
发表日期: 2005
DOI: 10.1080/08035250510028344
卷: 94, 期:7, 页:896-902
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Pediatrics
研究领域[WOS]: Pediatrics
关键词[WOS]: SEVERE RESPIRATORY-FAILURE ; EXOGENOUS SURFACTANT ; LUNG INJURY ; LAVAGE ; INHIBITION ; THERAPY ; MODEL
英文摘要:

Aim: A randomized, controlled clinical trial was performed in 19 Chinese neonatal intensive care units to evaluate the safety and efficacy of exogenous surfactant replacement therapy for severe meconium aspiration syndrome (MAS) in term and near-term neonates. Methods: Sixty-one term infants with severe MAS were randomly assigned to either a surfactant or a control group within 36 h after birth. The infants in the surfactant group (n=31) received an initial dose of porcine lung-derived surfactant (Curosurf(R)) at 200 mg/ kg, and repeated doses of 200, 100 and 100 mg/ kg were given at 6-12 h intervals to a maximum of four doses if oxygenation index (OI) deteriorated by >2 from baseline. The primary outcomes were a reduction of OI to less than 10 and an increase of the pre-treatment a/APO(2) ratio of 100% over baseline 24 h after surfactant treatment. The secondary outcomes were duration of mechanical ventilation, incidence of complications and survival to discharge from hospital. Results: The general demographic characteristics of the study subjects were similar. There was a trend for surfactant-treated infants to have an improvement in arterial oxygenation compared to the control group. In comparison with the control group at 24 h, the surfactant group had a lower mean OI (8.1 vs 10.9), more infants with a 100% increase of a/A PO2 (83% vs 48%, p<0.01) over baseline, and a larger area under the curve for PaO2/FiO(2) over baseline (3762+/-1877 vs 2715+/-1644 mmHg. h, p<0.05). Repeated measures of these parameters were also in favour of the surfactant group during 24 h to 3 and 7 d compared to the baseline (p<0.05). No differences were found in mean duration of mechanical ventilation, incidence of major complications and number of survivors between the two groups.

Conclusion: Surfactant replacement therapy improved oxygenation in the study subjects, suggesting that surfactant may have a role in the treatment of severe MAS in term and near-term infants.

语种: 英语
WOS记录号: WOS:000230847100016
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59791
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Shanghai Childrens Hosp, Shanghai 200040, Peoples R China
2.Nanjing Childrens Hosp, Nanjing, Jiangsu, Peoples R China
3.Beijing Univ, Hosp 1, Beijing 100871, Peoples R China
4.Shaoxing Matern Hosp, Shaoxing, Zhejiang, Peoples R China
5.Capital Inst Pediat Res, Beijing, Peoples R China
6.Suzhou Matern Hosp, Suzhou, Jiangsu, Peoples R China
7.Nanjing Matern Hosp, Nanjing, Jiangsu, Peoples R China
8.Xin Hua Hosp, Shanghai, Peoples R China
9.Wuxi Childrens Hosp, Wuxi, Jiangsu, Peoples R China
10.Shanghai Int Peace Matern Hosp, Shanghai, Peoples R China
11.Fudan Univ, Childrens Hosp, Shanghai 200032, Peoples R China
12.Zhejiang Univ, Childrens Hosp, Hangzhou 310027, Zhejiang, Peoples R China
13.Capital Med Univ, Beijing Childrens Hosp, Beijing, Peoples R China
14.Suzhou Univ, Suzhou Childrens Hosp, Suzhou, Jiangsu, Peoples R China
15.Wenzhou Med Coll, Wenzhou Yuying Childrens Hosp, Wenzhou, Zhejiang, Peoples R China
16.Peking Union Med Univ, Beijing Union Hosp, Beijing, Peoples R China
17.Nanjing Med Univ, Hosp 2, Nanjing, Jiangsu, Peoples R China
18.Jiaxin Matern Hosp, Jiaxin, Zhejiang, Peoples R China
19.Shanghai Med Univ 2, Shanghai Childrens Med Ctr, Shanghai, Peoples R China
20.Zhejiang Univ, Matern Hosp, Hangzhou 310027, Zhejiang, Peoples R China

Recommended Citation:
Huang, QW,Zhang, YM,Song, SM,et al. Treatment of severe meconium aspiration syndrome with porcine surfactant: A multicentre, randomized, controlled trial[J]. ACTA PAEDIATRICA,2005,94(7):896-902.
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