European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants-2013 Update

Data de publicació: 01/01/2013

Autors de IIS La Fe

Máximo Vento Torres

Autor

Autors aliens a IIS La Fe

Sweet, David G.
Carnielli, Virgilio
Greisen, Gorm
Hallman, Mikko
Ozek, Eren
Plavka, Richard
Saugstad, Ola D.
Simeoni, Umberto
Speer, Christian P.
Halliday, Henry L.

Grups d'Investigació

Perinatología

Leader

Máximo Vento Torres

Abstract

Despite recent advances in the perinatal management of neonatal respiratory distress syndrome (RDS), controversies still exist. We report updated recommendations of a European Panel of expert neonatologists who developed consensus guidelines after critical examination of the most up-to-date evidence in 2007 and 2010. This second update of the guidelines is based upon published evidence up to the end of 2012. Strong evidence exists for the role of antenatal steroids in RDS prevention, but it is still not clear if the benefit of repeated courses on respiratory outcomes outweighs the risk of adverse outcomes in the short and long term. Many practices involved in preterm neonatal stabilization at birth are not evidence based, including oxygen administration and positive pressure lung inflation, and they may at times be harmful. Surfactant replacement therapy is crucial in the management of RDS but the best preparation, optimal dose and timing of administration at different gestations is not completely clear. In addition, use of very early continuous positive airway pressure (CPAP) has altered the indications for prophylactic surfactant administration. Respiratory support in the form of mechanical ventilation may be lifesaving but can cause lung injury, and protocols should be directed at avoiding mechanical ventilation where possible by using non-invasive respiratory support such as CPAP. For babies with RDS to have best outcomes, it is essential that they have optimal supportive care, including maintenance of normal body temperature, proper fluid management, good nutritional support, appropriate management of the ductus arteriosus and support of the circulation to maintain adequate tissue perfusion. Copyright (c) 2013 S. Karger AG, Basel

Dades de la publicació

ISSN/ISSNe:: 1661-7800, 1661-7819
Tipus:: Article
Pàgines:: 353-368
DOI:: 10.1159/000349928
PubMed:: 23736015
Factor d'Impacte:: 1,423 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Carnielli, Virgilio:: Univ Politec Marche, Univ Hosp Ancona, Dept Neonatol, Ancona, Italy
Greisen, Gorm:: Rigshosp, Dept Neonatol, DK-2100 Copenhagen, Denmark

Univ Copenhagen, Copenhagen, Denmark

Univ Oulu, Oulu Univ Hosp, Inst Clin Med, Dept Pediat, Oulu, Finland
Ozek, Eren:: Marmara Univ, Fac Med, Dept Pediat, Istanbul, Turkey
Plavka, Richard:: Charles Univ Prague, Div Neonatol, Dept Obstet & Gynecol, Gen Fac Hosp, Prague, Czech Republic

Charles Univ Prague, Fac Med 1, Prague, Czech Republic
Saugstad, Ola D.:: Univ Oslo, Rikshosp, Dept Pediat Res, Oslo Univ Hosp, N-0027 Oslo, Norway
Simeoni, Umberto:: Aix Marseille Univ, AP HP, Hop Conception, Pole Neonatol, Marseille, France
Speer, Christian P.:: Univ Wurzburg, Univ Childrens Hosp, Dept Pediat, Wurzburg, Germany
Vento, Maximo:: Instituto de Investigación. Univ & Polytech Hosp La Fe, Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain

Keywords

Antenatal steroids; Continuous positive airway pressure; Evidence-based practice; Hyaline membrane disease; Mechanical ventilation; Oxygen supplementation; Patent ductus arteriosus; Preterm infant; Respiratory distress syndrome; Surfactant therapy; Thermoregulation