European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2016 Update

Fecha de publicación: 01/01/2017

Autores de IIS La Fe

Máximo Vento Torres

Autor

Participantes ajenos a IIS La Fe

Sweet, DG
Carnielli, V
Greisen, G
Hallman, M
Ozek, E
Plavka, R
Saugstad, OD
Simeoni, U
Speer, CP
Visser, GHA
Halliday, HL

Grupos

Perinatología

Leader

Máximo Vento Torres

Abstract

Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe. Methods for optimal delivery room management have become more evidence based, and protocols for lung protection, including initiation of continuous positive airway pressure and titration of oxygen, should be implemented from soon after birth. Surfactant replacement therapy is a crucial part of the management of RDS, and newer protocols for surfactant administration are aimed at avoiding exposure to mechanical ventilation, and there is more evidence of differences among various surfactants in clinical use. Newer methods of maintaining babies on non-invasive respiratory support have been developed and offer potential for greater comfort and less chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease although minimizing the time spent on mechanical ventilation using caffeine and if necessary postnatal steroids are also important considerations. Protocols for optimizing the general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome. (C) 2016 S. Karger AG, Basel

Datos de la publicación

ISSN/ISSNe:: 1661-7800, 1661-7819
Tipo:: Article
Páginas:: 107-125
DOI:: 10.1159/000448985
Factor de Impacto:: 1,114 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

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Métricas

Filiaciones

Sweet, DG:: Royal Matern Hosp, Reg Neonatal Unit, 274 Grosvenor Rd, Belfast BT12 6BB, Antrim, North Ireland
Carnielli, V:: Univ Hosp Ancona, Univ Polytech Marche, Dept Neonatol, Ancona, Italy
Greisen, G:: Rigshosp, Dept Neonatol, Copenhagen, Denmark

Univ Copenhagen, Copenhagen, Denmark
Hallman, M:: Univ Oulu, Oulu Univ Hosp, Dept Pediat & Adolescence, Oulu, Finland

Univ Oulu, Med Res Ctr, PEDEGO Res Unit, Oulu, Finland
Ozek, E:: Marmara Univ, Sch Med, Dept Pediat, Div Neonatol, Istanbul, Turkey
Plavka, R:: Charles Univ Prague, Gen Fac Hosp, Dept Obstet & Gynecol, Div Neonatol, Prague, Czech Republic

Charles Univ Prague, Fac Med 1, Prague, Czech Republic
Saugstad, OD:: Univ Oslo, Rikshosp, Oslo Univ Hosp, Dept Pediat Res, Oslo, Norway
Simeoni, U:: CHU Vaudois, Div Pediat, Lausanne, Switzerland

Univ Lausanne, Lausanne, Switzerland
Speer, CP:: Univ Childrens Hosp, Dept Pediat, Wurzburg, Germany
Vento, M:: Instituto de Investigación. Univ & Polytech Hosp La Fe, Hlth Res Inst La Fe, Dept Pediat, Neonatal Res Unit, Valencia, Spain
Visser, GHA:: Univ Med Ctr, Dept Obstet & Gynecol, Div Obstet, Utrecht, Netherlands
Halliday, HL:: Queens Univ Belfast, Royal Matern Hosp, Dept Child Hlth, Belfast BT7 1NN, Antrim, North Ireland

Keywords

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