Pressure Support Ventilation and Volume Guarantee During Surfactant Therapy

Abstract

Introduction: Intratracheal administration of surfactant is a very common procedure, however it is not well standarised.

Objectives: Complications found during surfactant therapy in Pressure-Support-Ventilation and Volume- Guarantee (PSV/VG) from Dräger-Babylog-8000.

Patients and Methods: Descriptive and prospective study in newborns with respiratory distress syndrome to whom surfactant was given in our Neonatal- Intensive-Care-Unit during the period of study: 2008- 2009. Curosurf was administrated through a duallumen- endotracheal-tube. Ventilatory mode: PSV/ VG. Ventilator parameters and vital signs before, during and after surfactant administration were monitorised (5 and 10 minutes).

Results: 14 doses of surfactant were given to 12 infants (3 of them same patient). 11 of them were preterm (32w, 1892,15gr). 6 weight less than 1500 g. Surfactant was administrated at 21,7h of life.

No changes in cardiac rate or oxygen saturation were found during the procedure. Significant differences between the FiO2 before and 5minutes (53,5-32,5%) p< 0.009 and 10minutes (53,5-28,35%) p< 0,043 after the administration of surfactant were recorded. There was no significant difference regarding cardiac rate. Low blood pressure was not detected at any time after surfactant.

None of the complications described in literature in relation to the administration of surfactant (pulmonary bleeding, air escape, apnoea, endotracheal tube obstruction) occurred in any of our cases.

Discussion: Surfactant therapy disminishes the requirements of supplementary oxygen. According to our data, PSV/VG could be a safe option for the administration of intratracheal surfactant as we have not recorded complications during this procedure. However more studies with a higher number of patients are needed to confirm these findings.