Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2023; 11(25): 5878-5886
Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5878
Effect of different ventilation methods combined with pulmonary surfactant on neonatal acute respiratory distress syndrome
Qing Qing, Ping Zha, Li-Ying Dai, Yang Wang
Qing Qing, Yang Wang, Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
Ping Zha, Li-Ying Dai, Department of Neonatology, Anhui Provincial Children's Hospital, Hefei 230001, Anhui Province, China
Author contributions: Qing Q and Wang Y contributed to conception and design, provision of study materials or patients; Wang Y contributed to administrative support; All authors contributed to collection and assembly of data; Qing Q contributed to data analysis and interpretation, manuscript writing; All authors contributed to final approval of manuscript.
Institutional review board statement: The ethical audit certificate of this study was provided by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University. (NO. AHYKD-LLWYH-036).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yang Wang, Doctor, Professor, Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230001, Anhui Province, China. yangwang202302@163.com
Received: July 12, 2023
Peer-review started: July 12, 2023
First decision: August 2, 2023
Revised: August 7, 2023
Accepted: August 11, 2023
Article in press: August 11, 2023
Published online: September 6, 2023
Processing time: 51 Days and 5.4 Hours
ARTICLE HIGHLIGHTS
Research background

Acute respiratory distress syndrome (ARDS) precipitates is widespread pulmonary injury in impacted individuals, the neonatal respiratory distress syndrome (NRDS), primarily observed in preterm infants, represents a prevalent critical condition in neonatal clinical settings.

Research motivation

Presently, respiratory ailments such as NRDS, congenital diaphragmatic hernia, and meconium aspiration syndrome can be effectively managed with high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) (HFOV+PS) inhalation therapy in neonates and infants. However, additional investigations are required to elucidate the impacts of the HFOV and PS combination on ARDS.

Research objectives

The aim of this study is to investigate the clinical efficacy of various ventilation strategies combined with PS therapy in the treatment of NRDS.

Research methods

A total of 20 neonates diagnosed with RDS, admitted between May 2021 and June 2022, were randomly assigned to either a research group or a control group. Neonates in the research group received treatment involving HFOV in conjunction with PS. In contrast, neonates in the control group were administered either controlled mechanical ventilation (CMV) or synchronous intermittent mandatory ventilation, combined with PS.

Research results

From 6-48 h post-treatment, both groups demonstrated significant improvements in arterial blood pH and oxygen partial pressure, along with a significant decrease in carbon dioxide partial pressure compared to pre-treatment values (P < 0.05). Although these changes progressed over time, there were no significant differences between the two groups (P > 0.05). However, the research group had significantly lower X-ray scores, shorter hospitalization time, and less time on O2 therapy compared to the control group (P < 0.05). Mortality rates were similar between the two groups (P > 0.05), but the research group had a significantly lower incidence of complications (P < 0.05).

Research conclusions

Our findings suggest that for infants with ARDS, the utilization of HFOV in conjunction with PS demonstrates a significant advantage over the use of CMV with PS. Specifically, the HFOV+PS approach notably reduces both the duration of hospitalization and the necessity for prolonged mechanical ventilation. Importantly, these benefits are achieved without any attendant increase in the incidence of complications. This evidence provides a compelling case for the preferential use of HFOV+PS in the management of infant ARDS, to optimize patient outcomes and enhance the efficiency of care.

Research perspectives

Our future research will be based on alleviating the economic pressure of patients and finding the cheapest treatment to treat Infant respiratory distress syndrome.