Preterm Birth
Conditions
Keywords
Preterm, Lung Ultrasound Score, Surfactant
Brief summary
Lung immaturity is a major issue in neonatal unit.The surfactant administration improves the pulmonary prognosis in premature infants with hyaline membrane disease who escape continuous positive airway pressure (CPAP). This surfactant had been administered at 5h25min of life in Saint Etienne from 2016 to 2019. Studies suggest that the earlier the surfactant is administered, the more it can reduce the rate of bronchodysplasia and mortality. And some studies show a pulmonary ultrasound could help to administrate the surfactant earlier This is why a new faster strategy for diagnosing preterms needing surfactant will be usefulness and have been done in Saint-Etienne since 2021 thanks to a ultrasound score (LUS).
Detailed description
This current study analyzes the impact of early Lungs Ultrasounds which use a semi-quantitative assessment : the Lung Ultrasound Score (LUS), in preterms \<33 weeks on the time to surfactant administration. The current hypothesis is that Lung Ultrasound can increase the number of preterms with surfactant replacement within the first 3 hours of life. This is a prospective, comparative, observational trial between two different cohorts : the last 6 months of 2019 (without Score LUS) versus the first 6 months of 2021 (with Score LUS).
Interventions
DRUGSurfactant administration until 2020
Surfactant is administrated if Fi02 \>30% among the Guidelines of 2019
DRUGSurfactant administration since 2021
Surfactant is administrated if Fi02 \>30% OR if score LUS \>8/18 among the literature
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
No minimum to 1 Days
Healthy volunteers
No
Inclusion criteria
* newborns \<33 weeks old * born at the Saint Etienne University Hospital * respiratory distress syndrome
Exclusion criteria
* chromosomal abnormality, * multi-polymalformations syndrome, * congenital pulmonary disease, * septic shock, * congenital lung infection, * meconium inhalation, * pneumothorax * conditions requiring surgery in the first week of life.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| administration time frame (min of life) | day 1 | Time from birth to surfactant administration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| FiO2 maximum | Week 1 | Collect in medical record.: the maximal value of FiO2 from birth to one week of life |
| delay from FiO2 maximum to FiO2 < 21% | Week 4 | Collect in medical record |
| Ventilation time (day) | Week 4 | Collect in medical record : number of day using a ventilation |
| Ventilation support | Week 4 | Collect in medical record : using a invasive ou a non invasive ventilation |
| Bronchodysplasia rate | Week 4 | Collect in medical record. |
Countries
France
Outcome results
None listed