study protochol (PDF)

RAM cannula x Hudson cannula efficiency study
Which patients
will be taken to
study !!

lllll

Transport and
Randomization!

(Nazal SIMV)

Surfactant
treatment

 Clinical findings (tachycardia, groaning, retractions) of RDS arising in our hospital between
260 / 7-346 / 7 weeks and
• There was no need for intubation in the delivery room and
• Preterm infants without severe congenital anomalies
 Patients taken to work will be brought to the unit under the Nazal CPAP from the
delivery room
 The unit can be quickly randomized to RAM cannula or short binazal cannula (Hudson)
group

• Noninvasive ventilation with a cannula in which the patient is randomized.
• Patients SLE 2000 will be connected to 5000 ventilators and the settings to be monitored in
nasal SIMV will be as follows.
• PEEP: 6 cm H2O, PIP: 15 cm H2O Speed: 20 / min IT: 0.40
• FiO2: FiO2 will be seted between 0,21-0,50 sPO2 in the range of 90-95%

• Surfactants will be administered at a dose of 100 mg / kg if FiO2> 0.40 is required to maintain a
saturation value of 90% or greater while receiving non-invasive respiratory support for both groups of
patients as described in the RDS management guide.
• A second dose of surfactant will be administered if the patient's FiO2 requirement is still above 0.30 at
postnatal 6th hour.
• Surfactant application will be given by the standard protocol of intubation - surfactant application extubation (INSURE). Entubation time will not exceed a few minutes

• Increased respiratory insufficiency findings (increased tachypnea, groaning, subcostal
intercostal withdrawal) under NID or
Noninvasive
ventilation
failure
Criteria !!

• Oxygen saturation followed by a pulse oximeter despite> 0.50 FiO2 is <90% or
• presence of apnea requiring frequent and positive pressure ventilation with acidosis (pH
<7.20 and PCO2> 60 cmH2O), bradycardia or
• Patients with pulmonary hemorrhage will be admitted to the mechanical ventilator with
acceptance of NIV deficiency as in our standard practice.
• These patients will continue with the initial NIV format when they are expanded