Terapêutica com surfactante em recém-nascidos prematuros: tendência para uma abordagem menos invasiva
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v30.i1.19182Palavras-chave:
INSURE, MIST, prematuridade, surfactante, ventilaçãoResumo
Introdução: A administração de surfactante por técnica minimamente invasiva (MIST) é um procedimento que visa reduzir o número de intubações e riscos associados. O objetivo deste estudo foi comparar a técnica MIST com a técnica INtubation-SURfactant-Extubation (INSURE).
Material e métodos: Análise retrospetiva (de janeiro 2015 a junho 2019) de recém-nascidos (RN) pré-termo sob ventilação não invasiva com pressão positiva contínua nas vias aéreas (nCPAP) tratados com surfactante.
Resultados: Foram incluídos 54 RN, que foram divididos em dois grupos: MIST (n=34) e INSURE (n=20). Não foram observadas diferenças significativas entre grupos relativamente à idade gestacional (p=0.480), peso ao nascer (p=0.299), fração inspirada de O2 (FiO2) prévia ao surfactante (p=0.220), duração da oxigenoterapia (p=0.306), progressão para intubação (p=0.712) ou tempo de permanência na unidade de cuidados intensivos neonatais (p=0.778). A variação de FiO2 antes e após a administração de surfactante foi maior no grupo MIST (14% vs 9%, p=0.078). Nenhuma das técnicas registou complicações relevantes.
Conclusões: MIST é uma técnica segura em RN pré-termo em nCPAP. Este estudo evidencia resultados semelhantes entre as técnicas MIST e INSURE, com uma maior diminuição das necessidades de FiO2 com a técnica MIST. Pode concluir-se que a técnica MIST é menos invasiva e tão eficaz como a INSURE.
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Direitos de Autor (c) 2021 Daniel Meireles, Luísa Neiva Araújo, Marta Nascimento, Liliana Pinho, Ana Cristina Freitas, Alexandra Almeida, Carmen Carvalho, Elisa Proença
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