The INSURE method in preterm infants of less than 30 weeks' gestation. 2010

Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Viale Morgagni, 85, 50134 Florence, Italy. cdani@unifi.It

OBJECTIVE Our aim was to identify the clinical characteristics which could distinguish infants who can be managed with INSURE (intubatio-surfactant-extubation) method for preventing mechanical ventilation (MV) and which could predict INSURE success or failure. METHODS Inborn infants with gestational age <30 weeks were Infants were categorised into three groups: (1) infants who needed MV in the delivery room; (2) infants spontaneously breathing who were treated only with NCPAP; (3) infants who were treated with INSURE method. RESULTS We studied 125 infants: 30 (24%) required MV, 75 (60%) received INSURE treatment, and 20 (16%) were treated with NCPAP. Sixty-eight (91%) infants were successfully treated with the INSURE method. Infants in the success group had less severe RDS and less occurrence of sepsis and pneumothorax, lower mortality, and shorter duration of stay in the NICU than infants in the failure group. A birth weight <750 g, pO(2)/FiO(2) <218, and a/ApO(2) <0.44 at the first blood gas analysis were independent risk factor for INSURE failure. CONCLUSIONS The INSURE method can be applied to the majority of extremely preterm infants and is followed by a high percentage of success.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234 Infant, Premature A human infant born before 37 weeks of GESTATION. Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D007235 Infant, Premature, Diseases Diseases that occur in PREMATURE INFANTS.
D007363 Intensive Care Units, Neonatal Hospital units providing continuing surveillance and care to acutely ill newborn infants. Neonatal Intensive Care Unit,Neonatal Intensive Care Units,Newborn Intensive Care Unit,Newborn Intensive Care Units,ICU, Neonatal,Neonatal ICU,Newborn ICU,Newborn Intensive Care Units (NICU),ICU, Newborn,ICUs, Neonatal,ICUs, Newborn,Neonatal ICUs,Newborn ICUs
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008297 Male Males
D011663 Pulmonary Surfactants Substances and drugs that lower the SURFACE TENSION of the mucoid layer lining the PULMONARY ALVEOLI. Surfactants, Pulmonary,Pulmonary Surfactant,Surfactant, Pulmonary
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012127 Respiratory Distress Syndrome, Newborn A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause. Infantile Respiratory Distress Syndrome,Neonatal Respiratory Distress Syndrome,Respiratory Distress Syndrome, Infant
D001724 Birth Weight The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms. Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth

Related Publications

Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
January 2015, The Turkish journal of pediatrics,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
February 2023, Journal of perinatology : official journal of the California Perinatal Association,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
October 2021, American journal of perinatology,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
March 2011, Archives de pediatrie : organe officiel de la Societe francaise de pediatrie,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
December 2006, Journal of paediatrics and child health,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
April 2012, Acta paediatrica (Oslo, Norway : 1992),
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
January 2016, Global pediatric health,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
February 2022, Seminars in perinatology,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
November 1989, Critical care medicine,
Carlo Dani, and Iuri Corsini, and Giovanna Bertini, and Giulia Fontanelli, and Simone Pratesi, and Firmino F Rubaltelli
January 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians,
Copied contents to your clipboard!