INTUBATION PROTOCOL AND VENTILATORY SUPPORT IN NEONATOLOGY: A SYSTEMATIC REVIEW OF CLINICAL TRIALS (Atena Editora)

Abstract

Introduction: Worldwide, 15 million babies are born prematurely each year, and preterm birth is one of the biggest direct causes of neonatal mortality and morbidity. Respiratory distress syndrome is the main cause of respiratory failure in premature newborns. Several non-invasive respiratory support modalities are available in neonatal intensive care to minimize invasive ventilation, such as continuous positive airway pressure and non-invasive positive pressure ventilation. Goal: To understand intubation and ventilatory support protocols in neonatology. Methodology: This is a systematic review of clinical trials, in the PubMed database, with the descriptors: “protocol” AND “intubation” AND “neonatology”, in the last 10 years. 7 scientific articles were selected, with full text and free. Results: The continuous positive airway pressure (CPAP) technique is the most used. Furthermore, providing nitric oxide (NO) in addition to oxygen during positive pressure ventilation for extremely preterm infants at birth is associated with a decreased need for supplemental oxygen treatments. In addition, high flow (HF) therapy is yet another non-invasive respiratory support modality for preterm infants. Finally, it was noted that the Intubate Surfactant Extubate (IN-SUR-E) method is not successful in all preterm infants with respiratory distress syndrome, with a failure rate of 19 to 69%. Conclusion: The intubation and ventilatory support protocols used in newborns with consolidated scientific evidence are continuous positive airway pressure, nitric oxide delivery and high flow therapy. Other methods such as IN-SUR-E have a failure rate with a relatively high variation, requiring further studies. It is concluded that any intervention in neonatology must be followed up over time for a better assessment of the potential adverse effects in this age group.