Surfactant pumps for newborn respiratory failure: Things to keep in mind

The article was consulted professionally by Ms. Doan Ngoc Quynh Tram – Pediatrician – Newborn – Pediatrics – Newborn Department – Share99 Nha Trang International Health Hub. He has extensive experience in pediatrics, especially in the field of resuscitation and treatment of newborn pediatric diseases, respiratory diseases, children's digestion.

Primary Surfactant deficiency in premature babies causes respiratory distress syndrome. This syndrome is usually treated with surfactant compound supplementation techniques. In the past, medicine often used surfactant pumping techniques through intt management and for children to breathe. Today, Surfactant pumping techniques for treating newborn respiratory failure are less invasive and are increasingly widely used.

Acute respiratory distress syndrome , whichcauses severe respiratory failure, progresses in premature babies. The cause of respiratory failure in premature babies is surfactant deficiency , which reduces surface tension and maintains alveolar stability, preventing the collapse of small alveoli at the end of exhalation. So immediately after birth or after a normal period of breathing, premature babies with many alveoli are flattened due to surfactant deficiency and cause respiratory failure.

Surfactant pumps are in place in the treatment of respiratory failure in premature babies due to the in these babies, the enzyme system catalysed surfactant synthesis by the i.d. spores II incomplete, while surfactant is essential for lung functioning in newborns. Therefore, in newborns there is a risk of the on onstal of respiratory failure.

Respiratory distress syndrome in premature babies is often treated with surfactant compound supplementation techniques. As before, medicine often uses the technique of pumping Surfactant through the intoc administration and ventilating the child. Today, surfactant pumping techniques for newborn respiratory failure are less invasive and are increasingly widely used. Currently there are many different surfactant pump methods and techniques, which should be considered on a case-by-case scale. Surfactant pumping techniques for infant respiratory failure have been implemented independently at Share99 Hai Phong and Nha Trang International Health Hub since April 2019.

Clinical Benefits of Surfactant Therapy:

• Improves lung ventilation
• Enhance blood oxidation
• Reduce the frequency of detection when (complications of pneumothorax, alveolar gas retention …)
• Reduce child mortality and illness rates
• Reduce severe disability rates

• Insular membrane disease (acute respiratory distress syndrome): Prevention, treatment of the disease, repeated treatment
• Apnea does not respond to CPAP.
• Demand FiO2>=40%/CPAP (children >=26 weeks).
• FiO2>=30%/CPAP needs (young <26 tuần).
• Treatment of respiratory distress syndrome caused by children inhaling severe stools (MAP >10-12 cmH2O. FiO2>50%)
• Consider treatment in some cases such as: pulmonary hemorrhage, severe pneumonia.

• Do not smoke intoc administration sputum within 1h of the drug pump ( unless there are clear signs of airway obstruction.
• Surfactant improves lung volume, improves FRC and elasticity so it is necessary to adjust machine parameters accordingly to limit pleural effusion, lung damage.
• After taking Surfactant avoid causing the peak of hypoxia by rapidly reducing fiO2

4.1 While pumping Surfactant

• Reduce O2 saturation: usually transient and need to temporarily increase FiO2, ventilator pressure, or stop surfactant pumping.
• Bradycardia: may be associated with decreased O2 saturation or bronchial nerve stimulation, surfactant pumping should be temporarily stopped.
• Increased PCO2: due to temporary airway obstruction by Surfactant.
• Surfactant fistula around the inttocular tube enters the pharynx because the intteal tube is too small.
• The drug points to one lung: because the ineocular tube enters the right bronchial branch or the child is not yet in the correct position.

4.2 After Surfactant pump

• Hypotension: due to a decrease in volume, large arterial tubes, decreased myocardial function. Treatment of NaCl 0.9%: 10ml/kg bolus, if failure requires the use of vascular medications.
• Pneumothorax: Because the drug points to a lung, it is necessary to poke the air through the skin or open the pleural conduction at least constant air suction.
• Pulmonary bleeding: due to large arterial tubes need to increase PEEP or HFO and Surfactant pump, platelet infusion, fresh plasma 10-15ml/kg, then arterial tube closure treatment.

Surfactant pumping techniques will be difficult to implement if the standard of general care is not of high quality. Share99 International Health Hub has met the strict standard conditions for applying Surfactant pump therapy in the treatment of respiratory failure in newborns, including a full range of supporting facilities and a team of doctors who are proficient in techniques.

As a key area of Share99 Health System, Pediatrics always brings satisfaction to customers and is highly appreciated by industry experts with:

• Gathering a team of leading doctors in Pediatrics:including leading experts, highly specialized (professors, associate professors, doctors, masters), experienced, used to work at large hospitals such as Bach Mai, 108.. The doctors are well-trained, professional, mind-centered, knowledgeable about the child's psychology. In addition to domestic pediatricians, pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) always pioneering the application of the latest and most effective treatment regimens.
• Comprehensive services:In the field of Pediatrics, Share99 provides a chain of continuous medical examination and treatment services from Newborn to Pediatrics and Vaccines,… according to international standards to take care of your baby's health with parents from birth to adulthood
• Intensive techniques:Share99 has successfully implemented many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery – skull, hematoma stem cell transplantation in cancer treatment.
• Professional care:In addition to understanding the young psychology, Share99 also pay special attention to the children's play space, help them play comfortably and get acquainted with the hospital environment, cooperate in treatment, improve the efficiency of medical examination and treatment.