Valor do teste de microbolhas estáveis para a predição de necessidade de segunda dose de surfactante em prematuros com ≥31 semanas de idade gestacional

• Ano de defesa: 2008
• Autor(a) principal: Verdum, Gabriela
• Orientador(a): Fiori, Humberto Holmer
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: MEDICINA; PEDIATRIA; PREMATUROS; SURFACTANTES PULMONARES; RECÉM-NASCIDO; RESPIRAÇÃO ARTIFICIAL; UNIDADES DE TERAPIA INTENSIVA NEONATAL; SÍNDROME DO DESCONFORTO RESPIRATÓRIO DO RECÉM-NASCIDO
• Link de acesso: http://hdl.handle.net/10923/4669

Objectives: To evaluate the usefulness of the stable microbbuble test in gastric aspirate to predict the need for a second dose of surfactant in a group of preterm infants who received selective surfactant prophylaxis based on a low microbbuble count, and to study the association between other variables and the need of retreatment in the same group of patients. Methods: A retrospective cohort study was preformed from October 2002 to November 2006 by reviewing 114 charts of the inborn preterm babies T 31 weeks admitted to Hospital São Lucas da PUCRS neonatal intensive care unit, who had Stable Microbubble Test count under 25 microbbubles/mm2 and received prophylactic (or early) surfactant treatment. Results: From the babies studied, 32% received two or more doses of surfactant. The main conditions associated with retreatment was respiratory distress syndrome, high necessity of oxygen and pneumothorax. Thirty six percent of the neonates which received more than one dose of surfactant had a microbubbles count under 10 microbubble/mm2 (sensivity 93%; 95% CI 77- 99%), a negative predictive value o 91% (95% CI 68-98%). However, the specificity of the test was low. Low gestational age was the main risk factor associated with the necessity of a second (or more) doses of surfactant. Conclusions: The re-dosing of surfactant is very unlikely with stable microbbuble test in gastric fluid above 10 microbubbles/mm2 and gestational ages above 27 weeks. However, low positive predictive values suggest that stable microbbuble test has little clinical aplicability to predict the need for retreatment in this low count range.