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Premedication for minimally invasive surfactant (MIST) or INSURE procedures
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| bet | 504/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
| Premedication for minimally invasive surfactant (MIST) or INSURE procedures: Dekker et al 2018 [6] in an RCT in 78 infants 26 to 36 weeks gestational age receiving MIST procedure reported low-dose sedation with propofol 1 mg/kg increased comfort during MIST procedure in preterm infants, but the need for transient non-invasive ventilation was increased (93% vs 47%). There were no differences in incidence of hypotension (9/30 (30%) vs 2/17 (12%)), bradycardia, intubation or pneumothoraxes. (LOE II)
Dekker et al 2016 [7] in an observational study of very preterm infants receiving MIST, 23 received propofol 1 mg/kg and 15 were not sedated. Preterm infants receiving MIST were more comfortable when sedation was given, but needed ventilation more often (100% versus 33%). Descamps et al 2017 [8]reported a case series of 35 very preterm infants receiving MIST premedicated with atropine 10 microgram/kg + propofol titration started at 0.5 mg/kg with a mean total dose of 1.5 mg/kg (8 infants also received nalbuphine 0.1 mg/kg).
Conclusion: Low-dose propofol 1 mg/kg before the MIST procedure in preterm infants increased comfort but also the need for transient non-invasive ventilation.(LOE II GOR D)
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