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Strategies for the prevention and treatment of lung immaturity in the neonate

Objective

Objectives:
Since treatment policies are not standardized and differ among EC countries, this concerted action will examine the most common clinical practices regarding the antenatal and postnatal treatment of fetal lung immaturity across Europe. Cross sectional surveys of treatment practices will be undertaken and integrated. The data will form the scientific basis for standardization of protocols in European centres regarding corticosteroid treatment and antenatal and postnatal surfactant administration.

In spite of the progress of the last 3 decades in the field of perinatal care, prematurity and disturbances of fetal adaptation to extrauterine life are still major causes of severe handicap. Seven to ten per cent of all newborns are delivered preterm. A large percentage of these will face problems related to the immaturity of several organ systems with the alteration of lung function being the most frequent. If the lung is immature, the newborn infant will develop respiratory distress syndrome (IRDS), which affects 10-15% of all pre-term babies or debilitating chronic lung diseases (e.g. bronchopulmonary dysplasia, BPD) resulting insignificant mortality and morbidity. Most of these infants need admission to the intensive care unit (ICU). Although most preterm infants survive the ICU without major sequelae, some require rehospitalisation and special long-term care for sever handicap.

Antenatal corticosteroid therapy is effective, yet approximately 10% of the neonates treated still develop IRDS. Treatment of pre-term neonates with therapeutic surfactants is now quite routine for RDS, but even this therapy is not devoid of complications and repeated doses requiring repeated endotracheal intubations are needed. Full implementation of the above treatments is, however, far from optimal and new strategies (such as intramniotic administration of surfactant) are envisaged. Since treatment policies are not standardized and differ among EC countries, this concerted action will examine the most common clinical practices regarding the antenatal and postnatal treatment of fetal lung immaturity across Europe. Cross sectional surveys of treatment practices will be undertaken and integrated. The data will form a scientific basis for standardization of protocols in European centres regarding corticosteroid treatment and antenatal and postnatal surfactant administration.05 05

Funding Scheme

CON - Coordination of research actions

Coordinator

Università degli Studi di Roma 'La Sapienza'
Address
Viale Del Policlinico
00161 Roma
Italy