TRATAMENTO DA SÍNDROME DO DESCONFORTO RESPIRATÓRIO NEONATAL: SURFACTANTE VS. CPAP
DOI:
https://doi.org/10.71248/ks3sfp91Palabras clave:
Recém-Nascido, Síndrome do Desconforto Respiratório do Recém-Nascido, TerapêuticaResumen
A síndrome do desconforto respiratório neonatal (SDRN) é uma importante causa de morbidade em recém-nascidos prematuros. Este estudo objetivou analisar comparativamente os desfechos do CPAP isolado, do CPAP associado ao surfactante e das técnicas menos invasivas de administração do surfactante no tratamento da SDRN. Realizou-se revisão sistemática, orientada pelo PRISMA 2020, com buscas nas bases PubMed e Scopus e inclusão de ensaios clínicos publicados entre 2015 e 2025, em português e inglês. Dos 1.313 registros identificados, nove estudos foram incluídos na síntese qualitativa. Os ensaios avaliaram CPAP, NCPAP, DUOPAP, INSURE, LISA, MIST, SNIPPV, surfactante nebulizado e administração guiada por ultrassonografia pulmonar. Parte dos estudos mostrou redução da necessidade ou do tempo de ventilação invasiva, da exposição ao oxigênio e da incidência de displasia broncopulmonar com estratégias que preservam a respiração espontânea. Contudo, alguns desfechos não apresentaram diferenças estatisticamente significativas, e a heterogeneidade clínica e metodológica limita conclusões de superioridade universal. As evidências sugerem benefício potencial da associação entre suporte não invasivo e surfactante, especialmente por técnicas menos invasivas, mas a interpretação definitiva depende da avaliação do risco de viés e da qualidade da evidência.
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