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INSURE Video


hehady

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I don't have a video clip of the INSURE technique, but it is not complicated to explain.

We use INSURE rather frequently for RDS-treatment/surfactant installation, in >27 week infants, with Xray-diagnosis of RDS, adequate nasal CPAP-pressure (which we consder 4-5 cm to be) and an a/A-ratio of <0.22.

1. Loading dose of teofyllin (5 mg/kg iv)

2. Slow injection of morphine before intubation (0.15-0.2 mg/kg iv)

3. Pentobarbital immediate before intubation (2-5 mg/kg iv).

4. Oral intubation. Don't push the tube to far down to avoid bronchial intubation. Check tube position clinically by listening for equal to the lungs. Fixate the tube by a single piece of tape, or hold the tube/infant's head with one hand.

5. Intratracheal administation of surfactant (100-200 mg/kg).

6. Naloxone iv (0.1 mg/kg). Wait and assist the infant's breathing until he/she breathe well and saturation >90%

7. Extubate and continue with nasal CPAP.

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Thanks Stefan for the reply. I have the details of the techinque, what I realy wanted is a teaching video for residents and fellows as I'm preparing a course on NCPAP and this could be of great help. I've seen one in one of the ESPR meetings by a Swedish colleague, but I do not how to access.

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