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Original Article
Neonatology (Perinatology)
Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial
Mohammad Kazem Sabzehei, Behnaz Basiri, Maryam Shokouhi, Sajad Ghahremani, Ali Moradi
Clin Exp Pediatr. 2022;65(4):188-193.   Published online July 28, 2021
Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)?
Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects.
Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique.
Review Article
Neonatology (Perinatology)
Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future
Ga Won Jeon
Clin Exp Pediatr. 2019;62(5):155-161.   Published online February 8, 2019
Following the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. Synthetic surfactants were designed to overcome limitations of natural surfactants such as cost, immune reactions, and infections elicited by animal proteins contained in natural surfactants. However, first-generation synthetic surfactants...
Original Article
Neonatology (Perinatology)
Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants
Ian Kim, Sung Shin Kim, Jee In Song, Seock Hwa Yoon, Ga Young Park, Yong-Wha Lee
Clin Exp Pediatr. 2019;62(5):166-172.   Published online October 24, 2018

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first...
Transient intubation for surfactant administration in the treatment of respiratory distress syndrome in extremely premature infants
Ji Won Koh, Jong-Wan Kim, Young Pyo Chang
Clin Exp Pediatr. 2018;61(10):315-321.   Published online September 16, 2018

Purpose: To investigate the effectiveness of transient intubation for surfactant administration and extubated to nasal continuous positive pressure (INSURE) for treatment of respiratory distress syndrome (RDS) and to identify the factors associated with INSURE failure in extremely premature infants. Methods: Eighty-four infants with gestational age less than 28 weeks treated with surfactant administration for RDS for 8 years were included. Perinatal...
Review Article
Neonatology (Perinatology)
Update of minimally invasive surfactant therapy
Gyu-Hong Shim
Clin Exp Pediatr. 2017;60(9):273-281.   Published online September 21, 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials...

Genetic risk factors associated with respiratory distress syndrome
Heui Seung Jo
Clin Exp Pediatr. 2014;57(4):157-163.   Published online April 30, 2014

Respiratory distress syndrome (RDS) among preterm infants is typically due to a quantitative deficiency of pulmonary surfactant. Aside from the degree of prematurity, diverse environmental and genetic factors can affect the development of RDS. The variance of the risk of RDS in various races/ethnicities or monozygotic/dizygotic twins has suggested genetic influences on this disorder. So far, several specific mutations in...

Original Article
Comparative study on effects of volume-controlled ventilation and pressure-limited ventilation for neonatal respiratory distress syndrome
Jae Jin Kim, Mun Jung Hwang, Sang Geel Lee
Clin Exp Pediatr. 2010;53(1):21-27.   Published online January 15, 2010

Purpose:In contrast with traditional time-cycled, pressure-limited ventilation, during volume-controlled ventilation, a nearly constant tidal volume is delivered with reducing volutrauma and the episodes of hypoxemia. The aim of this study was to compare the efficacy of pressure-regulated, volume controlled ventilation (PRVC) to Synchronized intermittent mandatory ventilation (SIMV) in VLBW infants with respiratory distress syndrome (RDS). Methods : 34 very low birth...
Review Article
Neonatal respiratory distress: recent progress in understanding pathogenesis and treatment outcomes
So Young Kim
Clin Exp Pediatr. 2010;53(1):1-6.   Published online January 15, 2010
Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal...
Original Article
Clinical feature of neonatal pneumothorax induced by respiratory distress syndrome and pneumonia
Ji-Sun Jung, Sang-Woo Park, Chun-Soo Kim, Sang-Lak Lee, Tae-Chan Kwon
Clin Exp Pediatr. 2009;52(3):310-314.   Published online March 15, 2009
Purpose : Pneumothorax is an important factor responsible for increased mortality and morbidity in neonates. Here, we compared the clinical findings and prognosis for neonatal pneumothorax induced by respiratory distress syndrome (RDS) and pneumonia. Methods : Between January 2001 and December 2005, 80 patients with neonatal pneumothorax induced by RDS and pneumonia and admitted to the NICU of Dongsan Medical...
Study of the risk factors for pulmonary interstitial emphysema related to mechanical ventilator care
Sang Yeob Kim, Pil Sang Lee, Sang Geel Lee
Clin Exp Pediatr. 2008;51(11):1179-1184.   Published online November 15, 2008
Purpose : Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. Methods : PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical...
The pharmacological treatment of patent ductus arteriosus in premature infants with respiratory distress syndrome: oral ibuprofen vs. indomethacin
Soo Jin Lee, Ji Young Kim, Eun Ae Park, Sejung Sohn
Clin Exp Pediatr. 2008;51(9):956-963.   Published online September 15, 2008
Purpose : Indomethacin is widely used for the prophylaxis and treatment of patent ductus arteriosus (PDA); however, it is associated with side effects such as renal failure, intraventricular hemorrhage, and gastrointestinal bleeding. Intravenous ibuprofen has been shown to be as effective as indomethacin in prompting PDA closure. If treatment with oral ibuprofen is as effective as indomethacin, it would have...
Case Report
A case of acute respiratory distress syndrome associated with congenital H-type tracheoesophageal fistula and gastroesophageal reflux
Heewon Chueh, Myo Jing Kim, Jin-A Jung
Clin Exp Pediatr. 2008;51(8):892-895.   Published online August 15, 2008
H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive....
Original Article
Oxygenation index as a respiratory parameter of respiratory distress syndrome in preterm infants
Ji Hyun Jeon, Ran Namgung, Min Soo Park, Kook In Park, Chul Lee
Clin Exp Pediatr. 2008;51(2):145-149.   Published online February 15, 2008
Purpose : To examine whether changes of oxygenation index (OI) by postnatal age were different by the number of surfactant administration, and different between subgroups of survival and death. Methods : From January 2005 to June 2006, preterm infants (n=84) diagnosed as respiratory distress syndrome (RDS) and treated with surfactant and ventilator were included. They were divided into two groups: Group...
Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia
Jee Yoon Park,, Ji Young Kim, Soo Jin Cho, Young Ju Kim, Hye sook Park, Eun Hee Ha, Eun Ae Park
Clin Exp Pediatr. 2007;50(3):248-254.   Published online March 15, 2007
Purpose : Inflammation plays a major role in the pathogenesis of RDS and BPD in the immature lung. We investigated the possible role of IL-10 and IL-12 in the cord blood of preterm newborns with RDS or BPD. Methods : Forty preterm newborns whose mothers received antenatal care at Ewha Womans University Mokdong Hospital between January 2003 to June 2005, and...
Case Report
A case of acute respiratory distress syndrome treated with surfactant and low dose methylprednisolone
Bo Yeon Choi, Kyong Mo Kim, Jong Seo Yoon, Joon Sung Lee
Clin Exp Pediatr. 2006;49(4):455-459.   Published online April 15, 2006
The major pathogenesis of acute respiratory distress syndrome (ARDS) is an inflammatory process that results from a diversity of injuries to the body. Due to the various cytokines and vasoactive peptides released from the endothelium, the vascular permeability is increased; the migration of inflammatory cells and the leakage of plasma proteins then occur and edema develops in the alveolus. There...
Original Article
A Study on the Effects of Early Surfactant Replacement and Gentle Ventilation in the Treatment of Respiratory Distress Syndrome
Yong Suk Lee, Ji Hye Lee, Sang Geel Lee
Clin Exp Pediatr. 2005;48(10):1096-1101.   Published online October 15, 2005
Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the...
Comparison of Clinical Progress between Single- and Multiple-dose Surfactant Treatment in Neonatal Respiratory Distress Syndrome
Chang Hee Kil, Ho Sang Jeon, Chong Woo Bae
Clin Exp Pediatr. 2005;48(10):1090-1095.   Published online October 15, 2005
Purpose : In the case of serious respiratory distress syndrome(RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose(group S) and multiple-dose(group M) pulmonary surfactant treatment group of neonatal RDS. Methods : We investigated 48 neonates who were...
Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children
Jung-Min Ko, Eun-Ju Ha, Eun-Hee Lee, So-Youn Lee, Hyo-Bin Kim, Soo-Jong Hong, Seong-Jong Park
Clin Exp Pediatr. 2005;48(6):599-605.   Published online June 15, 2005
Purpose : The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome(ARDS), and evaluate the physiologic variables as prognostic factors in the patients. Methods : Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit(PICU) during 20-month period. Results...
Serum Albumin Concentrations and Clinical Disorders by Gestational Ages in Preterm Babies
Mia Lee, Soo Youn, Baek Keun Lim, Jong Soo Kim
Clin Exp Pediatr. 2005;48(2):148-153.   Published online February 15, 2005
Purpose : The aim of this study was to determine the reference ranges of serum albumin levels depending on the gestational ages of preterm infants. We also intended to compare the mean serum albumin levels between groups of preterm infants that did not develop clinical disorders later, and groups that did develop clinical disorders such as respiratory distress syndrome, intraventricular...
Surfactant Therapy for Neonatal Respiratory Distress Syndrome : Experience in Korea Over 15 Years
Chong-Woo Bae, Young-Min Kim
Clin Exp Pediatr. 2004;47(9):940-948.   Published online September 15, 2004
Purpose : Surfactant replacement therapy in neonates with respiratory distress syndrome(RDS) has been used in Korea since 1990. We undertook a collective study of trials from multi-hospitals to evaluate results of neonates with RDS who were treated with surfactant during the past 15 years in Korea(Period I, P-I, 1990-91; Period II, P-II, 1996; Period-III, P-III; 2002). Methods : There were 60...
Association between the Human Surfactant Protein-A(SP-A) Gene Locus and Respiratory Distress Syndrome in Korean Neonates
Jae Hoon Choe, Myung Ho Oh, Jung Ho Ko, Sun Young Kim, In Kyu Lee, Chong Woo Bae
Clin Exp Pediatr. 2004;47(7):735-739.   Published online July 15, 2004
Purpose : Respiratory distress syndrome(RDS) is caused by a deficiency of pulmonary surfactant, which is a lipoprotein complex. Both low levels of surfactant protein A(SP-A) and SP-A alleles have been associated with RDS. However, the genes underlying susceptibility to RDS are insufficiently known. The candidate-gene approach was used to study the association between the SP-A gene locus and RDS in...
Cause and Prognosis of Pediatric Acute Respiratory Failure by Intrapulmonary Lesion
Hye-Young Lee, Ji-Suk Park, Hee-Ra Choi, Ji-Hyun Seo, Jeum-Su Kim, Jae-Young Lim, Myoung-Bum Choi, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
Clin Exp Pediatr. 2004;47(5):555-560.   Published online May 15, 2004
Purpose : Respiratory failure arises from derangements in pulmonary gas exchange. The causes may be classified as due to either lung disease or respiratory pump dysfunction. Problems with lung mechanics is an important cause of acute respiratory failure in children clinically. The aims of this study were to survey the cause and prognosis of children diagnosed with acute respiratory failure...
Prevention of Chronic Lung Disease with Early Dexamethasone Treatment in less than 32 Weeks Premature : Randomized Controlled Study
So Yun Shim, Su Jin Cho, Eun Ae Park
Clin Exp Pediatr. 2004;47(5):521-526.   Published online May 15, 2004
Purpose : The optimal timing and the consequences of dexamethasone therapy in chronic lung disease remain unknown. The purpose of this study was to determine whether early dexamethasone therapy would reduce the incidence of chronic lung disease and to determine the adverse effects and complications of prematurity associated with such therapy. Methods : Twenty neonates with hyaline membrane disease(dexamethasone n=10, placebo...
The Effect of Post-natal Weight Changes on the Development of Bronchopulmonary Dysplasia in Infants with Respiratory Distress Syndrome
Hye One Jhon, Young Min Kim, Hee Joo Hong, Chong Woo Bae
Clin Exp Pediatr. 2004;47(3):269-274.   Published online March 15, 2004
Purpose : The subjects were compared and measured for differences in the aspects of weight changes between the groups that developed bronchopulmonary dysplasia(BPD) after treatment and those that did not, to analyze the relations between the patterns of early weight change after birth and the development of BPD. Methods : Retrospective analysis of medical records were performed for birth weight and...
The Effect of Histologic Chorioamnionitis on the Development of Respiratory Distress Syndrome and Chronic Lung Disease in Preterm Infants
Heui seung Jo, Beyong Il Kim, Chang Won Choi, Jun Dong Park, Chong Jai Kim, Jung-Hwan Choi
Clin Exp Pediatr. 2004;47(2):150-156.   Published online February 15, 2004

Purpose: Histologic chorioamnionitis may play a role in the development of respiratory distress syndrome(RDS) and chronic lung disease(CLD) independently or through its association with preterm birth. We investigated the relationship between histologic chorioamnionitis and clinical complications including, RDS and CLD, of preterm infants. Methods: Clinical data were collected retrospectively from 478 preterm infants(gestational period≤34 weeks) who were admitted to the neonatal...
A Study on the Effects of the Early Use of Nasal CPAP in the Weaning of Mechanical Ventilators
Yeoung Ju Kim, Byun Kyung Jung, Sang Geel Lee
Clin Exp Pediatr. 2003;46(12):1200-1206.   Published online December 15, 2003
Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to...
Comparison of Clinical Courses According to the Existence of Patent Ductus Arteriosus in Respiratory Distress Syndrome
Ju Hee Seong, Hyeon Joo Lee, Hyun Kee Hong, Chong-Woo Bae, Yong-Mook Choi
Clin Exp Pediatr. 2003;46(11):1080-1084.   Published online November 15, 2003
Purpose : To compare perinatal characteristics, clinical courses, and overall morbidity between respiratory distress syndrome(RDS) with patent ductus arteriosus(PDA) and RDS without PDA in neonates. Methods : Eighty-three neonates who were diagnosed and treated for RDS in the neonatal intensive care unit(NICU) from Jan. 2000 to Dec. 2002 were included in this study. RDS was complicated with PDA(group A) in...
Correlation between Chest Radiographic Findings and Respiratory Indices in Neonates with Respiratory Distress Syndrome
Yong-Hwan Chung, Youn-Jin Park, Chong-Woo Bae, Dong-Wook Sung
Clin Exp Pediatr. 2003;46(7):655-660.   Published online July 15, 2003
Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio(a/APO2) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care...
A Clinical Study of the Acute Respiratory Distress Syndrome in Children
Taek Jin, Dong Soo Kim, Dong Hwan Shin
Clin Exp Pediatr. 2003;46(1):42-50.   Published online January 15, 2003
Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who...
Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome
Eun Ji Kim, Hae Sook Kim, Man Hoe Hur, Sang Geel Lee
Clin Exp Pediatr. 2002;45(10):1204-1212.   Published online October 15, 2002
Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with...
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