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Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann--Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time. [ABSTRACT FROM AUTHOR]

Pulmonary surfactant instillation is the treatment of choice in neonatal respiratory distress syndrome. The development of artificial surfactant has three decades of history. Animal-derived artificial surfactant is used in most countries and consists of 80% phospholipids and glycerol. 10% of the formulation is comprised of surfactant proteins, which have the critical role in surfactant function of lowering surface tension in the alveoli. Synthetic surfactants are made using synthetic peptide analogues as the surfactant protein counterparts. These are not the same as the human surfactant protein sequences; however, researchers are attempting to find the ideal synthetic peptide sequence for use in synthetic surfactants. Prophylactic and rescue surfactant therapy are two main therapeutic options. A recent recommendation emphasizes the importance of rescue therapy with continuous positive nasal airway pressure, rather than prophylactic use immediate after birth. This article briefly reviews the history and physiology of surfactant use, as well as clinical practice of surfactant and future studies. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to compare the effects of treatment of newborn babies with two different surfactants, Curosurf® and Surfacten®. Methods: We retrospectively reviewed the medical records from 2007 to 2009 and divided the patients into two groups: those who received Curosurf® (n=20) and those who received Surfacten® (n=21). We compared the groups for sex, gestational age (GA), birth weight, type of delivery, apgar score, maternal history, age at treatment, bronchopulmonary dysplasia (BPD), administration indomethacin for patent ductus arteriosus(PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), retinopathy of prematurity (ROP), pulmonary hemorrhage (PH), pneumothorax (PTX), duration of ventilation, need for oxygen, and administration. Results: The demographic and clinical variables were similar in both groups. The gestational age for Curosurf® and Surfacten® were 32.7±3.1 and, 30.5±4.3 weeks, respectively (P=0.08). Six newborns in the Curosurf® group and 8 in the Surfacten® group developed BPD (P=0.59). No significant differences were noted for NEC, IVH, PVL, ROP, PH, PTX between the two groups (IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX P=0.34). The mean duration of ventilation was 16.8 days with Curosurf® and 23.7 days with Surfacten®, but these differences were not statistically significant (P=0.43). The differences in duration of need for oxygen and administration were also not statistically significant (P=0.92, 0.91, respectively). Conclusion: This study indicated no significant differences between Curosurf® and Surfacten®. However, because of its convenience and the merit of minimal touching of the babies, the use of Curosurf® is recommended. [ABSTRACT FROM AUTHOR]

Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed. [ABSTRACT FROM AUTHOR]