Comparison of outcomes of Less Invasive Surfactant Administration (LISA) in prematurely born infants in the delivery suite (DS) and the neonatal unit (NNU).

Abstract

To compare outcomes of infants who received less invasive surfactant administration (LISA) in the delivery suite (LISA-DS) to those who received LISA on the neonatal unit (LISA-NNU). A prospective cohort study was undertaken of all infants who received LISA in a single centre. Clinical outcomes included admission temperature, the need for intubation, durations of invasive and non-invasive ventilation, length of hospital stay (LOS) and the incidences of bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH), retinopathy of prematurity (ROP) and requirement for home oxygen were compared between the two groups as were complications of the procedure. The 54 LISA-DS infants had similar gestational ages and birth weights to the 26 LISA-NNU infants (p=0.732, p=0.928 respectively). There were no significant differences between the admission temperatures (median (range) 36.8 (36-38.7) versus 36.8 (36.4-37.7) 0C p=0.451) or need for intubation in less than 72 hours of birth (28% versus 23%, p=0.656). The durations of invasive ventilation (median 2 (0-65) days versus 1 (0-35) days p=0.188) and non-invasive ventilation (median 37 (24-81) days versus 37 (3-225) days p=0.188) and the incidences of BPD (p=0.818), IVH (p=0.106), ROP (p=0.526) and home oxygen requirement (p 0.764) were similar. The percentage of successful first attempts with LISA (63% versus 70%, p=0.816) or associated with hypoxia episodes (32% versus 42%, p=0.194) did not differ significantly by site of administration. The outcomes of LISA performed on the delivery suite were similar to those of LISA performed on the neonatal unit.