Five-year single center experience on surfactant treatment in preterm infants with respiratory distress syndrome: LISA vs INSURE

Abstract

BackgroundSurfactant administration traditionally involved endotracheal intubation and mechanical ventilation, which is associated with a risk of barotrauma and volutrauma. ObjectiveTo compare the morbidity and mortality rates between LISA-treated and INSURE-treated premature babies with respiratory distress syndrome (RDS). MethodsWe assessed retrospectively the medical records of preterm infants who were born at 250/7 to 296/7 weeks of gestation and were administered surfactant initially either with LISA or INSURE method over a five-year period. ResultsAnalysis of the data of 205 LISA-treated and 178 INSURE-treated infants revealed the mean gestational age as 28.1 ± 1.3 and 28 ± 1.3 weeks and mean birth weight as 1041 ± 205 and 1029 ± 222 g in LISA and INSURE groups, respectively. The mechanical ventilation requirement in the first 72 h of life (%26.8–%42.1, p = 0.002) and the incidence of moderate-severe BPD (%12.2–%21.9, p = 0.01) were lower in LISA-treated infants. LISA method was found as an independent factor in reducing mechanical ventilation requirement in the first 72 h of life and incidence of moderate-severe BPD [RR: −0.49 (%95 CI −0.28 to −0.85), p = 0.01]. ConclusionData obtained from our five-year clinical experience are comparable with the recent literature. LISA is currently the most suitable method of surfactant administration and it should be the first choice in spontaneously breathing infants considering its favorable effects on respiratory morbidities in preterm infants with RDS.