Abstract
Purpose: The study aimed to examine whether prophylactic surfactant replacement therapy (SRT) with less invasive surfactant administration (LISA) by tracheal catheterization in a group of spontaneously breathing preterm infants would improve clinical outcomes compared to prophylactic SRT with the INtubation-SURfactantExtubation (INSURE) method.Methods: We compared 20 spontaneously breathing preterm infants, 25 to 29 weeks of gestation or with a birth weight of less than 1,250 g, treated with prophylactic SRT using a gastric tube (LISA group), to the 20 spontaneously breathing preterm infants matched by gestational age and birth weight, managed with prophylactic SRT via the INSURE method (INSURE group, historical control).Results: The LISA group had lower rates of mechanical ventilation (MV) 72 hours after birth (<i>P</i>=0.019) and at any time (<i>P</i>=0.025), lower frequency of bradycardia during SRT (<i>P</i>=0.031), and lower median duration of MV than the INSURE group (<i>P</i>=0.038). In multivariate analysis, the LISA method was associated with a significantly lower likelihood of receiving invasive ventilation during hospitalization (odds ratio [OR], 0.029; 95% confidence interval [CI], 0.001 to 0.938; <i>P</i>=0.046) and a decreased frequency of bradycardia during SRT (OR, 0.020; 95% CI, 0.001 to 0.535; <i>P</i>=0.020) as compared to the INSURE method.Conclusion: Prophylactic SRT using LISA via tracheal catheterization in preterm infants may significantly reduce exposure to MV during hospitalization and bradycardia during surfactant administration.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have