Abstract
BackgroundRespiratory distress syndrome (RDS) is a frequent complication of premature birth. Treating RDS by continuous positive airway pressure and less invasive surfactant administration (LISA) may reduce bronchopulmonary dysplasia. Surfactant, however, can be inactivated by bacterial infection. Therefore, potential routes of microbe transmission into the airway are of interest. The aim of this study was to evaluate microbiological contamination of catheters used for LISA procedures and its association with postnatal age.MethodsCatheter tips used for LISA procedures via the nasal route (LISA-n) in infants with RDS were placed into a sterile eSwab container directly after the procedure, cultured and examined for microbiological contamination.ResultsInterpretable results could be collected from 20 catheter tips. Four showed positive culture results (20%) with microbes potentially associated with the development of early onset neonatal sepsis. Risk of positive microbe detection increased with postnatal age (< 4 h: 10%; 4–18 h: 20%; > 18 h: 40%).ConclusionsIn this pilot study, the risk of tracheal microbe transmission following the LISA-n procedure increased with postnatal age. Although the clinical relevance of this finding is unclear, earlier surfactant administration might reduce the risk of catheter contamination.Trial registration numberSubstudy of the registered Trial: feasibility study – Neofact: NCT04086095, www.ClinicalTrials.gov, September 11, 2019.
Highlights
Respiratory distress syndrome (RDS) is a frequent complication of premature birth
Recent evidence suggests that RDS is best treated by continuous positive airway pressure (CPAP) combined with less invasive surfactant administration (LISA, [1,2,3])
Most reports using this approach administered surfactant via a thin catheter (TCA, [3,4,5,6]); this was favored in a recent update of the European Consensus Guidelines on the Management of Respiratory Distress Syndrome [4]
Summary
Respiratory distress syndrome (RDS) is a frequent complication of premature birth. Treating RDS by continuous positive airway pressure and less invasive surfactant administration (LISA) may reduce bronchopulmonary dysplasia. Recent evidence suggests that RDS is best treated by continuous positive airway pressure (CPAP) combined with less invasive surfactant administration (LISA, [1,2,3]). Most reports using this approach administered surfactant via a thin catheter (TCA, [3,4,5,6]); this was favored in a recent update of the European Consensus Guidelines on the Management of Respiratory Distress Syndrome [4].
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