Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants.

Abstract

AIM:

Providing less invasive surfactant administration (LISA) to spontaneously breathing preterm infants has been reported to reduce mechanical ventilation and bronchopulmonary dysplasia (BPD) in randomised controlled trials. This large cohort study compared these outcome measures between LISA-treated infants and controls.

METHODS:

Infants receiving LISA, who were born before 32 gestational weeks and enrolled in the German Neonatal Network, were matched to control infants by gestational age, umbilical cord pH, Apgar-score at 5 min, small for gestational age status, antenatal treatment with steroids, gender and highest supplemental oxygen during the first 12 h of life. Outcome data were compared with chi-square and Mann-Whitney U-tests and adjusted for multiple comparisons.

RESULTS:

Between 2009 and 2012, 1103 infants were treated with LISA at 37 centres. LISA infants had lower rates of mechanical ventilation (41% versus 62%, p < 0.001), postnatal dexamethasone treatment (2.5% versus 7%, p < 0.001), BPD (12% versus 18%, p = 0.001) and BPD or death (14% versus 21%, p < 0.001) than the controls.

CONCLUSION:

Surfactant treatment of spontaneously breathing infants was associated with lower rates of mechanical ventilation and BPD. Additional large-scale randomised controlled trials are needed to assess the possible long-term benefits of LISA.

• Authors: Wolfgang Göpel, Angela Kribs, Christoph Härtel, Stefan Avenarius, Norbert Teig, Peter Groneck, Dirk Olbertz, Claudia Roll, Matthias Vochem, Ursula Weller, Axel von der Wense, Christian Wieg, Jürgen Wintgens, Michael Preuss, Andreas Ziegler, Bernhard Roth, Egbert Herting, German Neonatal Network (GNN)
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 104 Issue 3 Pg. 241-6 (Mar 2015) ISSN: 1651-2227 [Electronic] Norway
• PMID: 25474712 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Video-Audio Media)
• Copyright: ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Chemical References

• Pulmonary Surfactants

Topics

• Bronchopulmonary Dysplasia (etiology, prevention & control)
• Female
• Humans
• Infant, Newborn
• Infant, Premature
• Male
• Matched-Pair Analysis
• Prospective Studies
• Pulmonary Surfactants (administration & dosage, therapeutic use)
• Respiration
• Respiration, Artificial (statistics & numerical data)
• Respiratory Distress Syndrome, Newborn (complications, prevention & control)
• Treatment Outcome