Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy?
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 INt...
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| Format: | Article |
| Language: | English |
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Korean Society of Neonatology
2022-02-01
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| Series: | Neonatal Medicine |
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| Online Access: | http://neo-med.org/upload/pdf/nm-2022-29-1-46.pdf |
| _version_ | 1797998962940051456 |
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| author | Hyung-Joon Joo Gyu Hong Shim |
| author_facet | Hyung-Joon Joo Gyu Hong Shim |
| author_sort | Hyung-Joon Joo |
| collection | DOAJ |
| description | 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 (P=0.019) and at any time (P=0.025), lower frequency of bradycardia during SRT (P=0.031), and lower median duration of MV than the INSURE group (P=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; P=0.046) and a decreased frequency of bradycardia during SRT (OR, 0.020; 95% CI, 0.001 to 0.535; P=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. |
| first_indexed | 2024-04-11T10:57:05Z |
| format | Article |
| id | doaj.art-13de558cb2154fa9bbe666bf7f26cdb8 |
| institution | Directory Open Access Journal |
| issn | 2287-9412 2287-9803 |
| language | English |
| last_indexed | 2024-04-11T10:57:05Z |
| publishDate | 2022-02-01 |
| publisher | Korean Society of Neonatology |
| record_format | Article |
| series | Neonatal Medicine |
| spelling | doaj.art-13de558cb2154fa9bbe666bf7f26cdb82022-12-22T04:28:44ZengKorean Society of NeonatologyNeonatal Medicine2287-94122287-98032022-02-01291465410.5385/nm.2022.29.1.461056Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy?Hyung-Joon Joo0Gyu Hong Shim1 Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, KoreaPurpose 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 (P=0.019) and at any time (P=0.025), lower frequency of bradycardia during SRT (P=0.031), and lower median duration of MV than the INSURE group (P=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; P=0.046) and a decreased frequency of bradycardia during SRT (OR, 0.020; 95% CI, 0.001 to 0.535; P=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.http://neo-med.org/upload/pdf/nm-2022-29-1-46.pdfrespiratory distress syndromepreterm infantspulmonary surfactantbradycardia |
| spellingShingle | Hyung-Joon Joo Gyu Hong Shim Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? Neonatal Medicine respiratory distress syndrome preterm infants pulmonary surfactant bradycardia |
| title | Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? |
| title_full | Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? |
| title_fullStr | Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? |
| title_full_unstemmed | Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? |
| title_short | Is Less Invasive Surfactant Administration Better than INtubation-SURfactant-Extubation for Prophylactic Surfactant Replacement Therapy? |
| title_sort | is less invasive surfactant administration better than intubation surfactant extubation for prophylactic surfactant replacement therapy |
| topic | respiratory distress syndrome preterm infants pulmonary surfactant bradycardia |
| url | http://neo-med.org/upload/pdf/nm-2022-29-1-46.pdf |
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