Less invasive surfactant administration and complications of preterm birth
Abstract In a large cohort study of the German Neonatal Network (GNN) we aimed to evaluate whether less invasive surfactant administration (LISA) strategy is associated with complications of preterm birth. Within the observational period n = 7533 very-low-birth-weight infants (VLBWI) with gestationa...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2018-05-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-018-26437-x |
| _version_ | 1818998807644340224 |
|---|---|
| author | Christoph Härtel Pia Paul Kathrin Hanke Alexander Humberg Angela Kribs Katrin Mehler Matthias Vochem Christian Wieg Claudia Roll Egbert Herting Wolfgang Göpel |
| author_facet | Christoph Härtel Pia Paul Kathrin Hanke Alexander Humberg Angela Kribs Katrin Mehler Matthias Vochem Christian Wieg Claudia Roll Egbert Herting Wolfgang Göpel |
| author_sort | Christoph Härtel |
| collection | DOAJ |
| description | Abstract In a large cohort study of the German Neonatal Network (GNN) we aimed to evaluate whether less invasive surfactant administration (LISA) strategy is associated with complications of preterm birth. Within the observational period n = 7533 very-low-birth-weight infants (VLBWI) with gestational age 22 0/7 to 28 6/7 weeks were enrolled in GNN; n = 1214 VLBWI never received surfactant, n = 2624 VLBWI were treated according to LISA procedure, n = 3695 VLBWI had surfactant via endotracheal tube (ETT). LISA was associated with a reduced risk for adverse outcome measures including mortality [odds ratio (OR) 0.66 (95% CI: 0.51–0.84), p < 0.001] bronchopulmonary dysplasia [BPD; OR 0.55 (95% CI: 0.49–0.62), p < 0.001], intracerebral hemorrhage (ICH) grade II-IV [OR 0.55 (95% CI: 0.48–0.64), p < 0.001] and retinopathy of prematurity [ROP; OR 0.62 (95% CI: 0.45–0.85), p < 0.001]. Notably, LISA was associated with an increased risk for focal intestinal perforation [FIP; OR 1.49 (95% CI: 1.14–1.95), p = 0.002]. The differences in FIP rates were primarily observed in VLBWI born <26 weeks (LISA: 10.0 vs. ETT: 7.4%, p = 0.029). Our observational data confirm that LISA is associated with improved outcome. In infants <26 weeks we noted an increased risk for FIP. Future randomized controlled trials including LISA need to integrate safety analyses for this particular subgroup. |
| first_indexed | 2024-12-20T22:07:24Z |
| format | Article |
| id | doaj.art-43ae25fa5b514f2ca99615232530b831 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-20T22:07:24Z |
| publishDate | 2018-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-43ae25fa5b514f2ca99615232530b8312022-12-21T19:25:15ZengNature PortfolioScientific Reports2045-23222018-05-01811710.1038/s41598-018-26437-xLess invasive surfactant administration and complications of preterm birthChristoph Härtel0Pia Paul1Kathrin Hanke2Alexander Humberg3Angela Kribs4Katrin Mehler5Matthias Vochem6Christian Wieg7Claudia Roll8Egbert Herting9Wolfgang Göpel10Department of Pediatrics, University of LübeckDepartment of Pediatrics, University of LübeckDepartment of Pediatrics, University of LübeckDepartment of Pediatrics, University of LübeckDepartment of Neonatology, University of CologneDepartment of Neonatology, University of CologneDepartment of Neonatology, Olga Hospital StuttgartDepartment of Neonatology, Klinikum AschaffenburgDepartment of Neonatology, Vest Children’s Hospital Datteln, University Witten-HerdeckeDepartment of Pediatrics, University of LübeckDepartment of Pediatrics, University of LübeckAbstract In a large cohort study of the German Neonatal Network (GNN) we aimed to evaluate whether less invasive surfactant administration (LISA) strategy is associated with complications of preterm birth. Within the observational period n = 7533 very-low-birth-weight infants (VLBWI) with gestational age 22 0/7 to 28 6/7 weeks were enrolled in GNN; n = 1214 VLBWI never received surfactant, n = 2624 VLBWI were treated according to LISA procedure, n = 3695 VLBWI had surfactant via endotracheal tube (ETT). LISA was associated with a reduced risk for adverse outcome measures including mortality [odds ratio (OR) 0.66 (95% CI: 0.51–0.84), p < 0.001] bronchopulmonary dysplasia [BPD; OR 0.55 (95% CI: 0.49–0.62), p < 0.001], intracerebral hemorrhage (ICH) grade II-IV [OR 0.55 (95% CI: 0.48–0.64), p < 0.001] and retinopathy of prematurity [ROP; OR 0.62 (95% CI: 0.45–0.85), p < 0.001]. Notably, LISA was associated with an increased risk for focal intestinal perforation [FIP; OR 1.49 (95% CI: 1.14–1.95), p = 0.002]. The differences in FIP rates were primarily observed in VLBWI born <26 weeks (LISA: 10.0 vs. ETT: 7.4%, p = 0.029). Our observational data confirm that LISA is associated with improved outcome. In infants <26 weeks we noted an increased risk for FIP. Future randomized controlled trials including LISA need to integrate safety analyses for this particular subgroup.https://doi.org/10.1038/s41598-018-26437-x |
| spellingShingle | Christoph Härtel Pia Paul Kathrin Hanke Alexander Humberg Angela Kribs Katrin Mehler Matthias Vochem Christian Wieg Claudia Roll Egbert Herting Wolfgang Göpel Less invasive surfactant administration and complications of preterm birth Scientific Reports |
| title | Less invasive surfactant administration and complications of preterm birth |
| title_full | Less invasive surfactant administration and complications of preterm birth |
| title_fullStr | Less invasive surfactant administration and complications of preterm birth |
| title_full_unstemmed | Less invasive surfactant administration and complications of preterm birth |
| title_short | Less invasive surfactant administration and complications of preterm birth |
| title_sort | less invasive surfactant administration and complications of preterm birth |
| url | https://doi.org/10.1038/s41598-018-26437-x |
| work_keys_str_mv | AT christophhartel lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT piapaul lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT kathrinhanke lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT alexanderhumberg lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT angelakribs lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT katrinmehler lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT matthiasvochem lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT christianwieg lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT claudiaroll lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT egbertherting lessinvasivesurfactantadministrationandcomplicationsofpretermbirth AT wolfganggopel lessinvasivesurfactantadministrationandcomplicationsofpretermbirth |