Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants. (March 2015)

• Record Type: Journal Article
• Authors: Göpel, Wolfgang; Kribs, Angela; Härtel, Christoph; Avenarius, Stefan; Teig, Norbert; Groneck, Peter; Olbertz, Dirk; Roll, Claudia; Vochem, Matthias; Weller, Ursula; von der Wense, Axel; Wieg, Christian; Wintgens, Jürgen; Preuss, Michael; Ziegler, Andreas; Roth, Bernhard; Herting, Egbert; for the German Neonatal Network (GNN)
• Is Part Of: Acta pædiatrica. Volume 104:Number 3(2015:Mar.)
• Page Start: 241
• Page End: 246
• Publication Date: 2015-03
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12883
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12883-abs-0001"> <title>Abstract</title> <sec id="apa12883-sec-0001" sec-type="section"> <title>Aim</title> <p>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.</p> </sec> <sec id="apa12883-sec-0002" sec-type="section"> <title>Methods</title> <p>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 <italic>U</italic>‐tests and adjusted for multiple comparisons.</p> </sec> <sec id="apa12883-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="apa12883-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>