Neonatal Med.  2018 Aug;25(3):109-117. 10.5385/nm.2018.25.3.109.

Clinical Outcomes of Minimally Invasive Surfactant Therapy via Tracheal Catheterization in Neonates with a Gestational Age of 30 Weeks or More Diagnosed with Respiratory Distress Syndrome

• Seo MY
• Shim GH
• Chey MJ

• KMID: 2436127
• DOI: http://doi.org/10.5385/nm.2018.25.3.109

Abstract

PURPOSE
Minimally invasive surfactant therapy (MIST) is currently used as a method of surfactant replacement therapy (SRT) for the treatment of respiratory distress syndrome (RDS) in preterm infants with a gestational age of less than 30 weeks. However, few studies have been conducted on MIST in neonates with a gestational age of 30 weeks or more. In this study, we compared MIST with endotracheal intubation as a rescue SRT for spontaneously breathing neonates with a gestational age of 30 weeks or more who were diagnosed with RDS.
METHODS
We investigated the clinical characteristics of spontaneously breathing neonates admitted to the neonatal intensive care unit of the Inje University Sanggye Paik Hospital from January 1, 2014 to December 31, 2016. These neonates were born at a gestational age of 30 weeks or more and were diagnosed with RDS. The neonates who were administered surfactant by MIST were categorized into the MIST group (n=16) and those who underwent endotracheal intubation were categorized into the control group (n=45). Thereafter, the clinical characteristics between the groups were compared.
RESULTS
Compared to the control group, the MIST group was less likely to require mechanical ventilation within 72 hours (P < 0.001). The frequency of bradycardia during SRT was also low in the MIST group (P=0.033).
CONCLUSION
MIST is considered relatively feasible and safe for treating RDS for reducing the need for mechanical ventilation and decreasing the occurrence of bradycardia during surfactant administration in neonates with a gestational age of 30 weeks or more.

Keyword

Noninvasive ventilation; Minimally invasive surfactant therapy; Respiratory distress syndrome; Mechanical ventilation; Bradycardia

MeSH Terms

Bradycardia
Catheterization*
Catheters*
Gestational Age*
Humans
Infant, Newborn*
Infant, Premature
Intensive Care, Neonatal
Intubation, Intratracheal
Methods
Noninvasive Ventilation
Respiration
Respiration, Artificial

Figure

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  Figure 1. Study population of this study and subgrouping by minimally invasive surfactant therapy (MIST) and control groups. Abbreviations: RDS, respiratory distress syndrome; SRT, surfactant replacement therapy; NICU, neonatal intensive care unit.

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  Figure 2. Neonatal clinical outcomes: (A) need for >1 dose of surfactant, (B) events for bradycardia, (C) mean duration of mechanical ventilation, (D) mean duration of hospitalization. Values are expressed as mean. *Statistically significant (P<0.05). Abbreviations: GA, gestational age; MIST, minimally invasive surfactant therapy.

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