Perinatology.  2022 Mar;33(1):27-36. 10.14734/PN.2022.33.1.27.

A Single Center Experience of Less Invasive Surfactant Administration during 6-Year

• Bae E
• Shim GH

• KMID: 2527754
• DOI: http://doi.org/10.14734/PN.2022.33.1.27

Abstract

Objective
The aim of this study was to evaluate the feasibility, efficacy, and safety of less invasive surfactant administration (LISA) in preterm and term infants with respiratory distress syndrome (RDS).
Methods
We retrospectively investigated preterm and term infants born at a gestational age of 25 weeks or above who were diagnosed with RDS and admitted to the neonatal intensive care unit from January 1, 2015 to December 31, 2020. Of 277 patients, 124 were administered pulmonary surfactant by LISA (LISA group), and 153 were administered by endotracheal intubation (ETT, ETT group). We compared the clinical characteristics, adverse effects, and morbidities of the 2 groups.
Results
The LISA group had lower rates of invasive mechanical ventilation (IMV) at 72 hours after birth (P<0.001) and during hospitalization (P<0.001), higher frequency of the need for a second dose of surfactant (P=0.022), lower prevalence of periventricular leukomalacia (PVL, P=0.042), longer duration of noninvasive ventilation (NIV, P=0.003), and longer duration of IMV (P=0.014) than the ETT group. There were no significant differences in reflux, bradycardia, or decreased oxygen saturation during surfactant replacement therapy. In multivariate analysis, the LISA group also had lower rates of IMV at 72 hours after birth (P<0.001; adjusted odds ratio [aOR], 0.063; 95% confidence interval [CI], 0.033-0.122) and during hospitalization (P<0.001; aOR, 0.040; 95% CI, 0.018-0.089).
Conclusion
The LISA method may reduce the exposure to IMV in infants with RDS born after 25 weeks of gestation including late preterm and term infants.

Keyword

Pulmonary surfactants; Respiratory distress syndrome; Noninvasive ventilation; Mechani cal ventilation