TY - JOUR
T1 - Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants
AU - Göpel, Wolfgang
AU - Kribs, Angela
AU - Härtel, Christoph
AU - Avenarius, Stefan
AU - Teig, Norbert
AU - Groneck, Peter
AU - Olbertz, Dirk
AU - Roll, Claudia
AU - Vochem, Matthias
AU - Weller, Ursula
AU - Von Der Wense, Axel
AU - Wieg, Christian
AU - Wintgens, Jürgen
AU - Preuss, Michael
AU - Ziegler, Andreas
AU - Roth, Bernhard
AU - Herting, Egbert
N1 - Publisher Copyright:
©2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Aim 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. Methods 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 U-tests and adjusted for multiple comparisons. Results 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. Conclusion 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.
AB - Aim 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. Methods 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 U-tests and adjusted for multiple comparisons. Results 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. Conclusion 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.
UR - http://www.scopus.com/inward/record.url?scp=84923083374&partnerID=8YFLogxK
U2 - 10.1111/apa.12883
DO - 10.1111/apa.12883
M3 - Journal articles
C2 - 25474712
AN - SCOPUS:84923083374
SN - 0803-5253
VL - 104
SP - 241
EP - 246
JO - Acta Paediatrica, International Journal of Paediatrics
JF - Acta Paediatrica, International Journal of Paediatrics
IS - 3
ER -