Comparison of Beractant Administration by Thin Catheter vs Intubation-Surfactant-Extubation (INSURE) in Preterm Infants Less than 34 Weeks Gestational Age with Respiratory Distress Syndrome - A Single Centre Experience.
J Neonatal Perinatal Med
; 16(2): 239-245, 2023.
Article
en En
| MEDLINE
| ID: mdl-37270819
ABSTRACT
BACKGROUND:
Poractant administration with thin catheter is gradually gaining popularity compared to the INSURE technique. However, there is little evidence to use thin catheters for administration of beractant. With this background, we compared the effect of beractant administration with INSURE vs thin catheter in preterm infants less than 34 weeks with RDS on death/chronic lung disease (CLD).METHODS:
This prospective cohort study was conducted in a tertiary NICU where inborn preterm infants≤34 weeks with RDS receiving beractant by INSURE or thin catheter were studied over two epochs- Epoch1- INSURE (Jan 2020-Oct 2020) & Epoch 2- Surfactant through thin catheter (Nov 2020-July 2021).The primary outcome was occurrence of death/CLD. Procedure related complications like transient bradycardia/desaturation, pneumothorax, failure of procedure, rates of other outcomes like failure of CPAP within 72hr, duration of invasive mechanical ventilation/ CPAP support, oxygen supplementation, other major neonatal morbidities & mortality were evaluated as secondary outcomes.RESULTS:
The combined outcome of death/CLD was significantly lower in the thin catheter epoch (RR 0.56, 95% CI 0.34-0.90, pâ=â0.012). When analyzed independently for death/CLD, we found significantly lower number of deaths in the thin catheter epoch (RR 0.44, 95% CI 0.23-0.83, pâ=â0.008). Number of infants who failed CPAP within 72âhrs of life was lower in thin catheter epoch (RR 0.59, 95% CI 0.41-0.85, pâ=â0.003). Transient bradycardia/desaturation was higher during thin catheter technique (RR 4.17, 95% CI 2.22-7.69, pâ<â0.001). Incidence of severe IVH was lower with thin catheter technique (RR 0.13, 95% CI 0.02-0.98, pâ=â0.034).CONCLUSION:
Beractant administration by thin catheter reduces combined outcome of death/CLD.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Síndrome de Dificultad Respiratoria del Recién Nacido
/
Surfactantes Pulmonares
/
Enfermedades Pulmonares
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
/
Newborn
Idioma:
En
Revista:
J Neonatal Perinatal Med
Año:
2023
Tipo del documento:
Article