Carlo Dani1, Fabio Mosca2, Giovanni Vento3, Paolo Tagliabue4, Simonetta Picone5, Gianluca Lista6, Vassilios Fanos7, Simone Pratesi8, Luca Boni9,10. 1. a Department of Neurosciences, Psychology , Drug Research and Child Health, University of Florence , Florence , Italy. 2. b Department of Clinical Sciences and Community Health, NICU , Università degli Studi di Milano , Milan , Italy. 3. c Division of Neonatology , Fondazione Policlinico Universitario A. Gemelli-Università Cattolica del Sacro Cuore , Rome , Italy. 4. d Neonatology and Neonatal Intensive Care Unit , MBBM Foundation , Monza , Italy. 5. e Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care , Casilino General Hospital, ASL RM B , Roma , Italy. 6. f Division of Neonatology , "V. Buzzi" Children's Hospital - ASST FBF/Sacco , Milan , Italy. 7. g Neonatal Intensive Care Unit, Institute of Puericulture and Neonatal Section, Department of Surgery , University of Cagliari , Cagliari , Italy. 8. h Division of Neonatology , Careggi University Hospital of Florence , Florence , Italy. 9. i Clinical Trials Coordinating Center , Istituto Toscano Tumori , Florence , Italy. 10. j Department of Human Pathology and Oncology , University of Florence , Florence , Italy.
Abstract
OBJECTIVE: To evaluate surfactant effectiveness for the treatment of respiratory distress syndrome (RDS) in late preterm infants. METHODS: We performed a retrospective cohort study of infants born between 34+0 and 36+6 weeks of gestation admitted for respiratory failure in seven perinatal centers from January 2010 to December 2014. We evaluated changes of FiO2, PaO2 and a/APO2 in surfactant-treated patients, and the need and duration of MV, the duration of noninvasive respiratory support, stay in NICU and in hospital in surfactant-treated and untreated late preterm infants with RDS alone. RESULTS: We studied 562 infants with RDS, 252 (45%) were treated with surfactant and 310 (55%) were not. FiO2, PaO2 and a/APO2 significantly improved after surfactant treatment. The adjusted odds ratio for the need of MV and the adjusted differences of duration of noninvasive respiratory support, and of NICU and hospital stay were not different in the surfactant and non-surfactant groups. CONCLUSIONS: Surfactant therapy was followed by a quick and persisting significant improvement of respiratory function in late preterm infants with RDS. Surfactant did not improve short-term outcomes in our population probably because other factors such as the gestational age, occurrence of complications and poor feeding play a relevant role.
OBJECTIVE: To evaluate surfactant effectiveness for the treatment of respiratory distress syndrome (RDS) in late preterm infants. METHODS: We performed a retrospective cohort study of infants born between 34+0 and 36+6 weeks of gestation admitted for respiratory failure in seven perinatal centers from January 2010 to December 2014. We evaluated changes of FiO2, PaO2 and a/APO2 in surfactant-treated patients, and the need and duration of MV, the duration of noninvasive respiratory support, stay in NICU and in hospital in surfactant-treated and untreated late preterm infants with RDS alone. RESULTS: We studied 562 infants with RDS, 252 (45%) were treated with surfactant and 310 (55%) were not. FiO2, PaO2 and a/APO2 significantly improved after surfactant treatment. The adjusted odds ratio for the need of MV and the adjusted differences of duration of noninvasive respiratory support, and of NICU and hospital stay were not different in the surfactant and non-surfactant groups. CONCLUSIONS: Surfactant therapy was followed by a quick and persisting significant improvement of respiratory function in late preterm infants with RDS. Surfactant did not improve short-term outcomes in our population probably because other factors such as the gestational age, occurrence of complications and poor feeding play a relevant role.
Entities:
Keywords:
Late preterm; infant; respiratory distress syndrome; surfactant
Authors: Wesley Jackson; Genevieve Taylor; Nicolas A Bamat; Kanecia Zimmerman; Reese Clark; Daniel K Benjamin; Matthew M Laughon; Rachel G Greenberg; Christoph P Hornik Journal: J Perinatol Date: 2020-02-20 Impact factor: 2.521
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