Amelie Stritzke1, Khorshid Mohammad1, Prakesh S Shah2, Xiang Y Ye3, Vineet Bhandari4, Albert Akierman1, Adele Harrison5, Valerie Bertelle6, Abhay Lodha1,7. 1. a Department of Pediatrics, Section of Neonatology, Foothills Medical Centre , Cumming School of Medicine, University of Calgary , Calgary , Canada. 2. b Department of Paediatrics , Institute of HPME, University of Toronto, Mount Sinai Hospital , Toronto , Canada. 3. c Samuel Lunenfeld-Tanenbaum Research Institute , Mount Sinai Hospital , Toronto , Canada. 4. d Section of Neonatal-Perinatal Medicine, Drexel University College of Medicine, St. Christopher's Hospital for Children , Philadelphia , PA , USA. 5. e Victoria General Hospital , Victoria , British Columbia , Canada. 6. f Faculté de Médecine de l'Université de Sherbrooke CIUSS Estrie-CHUS , Sherbrooke, Québec , Canada. 7. g Department of Pediatrics & Community Health Sciences , University of Calgary, Alberta Children's Hospital Research Institute , Calgary , Canada.
Abstract
BACKGROUND: Use, timing and doses of surfactant in preterm infants are variable in practice in modern NICUs. OBJECTIVE: The objective of this study is to explore the association between use and timing of surfactant administration and common neonatal adverse outcomes in preterm infants with gestational age (GA) < 28 weeks. MATERIAL AND METHODS: Neonates admitted to a participating Canadian Neonatal Network NICU between 2013 and 2015 were studied. Infants were divided into three groups based on surfactant administration: none, early (within 30 min of life), and late surfactant (>30 min). The primary outcome was a composite of ≥2 predefined outcomes: bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) and severe neurological injury (intraventricular hemorrhage or intraventricular hemorrhage (IVH) grade III/IV ± periventricular leukomalacia). RESULTS: Of 2512 eligible neonates, 430 were in the early, and 1228 were in the late surfactant group. There was no difference in the primary outcome (p = .88). There was a slightly lower risk of late onset sepsis [25% versus 29%, adjusted odds ratio (aOR): 0.8; 95% CI: 0.6-0.9] and ROP (12.4 versus 15%, aOR: 0.7; 95% CI: 0.5-0.9) in the early surfactant group. CONCLUSIONS: In preterm neonates, early administration of surfactant within 30 min of life was not associated with an increased risk of the primary composite outcome, but did have decreased rates of late onset sepsis and ROP.
BACKGROUND: Use, timing and doses of surfactant in preterm infants are variable in practice in modern NICUs. OBJECTIVE: The objective of this study is to explore the association between use and timing of surfactant administration and common neonatal adverse outcomes in preterm infants with gestational age (GA) < 28 weeks. MATERIAL AND METHODS: Neonates admitted to a participating Canadian Neonatal Network NICU between 2013 and 2015 were studied. Infants were divided into three groups based on surfactant administration: none, early (within 30 min of life), and late surfactant (>30 min). The primary outcome was a composite of ≥2 predefined outcomes: bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) and severe neurological injury (intraventricular hemorrhage or intraventricular hemorrhage (IVH) grade III/IV ± periventricular leukomalacia). RESULTS: Of 2512 eligible neonates, 430 were in the early, and 1228 were in the late surfactant group. There was no difference in the primary outcome (p = .88). There was a slightly lower risk of late onset sepsis [25% versus 29%, adjusted odds ratio (aOR): 0.8; 95% CI: 0.6-0.9] and ROP (12.4 versus 15%, aOR: 0.7; 95% CI: 0.5-0.9) in the early surfactant group. CONCLUSIONS: In preterm neonates, early administration of surfactant within 30 min of life was not associated with an increased risk of the primary composite outcome, but did have decreased rates of late onset sepsis and ROP.
Entities:
Keywords:
Bronchopulmonary dysplasia; neonatal intensive care unit; premature Infant; retinopathy of prematurity; surfactant
Authors: Hani B AlBalawi; Nada S AlBalawi; Nada A AlSuhaimi; Amani A AlBalawi; Amani S AlAtawi; Hyder O Mirghani; Hassan A Al-Dhibi; Saad H AlEnezi Journal: Middle East Afr J Ophthalmol Date: 2020-07-20
Authors: Fernando R Moya; Jan Mazela; Paul M Shore; Steven G Simonson; Robert Segal; Phillip D Simmons; Timothy J Gregory; Carlos G Guardia; Judy R Varga; Neil N Finer Journal: BMC Pediatr Date: 2019-05-11 Impact factor: 2.125