Zhihui Rong1, Liwen Chang1, Hongbin Cheng2, Huizhen Wang3, Xiaofang Zhu4, Fen Peng5, Qihong Fan6, Wei Lu7, Rui Pan8, Li Xiong9, Rong Jiao10, Jie Sun11, Shiwen Xia12, Jijian Xie13. 1. Neonatal Intensive Care Unit, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China. 2. Neonatal Intensive Care Unit, Huangshi Maternity and Children's Healthy Hospital, Huangshi, Hubei, China. 3. Neonatal Intensive Care Unit, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. 4. Neonatal Intensive Care Unit, Jingzhou Central Hospital, Jingzhou, Hubei, China. 5. Neonatal Intensive Care Unit, University Hospital of Hubei University for Nationalities, Wuhan, Hubei, China. 6. Neonatal Intensive Care Unit, The First Affiliated Hospital of Yangtze University, The First People's Hospital of Jingzhou, Jingzhou, Hubei, China. 7. Neonatal Intensive Care Unit, The First Clinical Medical School of the Three Gorges University Yichang Central People's Hospital, Yichang, Hubei, China. 8. Neonatal Intensive Care Unit, Xiangyang Central Hospital, Xiangyang, Hubei, China. 9. Neonatal Intensive Care Unit, The First People's Hospital of Tianmen, Tianmen, Hubei, China. 10. Neonatal Intensive Care Unit, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, Hubei, China. 11. Neonatal Intensive Care Unit, Huanggang Central Hospital, Huanggang, Hubei, China. 12. Neonatal Intensive Care Unit, Hubei Maternal and Child Health Hospital, Wuhan, Hubei, China. 13. Neonatal Intensive Care Unit, Taihe Hospital, Shiyan, Hubei, China.
Abstract
OBJECTIVE:Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS. STUDY DESIGN:Preterm infants born between 260/7 and 326/7 weeks of gestation and needed nasal continuous positive airway pressure (nCPAP) immediately after birth were randomly assigned to the early or rescue Calsurf treatment group. In the early treatment group, neonates were intubated, administered surfactant with bag-mask ventilation, and extubated to nCPAP (INSURE [intubation-surfactant-extubation]). In the rescue treatment group, InSurE was given until the clinical manifestation and chest X-ray displayed RDS. The primary outcome was to compare the reintubation rate within 72 hour age between the two groups. RESULTS: Among 305 neonates randomized to the early (n = 154) and rescue (n = 151) groups, the reintubation rate within 72 hours of age in these two groups did not differ significantly (p > 0.05). The incidence of oxygen dependence until 36 weeks' corrected age was similar in both groups. CONCLUSION: No differences were observed between early and rescue Calsurf treatment groups with respect to the reintubation rate within 72 hours of age and the incidence of bronchopulmonary dysplasia. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
RCT Entities:
OBJECTIVE: Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS. STUDY DESIGN: Preterm infants born between 260/7 and 326/7 weeks of gestation and needed nasal continuous positive airway pressure (nCPAP) immediately after birth were randomly assigned to the early or rescue Calsurf treatment group. In the early treatment group, neonates were intubated, administered surfactant with bag-mask ventilation, and extubated to nCPAP (INSURE [intubation-surfactant-extubation]). In the rescue treatment group, InSurE was given until the clinical manifestation and chest X-ray displayed RDS. The primary outcome was to compare the reintubation rate within 72 hour age between the two groups. RESULTS: Among 305 neonates randomized to the early (n = 154) and rescue (n = 151) groups, the reintubation rate within 72 hours of age in these two groups did not differ significantly (p > 0.05). The incidence of oxygen dependence until 36 weeks' corrected age was similar in both groups. CONCLUSION: No differences were observed between early and rescue Calsurf treatment groups with respect to the reintubation rate within 72 hours of age and the incidence of bronchopulmonary dysplasia. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.