Comparison of the effect of surfactant administration during nasal continuous positive airway pressure with that of nasal continuous positive airway pressure alone on respiratory distress syndrome

• Main Authors: Ameer Isam Al Aasam (Author), Ruqeya Mohammed Obeyis (Author), Qasim Mohammed Hashim (Author), Jasim Mohammed Hashim (Author), Alaa Jumaah Manji Nasrawi (Author)
• Format: Book
• Published: Zaslavsky O.Yu., 2024-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2224-0551; 2307-1168; 10.22141/2224-0551.19.5.2024.1723
• Keywords: respiratory distress syndrome; surfactant; continuous positive airway pressure; premature newborns; Pediatrics; RJ1-570
• Source: Zdorovʹe Rebenka, Vol 19, Iss 5, Pp 287-292 (2024)

Background. The American Academy of Pediatrics states that prophylactic surfactant is no longer advised when continuous positive airway pressure (CPAP) is frequently used to stabilize preterm newborns and where the rate of prenatal corticosteroid is high. On the other hand, the European Consensus Guidelines on the Management of Respiratory Distress Syndrome (RDS) urge giving prophylactic surfactants to infants with RDS as early as possible. In this study, we aim to investigate the appropriate guidelines to be adopted in our neonatal intensive care unit about selective or elective INSURE (intubation-surfactant-extubation) method. Materials and methods. This is a clinical trial in which a total number of 120 neonate patients were diagnosed with RDS and had gestational age of 30-34 weeks. Two neonatal intensive care units have been included in the study: group A (n = 87) was treated with CPAP plus INSURE and group B (n = 33) was treated with CPAP only. The primary outcome we searched for is the fate of the patients. The secondary outcomes were length of hospital stay, CPAP management, oxygen therapy, and RDS complications. Results. Group B show a shorter length of hospital stay and CPAP treatment; however, this difference was not statistically significant. On the other hand, oxygen therapy duration was significantly shorter in group B than in group A. Both groups show very close rates of RDS complications (32 vs 33 %). Regarding the primary outcomes, group A had a better survival rate in comparison to group B (88.5 vs 78.8 %); however, this difference was not significant, with P-value of 0.173. Conclusions. In neonates with RDS, the routine INSURE method followed by CPAP gives no more superiority in outcomes (both primary, i.e. survival rate, and secondary, i.e. complications) than CPAP alone.