Observation of the therapeutic effect of less invasive surfactant administration on respiratory distress syndrome in extremely premature infants

DOI: 10.12201/bmr.202410.00018

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  Abstract: Objective: To observe the clinical efficacy and safety of less invasive surfactant administration (LISA) in the treatment of respiratory distress syndrome in extremely premature infants. Method: A prospective study was conducted on premature infants diagnosed with RDS admitted to the neonatal intensive care unit of Xiaogan Central Hospital from January 2021 to December 2023, with gestational age of 28+0~31+6W. They were randomly divided into the LISA group and the intubation administration of surfactant extubation (InSurE) group. The incidence of adverse events, blood gas analysis before and after administration, pulse oxygen saturation (SPO2), changes in blood pressure, clinical efficacy, complications, and outcomes were compared between the two groups.Result: A total of 65 cases were included, with 33 cases in the LISA group and 32 cases in the InSurE group. There was no statistically significant difference in the incidence of drug reflux, bradycardia, apnea, or SPO2<80% between the two groups of operations (P>0.05); During the operation, the SPO2 of the LISA group was lower than that of the InSurE group, and the blood pressure monitoring at the 2nd and 4th minutes was lower than that of the InSurE group at the corresponding time points, with statistically significant differences (P<0.05). After 1 hour of treatment, the PaO2 in the LISA group was higher than that in the InSurE group, and the PaCO2 was lower than that in the InSurE group, with statistically significant differences (P<0.05). The mechanical ventilation ratio and oxygen therapy time within 72 hours in the LISA group were lower than those in the InSurE group, and the differences were statistically significant (P<0.05); There was no statistically significant difference in the reuse rate of PS, NCPAP treatment time, and hospitalization time between the two groups (P>0.05). The incidence of grade 3-4 intraventricular hemorrhage in the LISA group was lower than that in the InSurE group, and the difference was statistically significant (P<0.05); There was no statistically significant difference in the incidence of other complications between the two groups (P>0.05). Conclusion: Less invasive PS treatment for extremely premature infants with RDS can reduce the incidence of mechanical ventilation, shorten oxygen therapy time, and reduce the occurrence of severe PIVH.

  Key words: Respiratory distress syndrome; Extremely premature infants; pulmonary surfactant; LISA; InSurE; 

  Submit time: 8 October 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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