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Early surfactant in spontaneously breathing with nCPAP in ELBW infants – a single centre four year experience
Author(s) -
Kribs Angela,
Vierzig Anne,
Hünseler Christoph,
Eifinger Frank,
Welzing Lars,
Stützer Hartmut,
Roth Bernhard
Publication year - 2008
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00617.x
Subject(s) - medicine , bronchopulmonary dysplasia , continuous positive airway pressure , respiratory distress , demographics , ventilation (architecture) , pediatrics , pulmonary surfactant , anesthesia , gestational age , pregnancy , mechanical engineering , genetics , demography , physics , engineering , sociology , obstructive sleep apnea , biology , thermodynamics
Objective: To evaluate whether the experience with a method to administer surfactant during spontaneous breathing with nasal continuous positive airway pressure (nCPAP) as primary respiratory support in infants with respiratory distress syndrome (RDS) influences the frequency of its use and affects the outcome of patients. Methods: All inborn extremely low birthweight (ELBW) infants treated after introduction of the method were retrospectively studied (n = 196). The entire observational period was divided into four periods (periods 1–4) and compared with a control period (period 0) (n = 51). Primary respiratory support, demographics, prenatal risks and outcomes were compared. Results: There were no changes in demographics or prenatal risks over time. The choice of nCPAP as initial airway management significantly increased from 69% to 91% and for nCPAP with surfactant from 75% to 86%. The rate of nCPAP failure decreased from 46% to 25%. Survival increased significantly between periods 0 and 1 from 76% to 90% and survival without bronchopulmonary dysplasia (BPD) rose from 65% to 80%. No changes in nonpulmonary outcomes were observed. Conclusion: The success of nCPAP increased with increasing use of nCPAP with surfactant. Simultaneously, mortality decreased without deterioration of other outcomes indicating that the use of surfactant in spontaneous breathing with nCPAP could be beneficial.