Effect of Surfactant Therapy Using Orogastric Tube for Tracheal Catheterization in Preterm Newborns with Respiratory Distress.

OBJECTIVE

To assess the outcome of a modified method of Minimally Invasive Surfactant Therapy (MIST) therapy where an orogastric tube was used for tracheal catherization to deliver surfactant in preterm newborns less than 34 wk of gestation with respiratory distress syndrome (RDS).

METHODS

A single centre, prospective observational study was conducted to enroll eligible inborn preterm neonates with gestation age more than 24 wk but less than 34 wk and suffering from RDS to receive surfactant using MIST. Results were compared with a historical cohort of preterms who received surfactant with InSurE (Intubate, Surfactant, Extubate) technique.

RESULTS

Sixty four cases in the modified MIST group were compared with a historic cohort of 68 cases in the InSurE group. There were no differences in the requirement of intubation and mechanical ventilation (MV) in the first 72 h but the duration of MV and continuous positive airway pressure (CPAP) were significantly less in modified MIST group. Other neonatal morbidities and mortality rates were similar in either of the groups.

CONCLUSIONS

The modified MIST technique is an effective method for the treatment of RDS in preterms with better clinical efficacy and comparable outcomes than the more invasive InSurE procedure and deserves further evaluation.