Comparison of Outcomes of Less Invasive Surfactant Administration in Prematurely Born Infants in the Delivery Suite and the Neonatal Unit.

OBJECTIVE

This study aimed to compare outcomes of infants who received less invasive surfactant administration (LISA) in the delivery suite (LISA-DS) with those who received LISA on the neonatal unit (LISA-NNU).

STUDY DESIGN

A prospective cohort study was undertaken of all infants who received LISA in a single center. Clinical outcomes included admission temperature, the need for intubation, durations of invasive and noninvasive ventilation, length of hospital stay and the incidences of bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and requirement for home oxygen were compared between the two groups as were complications of the procedure.

RESULTS

The 54 LISA-DS infants had similar gestational ages and birth weights to the 26 LISA-NNU infants ( = 0.732, 0.928, respectively). There were no significant differences between the admission temperatures (median [range]: 36.8 [36-38.7] vs. 36.8°C [36.4-37.7];  = 0.451) or need for intubation in less than 72 hours of birth (28 vs. 23%,  = 0.656). The durations of invasive ventilation (median: 2 [0-65] vs. 1 [0-35] days;  = 0.188) and noninvasive ventilation (median: 37 [24-81] vs. 37 [3-225] days;  = 0.188) and the incidences of BPD ( = 0.818), IVH ( = 0.106), ROP ( = 0.526), and home oxygen requirement ( = 0.764) were similar. The percentage of successful first attempts with LISA (63 vs. 70%,  = 0.816) or associated with hypoxia episodes (32 vs. 42%,  = 0.194) did not differ significantly by site of administration.

CONCLUSION

The outcomes of LISA performed on the DS were similar to those of LISA performed on the NNU.

KEY POINTS

· Prematurely born infants who received LISA in the DS had comparable clinical outcomes to infants who received LISA on NNU.. · No significant differences in admission temperature was noticed in infants who received LISA, in DS versus NNU..