Division of Neonatology, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Neonatology. 2024;121(4):530-535. doi: 10.1159/000537904. Epub 2024 Apr 10.
Less invasive surfactant application (LISA) is associated with improved short-term outcomes in preterm infants. Data on LISA eligibility and success for infants <28 weeks of gestation are lacking.
Preterm infants <28 weeks of gestation who were born and actively treated in our tertiary care center in 2018 were included in the retrospective study. We assessed baseline characteristics, delivery room (DR) management, LISA success and complications, and short-term outcome.
In total, 57 infants received LISA in the DR. LISA eligibility was 73% at 22 weeks, 88% at 23 weeks, and >90% at gestational ages >24 weeks. LISA was successful in 63% of infants. LISA failure was associated with increased risk for high-grade IVH (OR 17.88), death (OR 10.94), and a reduced chance for survival without complications (OR 8.75).
Our report justifies LISA as a mode for surfactant application in preterm infants. It contributes to the call for studies to define risk factors for LISA failure.
微创表面活性剂应用(LISA)与早产儿短期预后改善相关。缺乏 <28 孕周婴儿 LISA 适应证和成功率的数据。
本回顾性研究纳入了 2018 年在我们三级医疗中心出生并积极治疗的 <28 孕周的早产儿。我们评估了基线特征、产房(DR)管理、LISA 成功率和并发症以及短期结局。
共有 57 名婴儿在 DR 中接受了 LISA。22 周时 LISA 适应证为 73%,23 周时为 88%,>24 周时 >90%。63%的婴儿 LISA 成功。LISA 失败与高等级 IVH(OR 17.88)、死亡(OR 10.94)的风险增加以及无并发症生存机会降低(OR 8.75)相关。
本报告证明 LISA 是早产儿表面活性剂应用的一种模式。它有助于呼吁开展研究来确定 LISA 失败的危险因素。