Short-Term Outcome after Repeated Less Invasive Surfactant Administration: A Retrospective Cohort Study

L.P.M. Kleijkers, Jooske Van Der Spil, Lobke C.E. Janssen, Jeanne P. Dieleman, Peter Andriessen, Anton H. van Kaam, Wes Onland, Hendrik J. Niemarkt (Corresponding author)

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

4 Citaten (Scopus)


Introduction: Less invasive surfactant administration (LISA) to preterm infants is associated with decreased risk for death or BPD. After LISA, a considerable proportion requires a second dose of surfactant because of ongoing respiratory distress syndrome, raising a clinical dilemma between intubation or performing a repeated LISA (re-LISA) procedure. We aim to assess efficacy of re-LISA in avoiding subsequent nasal continuous positive airway pressure failure (need for intubation in the first 72 h of life; CPAP-F), to identify factors associated with subsequent CPAP-F, and to compare short-term outcomes following re-LISA to surfactant retreatment by endotracheal intubation and mechanical ventilation. Methods: This was an observational retrospective study in two Dutch NICUs. Inclusion criterion was infants with gestational age <32 0/7 weeks requiring a second surfactant dose. Multivariate logistic regression analysis was performed. Results: Of 209 infants requiring second surfactant dose, 132 received re-LISA. Subsequent CPAP-F was observed in 56 (42%) infants and was associated with extreme prematurity (OR 2.6, 95% CI: 1.2-5.8) and FiO2>0.5 (OR 5.4, 95% CI: 2.0-14.7). Infants receiving re-LISA had a lower risk of death or BPD compared to infants intubated for the second surfactant dose (OR 0.4, 95% CI: 0.2-0.9). Infants with CPAP-F after re-LISA had similar outcomes compared to those intubated for second surfactant dose. Conclusion: Re-LISA is effective in reducing CPAP-F and is associated with lower risk of death or BPD compared to retreatment via an endotracheal tube. Infants failing CPAP after re-LISA have similar outcomes compared to intubated infants. These findings support the use of re-LISA in preterm infants with ongoing RDS.

Originele taal-2Engels
Pagina's (van-tot)719-726
Aantal pagina's8
Nummer van het tijdschrift6
Vroegere onlinedatum20 sep. 2022
StatusGepubliceerd - dec. 2022


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