Early surfactant in spontaneously breathing with nCPAP in ELBW infants – a single centre four year experience
Article first published online: 19 FEB 2008
©2007 The Author(s)/Journal Compilation ©2007 Foundation Acta Pædiatrica/Acta Pædiatrica
Volume 97, Issue 3, pages 293–298, March 2008
How to Cite
Kribs, A., Vierzig, A., Hünseler, C., Eifinger, F., Welzing, L., Stützer, H. and Roth, B. (2008), Early surfactant in spontaneously breathing with nCPAP in ELBW infants – a single centre four year experience. Acta Paediatrica, 97: 293–298. doi: 10.1111/j.1651-2227.2007.00617.x
- Issue published online: 19 FEB 2008
- Article first published online: 19 FEB 2008
- Received 18 May 2007; accepted 5 November 2007.
- Extremely low birthweight infant;
- Surfactant introduction
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.