COMPARISON OUTCOME OF SURFACTANT ADMINISTRATION VIA TRACHEAL CATHETERIZATION DURING SPONTANEOUS BREATHING WITH INSURE

Abstract

Surfactant administration via thin endotracheal catheter (Tec) seems to be less invasive than InSurE method .We analyzed data obtained from multicenter hospitals. This multi center randomized clinical trial study was conducted concomitant within NICU of three university hospitals of Tabriz, Isfahan and Mashhad for a period of 20 months on neonates with gestational age of 27-32 weeks. All infants received nCPAP before administration of surfactant. If we required fio2>30%to maintain spo2 >85% then surfactant was administered. A 5f vascular catheter was placed through 1 to 2 cm below the vocal cords and surfactant was administrated slowly. Mean gestational age in TEC was 29.6 weeks and in InSurE was the same. Mean weight in TEC was 1339 grams and in InSurE was 1304 gram. Surfactant was administered to 66 preterm via TEC method and to 70 infant via InSurE. Mortality in TEC group was significantly lower than InSurE. P<0.01RR=0.56, CI, 95(0.420.76). NEC reduced in TEC. CPAP duration decreased in two centers, p<.05 but increased in another center. Fio2 decreased rapidly and HCO3 increased 2 hours after surfactant P<0.03 in TEC. The average mean of Oxygen supplementation, BPD, Mechanical ventilation between two groups was not statistically significant. TEC method was effective in treating RDS. Mortality was significantly decreased in TEC group. As TEC procedure is a new method of surfactant administration and there are few studies about it, so it is too early to be certain about all aspects of this procedure.