Effectiveness of A Respiratory Care Protocol Including Less Invasive Surfactant Administration in ≥ 35 Weeks Gestational Age Infants.

IF 2.3 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-08-01 DOI:10.1002/ppul.71257

Etze Chotzoglou, Arun Prasath, Riddhi Desai, Lebanon David, Nancy Ornelas, Patti Burchfield, Larry Steven Brown, David B Nelson, Venkatakrishna Kakkilaya

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引用次数: 0

Abstract

Background: In October 2018, a respiratory care protocol (RCP) including less invasive surfactant administration (LISA), was introduced for preterm infants admitted on continuous positive airway pressure (CPAP).

Study design: We compared respiratory care practices and outcomes of ≥ 35-week gestational age (GA) infants between a pre-RCP (Jan 2016 to September 2018) and a post-RCP cohort (Oct 2018 to Dec 2021). Infants requiring < 24 h of CPAP and diagnosed with meconium aspiration syndrome were excluded.

Results: Of the 260 infants meeting inclusion criteria, 126 belonged to the pre-RCP and 134 to post-RCP cohort. Compared to pre-RCP, a lower proportion of infants in the post-RCP received CPAP on admission but a higher proportion received surfactant therapy (8% vs 22%, p < 0.001). Notably, surfactant therapy was associated with lower FiO₂ requirement for 24 h and respiratory severity score for 48 h in the post-RCP cohort. However, there was no difference in any of the outcomes such as the need for mechanical ventilation, incidence of pneumothorax and length of hospital stay between two cohorts.

Conclusions: Implementing an RCP increased surfactant use with associated improvement in oxygenation but did not improve outcomes. Further studies are necessary to evaluate the role of LISA in ≥ 35-week GA infants.

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≥35周胎龄婴儿呼吸护理方案包括微创表面活性剂的有效性

背景：2018年10月，针对持续气道正压通气（CPAP）入院的早产儿，引入了一种呼吸护理方案（RCP），包括微创表面活性剂给药（LISA）。研究设计：我们比较了rcp前（2016年1月至2018年9月）和rcp后（2018年10月至2021年12月）≥35周胎龄（GA）婴儿的呼吸保健实践和结果。结果：在符合纳入标准的260名婴儿中，126名属于rcp前队列，134名属于rcp后队列。与rcp前相比，rcp后的婴儿在入院时接受CPAP的比例较低，但接受表面活性剂治疗的比例较高（8%比22%，rcp后队列中24小时的p 2要求和48小时的呼吸严重程度评分）。然而，在两个队列之间，机械通气需求、气胸发生率和住院时间等任何结果均无差异。结论：实施RCP增加了表面活性剂的使用，并改善了氧合，但没有改善结果。需要进一步的研究来评估LISA在≥35周的GA婴儿中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.