Surfactant therapy in premature babies: SurE or InSurE

Background: Preterm infants with respiratory distress syndrome (RDS) requiring surfactant therapy have been traditionally receiving surfactant by intubation surfactant and extubation technique (InSurE), which comprises of tracheal intubation, surfactant administration, and extubation. However, more...

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Bibliographic Details
Published in:Pediatric pulmonology 2019-11, Vol.54 (11), p.1747-1752
Main Authors: Jena, Soumya R., Bains, Harmesh S., Pandita, Aakash, Verma, Anup, Gupta, Vishal, Kallem, Venkat R., Abdullah, Mohammed, Kawdiya, Apurva, on behalf of SURE group
Format: Article
Language:English
Subjects:
Bronchopulmonary Dysplasia
Continuous Positive Airway Pressure
Female
Humans
Infant, Newborn
Infant, Premature
Intubation
Intubation, Intratracheal
Male
mechanical ventilation
neonatal pulmonary medicine
Pulmonary Surfactants - therapeutic use
Respiration, Artificial
Respiratory distress syndrome
Respiratory Distress Syndrome, Newborn - drug therapy
Respiratory therapy
surfactant biology and pathophysiology
Surfactants
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Summary:Background: Preterm infants with respiratory distress syndrome (RDS) requiring surfactant therapy have been traditionally receiving surfactant by intubation surfactant and extubation technique (InSurE), which comprises of tracheal intubation, surfactant administration, and extubation. However, more recently noninvasive methods like least invasive surfactant therapy or minimally invasive surfactant therapy have been reported to be successful. These methods, avoid intubation thus minimize airway trauma and avoid barotrauma. The primary aim of this randomized trial was to compare the need for mechanical ventilation (MV) between the administration of surfactant via a thin catheter during spontaneous breathing and the InSurE technique. Methods: Preterm infant's ≤34 weeks with RDS requiring continuous positive airway pressure (CPAP) within 6 hours of life were prospectively randomized to receive early surfactant either by SurE (surfactant without endotracheal tube intubation) or InSurE technique. The need for MV within the first 72 hours and other related outcomes were analyzed between the two groups. Results: One hundred seventy‐five infants in each group were analyzed. The need for MV in the first 72 hours of life was significantly lower in the SurE group compared to the InSurE group (19% vs 40%, P 
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.24479