Less-Invasive Surfactant Administration Versus Intubation-Surfactant Extubation in Preterm Neonates with Respiratory Distress

Planshu Girdhar, Sunita Arora, Mandeep Singh Khurana, Gursharan Singh Narang

Abstract

Background: Respiratory distress syndrome (RDS) is one of the most common complications of prematurity. To treat this condition, less-invasive techniques have been developed, in which surfactant administration is done effectively while the neonate is breathing spontaneously.

Aim: To compare the need and duration of mechanical ventilation and the mortality rates between the less-invasive surfactant administration (LISA) group and the intubation-surfactant-extubation (InSurE) group.

Materials and Methods: This randomized control trial included 60 preterm neonates born between 28+0 and 33+6 weeks of gestation, who received surfactant therapy for RDS. They were equally randomized into 2 groups: the intervention group received LISA and the control group received InSurE.

Results: The need and duration of mechanical ventilation significantly reduced in the intervention group, with P = .049. No significant difference was found in the mortality rates between both the groups.

Conclusion: Delivery of surfactant using the LISA technique is feasible in the treatment of RDS in preterm neonates. Avoiding mechanical ventilation and administering surfactant during spontaneous breathing without intubation and positive pressure ventilation is more physiologic and could have a beneficial effect in reducing major morbidities.