Kleijkers L.M.P.a· Van Der Spil J.b· Janssen L.C.E.a· Dieleman J.P.c· Andriessen P.a· van Kaam A.H.b,d· Onland W.b,d· Niemarkt H.J.a

Author affiliations

aDepartment of Pediatrics, Máxima Medical Centre, Veldhoven, The Netherlands
bDepartment of Neonatology, Emma’s Children Hospital, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
cMMC Academy, Máxima Medical Centre, Veldhoven, The Netherlands
dAmsterdam Reproduction & Development, Amsterdam, The Netherlands

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Article / Publication Details

First-Page Preview

Received: April 04, 2022
Accepted: July 20, 2022
Published online: September 20, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Introduction: Less invasive surfactant administration (LISA) to preterm infants is associated with decreased risk for death or BPD. After LISA, a considerable proportion requires a second dose of surfactant because of ongoing respiratory distress syndrome, raising a clinical dilemma between intubation or performing a repeated LISA (re-LISA) procedure. We aim to assess efficacy of re-LISA in avoiding subsequent nasal continuous positive airway pressure failure (need for intubation in the first 72 h of life; CPAP-F), to identify factors associated with subsequent CPAP-F, and to compare short-term outcomes following re-LISA to surfactant retreatment by endotracheal intubation and mechanical ventilation. Methods: This was an observational retrospective study in two Dutch NICUs. Inclusion criterion was infants with gestational age <32 0/7 weeks requiring a second surfactant dose. Multivariate logistic regression analysis was performed. Results: Of 209 infants requiring second surfactant dose, 132 received re-LISA. Subsequent CPAP-F was observed in 56 (42%) infants and was associated with extreme prematurity (OR 2.6, 95% CI: 1.2–5.8) and FiO2>0.5 (OR 5.4, 95% CI: 2.0–14.7). Infants receiving re-LISA had a lower risk of death or BPD compared to infants intubated for the second surfactant dose (OR 0.4, 95% CI: 0.2–0.9). Infants with CPAP-F after re-LISA had similar outcomes compared to those intubated for second surfactant dose. Conclusion: Re-LISA is effective in reducing CPAP-F and is associated with lower risk of death or BPD compared to retreatment via an endotracheal tube. Infants failing CPAP after re-LISA have similar outcomes compared to intubated infants. These findings support the use of re-LISA in preterm infants with ongoing RDS.

© 2022 S. Karger AG, Basel

References Dargaville PA. CPAP, surfactant, or both for the preterm infant: resolving the dilemma. JAMA Pediatr. 2015;169(8):715–7. Dargaville PA, Gerber A, Johansson S, De Paoli AG, Kamlin COF, Orsini F, et al. Incidence and outcome of CPAP failure in preterm infants. Pediatrics. 2016;138(1):e20153985. Herting E, Hartel C, Gopel W. Less invasive surfactant administration: best practices and unanswered questions. Curr Opin Pediatr. 2020;32(2):228–34. Herting E, Hartel C, Gopel W. Less invasive surfactant administration (LISA): chances and limitations. Arch Dis Child Fetal Neonatal Ed. 2019;104(6):F655–9. Abdel-Latif ME, Davis PG, Wheeler KI, De Paoli AG, Dargaville PA. Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome. Cochrane Database Syst Rev. 2021;5:CD011672. Aldana-Aguirre JC, Pinto M, Featherstone RM, Kumar M. Less invasive surfactant administration versus intubation for surfactant delivery in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2017;102(1):F17–23. Jeffreys E, Hunt K, Dassios T, Greenough A. UK survey of less invasive surfactant administration. Arch Dis Child Fetal Neonatal Ed. 2019;104(5):F567. Klotz D, Porcaro U, Fleck T, Fuchs H. European perspective on less invasive surfactant administration-a survey. Eur J Pediatr. 2017;176(2):147–54. Kurepa D, Perveen S, Lipener Y, Kakkilaya V. The use of less invasive surfactant administration (LISA) in the United States with review of the literature. J Perinatol. 2019;39(3):426–32. De Luca D, Shankar-Aguilera S, Bancalari E. LISA/MIST: complex clinical problems almost never have easy solutions. Semin Fetal Neonatal Med. 2021;26(2):101230. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, et al. European consensus guidelines on the management of respiratory distress syndrome: 2019 update. Neonatology. 2019;115(4):432–50. Reynolds P, Bustani P, Darby C, Fernandez Alvarez JR, Fox G, Jones S, et al. Less-invasive surfactant administration for neonatal respiratory distress syndrome: a consensus guideline. Neonatology. 2021;118(5):586–92. Janssen LC, Van Der Spil J, van Kaam AH, Dieleman JP, Andriessen P, Onland W, et al. Minimally invasive surfactant therapy failure: risk factors and outcome. Arch Dis Child Fetal Neonatal Ed. 2019;104(6):F636–42. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723–9. Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013–2018. JAMA. 2022;327(3):248–63. Sun H, Zhou Y, Xiong H, Kang W, Xu B, Liu D, et al. Prognosis of very preterm infants with severe respiratory distress syndrome receiving mechanical ventilation. Lung. 2015;193(2):249–54. Gopel W, Kribs A, Ziegler A, Laux R, Hoehn T, Wieg C, et al. Avoidance of mechanical ventilation by surfactant treatment of spontaneously breathing preterm infants (AMV): an open-label, randomised, controlled trial. Lancet. 2011;378(9803):1627–34. Kribs A, Roll C, Gopel W, Wieg C, Groneck P, Laux R, et al. Nonintubated surfactant application vs conventional therapy in extremely preterm infants: a randomized clinical trial. JAMA Pediatr. 2015;169(8):723–30. Kanmaz HG, Erdeve O, Canpolat FE, Mutlu B, Dilmen U. Surfactant administration via thin catheter during spontaneous breathing: randomized controlled trial. Pediatrics. 2013;131(2):e502–9. Dargaville PA, Kamlin COF, Orsini F, Wang X, De Paoli AG, Kanmaz Kutman HG, et al. Effect of minimally invasive surfactant therapy vs sham treatment on death or bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: the OPTIMIST-A randomized clinical trial. JAMA. 2021;326(24):2478–87. Shima Y, Takemura T, Akamatsu H, Kawakami T, Yoda H. Clinicopathological analysis of premature infants treated with artificial surfactant. J Nippon Med Sch. 2000;67(5):330–4. Dargaville PA, Aiyappan A, De Paoli AG, Dalton R G B, Kuschel CA, Kamlin CO, et al. Continuous positive airway pressure failure in preterm infants: incidence, predictors and consequences. Neonatology. 2013;104(1):8–14. Fortas F, Loi B, Centorrino R, Regiroli G, Ben-Ammar R, Shankar-Aguilera S, et al. Enhanced INSURE (ENSURE): an updated and standardised reference for surfactant administration. Eur J Pediatr. 2022;181(3):1269–75. De Luca D, van Kaam AH, Tingay DG, Courtney SE, Danhaive O, Carnielli VP, et al. The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity. Lancet Respir Med. 2017;5(8):657–66. Article / Publication Details

First-Page Preview

Received: April 04, 2022
Accepted: July 20, 2022
Published online: September 20, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

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