CC BY-NC-ND 4.0 · Am J Perinatol 2019; 36(09): 943-948
DOI: 10.1055/s-0038-1675645
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Underdosing of Surfactant for Preterm Babies with Respiratory Distress Syndrome in Clinical Practice: A Retrospective Cohort Study

Hector Boix
1  Department of Neonatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Segundo Rite
2  Division of Neonatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
,
Luis Arruza
3  Department of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
,
Cristina Fernandez
1  Department of Neonatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Itziar Serrano
2  Division of Neonatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
,
Irene Baquedano
2  Division of Neonatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
,
Ana Sanchez
4  Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
,
Erika Ferreira
4  Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
,
Patricia Fernandez
3  Department of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
,
Rosa Gonzalez
3  Department of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
,
M. Dolores Elorza
4  Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
› Author Affiliations
Funding This study was supported by Chiesi España, S.A.U., Barcelona, Spain. Chiesi España, S.A.U. was not involved in the collection and interpretation of data, as well as writing of the manuscript.
Further Information

Publication History

04 May 2018

25 September 2018

Publication Date:
10 November 2018 (online)

Abstract

Objective To evaluate the initial doses of surfactant administered to preterm infants with respiratory distress syndrome.

Study Design This is a retrospective cohort study of 206 preterm infants admitted in four level III neonatal intensive care units of acute tertiary care hospitals in Spain between 2013 and 2015.

Results The mean initial dose of surfactant was 173.9 (37.3) mg/kg, and 47.5% of infants received a dose of 200 mg/kg ± 10% (180–220 mg/kg), 47% less than 180 mg/kg (–10%), and 5.4% more than 220 mg/kg (+10%). Very preterm infants (<28 weeks) received higher initial doses than more mature infants, but in all cases, the mean doses were below the recommended 200 mg/kg (by 9.2% in gestational age 23–28 weeks, by 15.9% in 29–32 weeks, and by 24.3% in >32 weeks).

Conclusion Administration of surfactant below the prescribed dose is a frequent error in clinical practice. Inadvertently rounding down doses seems a plausible explanation.

Authors' Contributions

The principal investigator H. B. had full access to the data in the study and takes responsibility for the integrity and accuracy of the data analysis. H. B. was responsible for the original conception and design of the study and drafted the final version of the manuscript. Coauthors S. R., M. D. E., and L. A. assisted in the implementation of the project, critical review of the manuscript at each step, and all data analysis, and participated in the manuscript approval of the final draft.