Klin Padiatr 2022; 234(05): 347-348
DOI: 10.1055/s-0042-1754523
Abstracts
Poster
Poster Walk 5: Grundlagenforschung, Sonstiges (Funktionelle Störungen, Rehabilitation, NIV, Schlaf etc.)

Intratracheal treatment of surfactant plus topical steroids in very low birth weight (VLBW) infants following premature rupture of the membranes

I Ricklefs
1   University of Luebeck, Department for Paediatrics, Luebeck, Germany
,
K Mehler
2   Division of Neonatology, University of Cologne, Köln, Germany
,
W Göpel
1   University of Luebeck, Department for Paediatrics, Luebeck, Germany
,
C Härtel
3   Department of Paediatrics, University of Würzburg, Würzburg, Germany
,
E Herting
1   University of Luebeck, Department for Paediatrics, Luebeck, Germany
,
G Stichtenoth
1   University of Luebeck, Department for Paediatrics, Luebeck, Germany
› Author Affiliations
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Preterm birth following preterm premature rupture of membranes (PPROM) increases the risk for severe neonatal respiratory failure, persistent pulmonary hypertension, pulmonary inflammation, dry lung syndrome and development of bronchopulmonary dysplasia (BPD). Surfactant may serve as a carrier for anti-inflammatory topical steroids. Recent studies showed a reduced risk for BPD in VLBW infants (birth weight <1500g) with severe respiratory distress syndrome after treatment with mixtures of pulmonary surfactant and budesonide (SurPluS).

We conducted a retrospective analysis of a cohort of VLBW infants with gestational age between 22+0 and 32+6 weeks with PPROM lasting for more than 5 days that received SurPluS (100-200mg/kg surfactant and 500µg budesonide). This group was matched at a 1:2 ratio with a VLBW cohort of the German Neonatal Network (GNN), using the variables birth weight, gestational age, sex, prenatal steroid treatment, duration of PPROM, oxygen supplemental during the first 12 hours and amniotic infection syndrome.

The SurPluS cohort (n=15) showed no differences in birth weight, duration of PPROM, arterial umbilical cord pH and APGAR compared to GNN controls (n=30). Duration of conventional ventilation (4.0 ± 5.4 days vs. 13.8 ± 17.4 days, p=0.007) and duration of oxygen supplement (23.6 ± 25.6 days vs. 53.2 ± 48 days, p= 0.01) were significantly shorter in the SurPluS group. We found no differences in the duration of non-invasive ventilation. The frequency of intraventricular haemorrhage (20% vs. 37%), BPD at 36 weeks (20% vs. 30%) and pneumothorax (12% vs. 27%) was lower in the SurPluS cohort, however without statistical significance. Two infants of each group died.

Combined treatment of surfactant plus budesonide may improve short term morbidity of VLBW infants born after long term PPROM. Limitations of this investigation result from the retrospective matched pairs design and the small number of investigated cases. A multicenter observational study is planned to confirm our findings.



Publication History

Article published online:
21 September 2022

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