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Am J Perinatol 2019; 36(14): 1492-1497
DOI: 10.1055/s-0039-1678530
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Multicentered Randomized Study on Early versus Rescue Calsurf Administration for the Treatment of Respiratory Distress Syndrome in Preterm Infants

Zhihui Rong
1   Neonatal Intensive Care Unit, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Liwen Chang
1   Neonatal Intensive Care Unit, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Hongbin Cheng
2   Neonatal Intensive Care Unit, Huangshi Maternity and Children's Healthy Hospital, Huangshi, Hubei, China
,
Huizhen Wang
3   Neonatal Intensive Care Unit, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
,
Xiaofang Zhu
4   Neonatal Intensive Care Unit, Jingzhou Central Hospital, Jingzhou, Hubei, China
,
Fen Peng
5   Neonatal Intensive Care Unit, University Hospital of Hubei University for Nationalities, Wuhan, Hubei, China
,
Qihong Fan
6   Neonatal Intensive Care Unit, The First Affiliated Hospital of Yangtze University, The First People's Hospital of Jingzhou, Jingzhou, Hubei, China
,
Wei Lu
7   Neonatal Intensive Care Unit, The First Clinical Medical School of the Three Gorges University Yichang Central People's Hospital, Yichang, Hubei, China
,
Rui Pan
8   Neonatal Intensive Care Unit, Xiangyang Central Hospital, Xiangyang, Hubei, China
,
Li Xiong
9   Neonatal Intensive Care Unit, The First People's Hospital of Tianmen, Tianmen, Hubei, China
,
Rong Jiao
10   Neonatal Intensive Care Unit, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, Hubei, China
,
Jie Sun
11   Neonatal Intensive Care Unit, Huanggang Central Hospital, Huanggang, Hubei, China
,
Shiwen Xia
12   Neonatal Intensive Care Unit, Hubei Maternal and Child Health Hospital, Wuhan, Hubei, China
,
Jijian Xie
13   Neonatal Intensive Care Unit, Taihe Hospital, Shiyan, Hubei, China
› Author Affiliations
Funding This study was supported by the research clinicians of Huazhong University of Science and Technology (second batch) and China International Medical Foundation 2018.
Further Information

Publication History

30 August 2018

03 January 2019

Publication Date:
04 February 2019 (online)

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Abstract

Objective Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS.

Study Design Preterm infants born between 260/7 and 326/7 weeks of gestation and needed nasal continuous positive airway pressure (nCPAP) immediately after birth were randomly assigned to the early or rescue Calsurf treatment group. In the early treatment group, neonates were intubated, administered surfactant with bag–mask ventilation, and extubated to nCPAP (INSURE [intubation–surfactant–extubation]). In the rescue treatment group, InSurE was given until the clinical manifestation and chest X-ray displayed RDS. The primary outcome was to compare the reintubation rate within 72 hour age between the two groups.

Results Among 305 neonates randomized to the early (n = 154) and rescue (n = 151) groups, the reintubation rate within 72 hours of age in these two groups did not differ significantly (p > 0.05). The incidence of oxygen dependence until 36 weeks' corrected age was similar in both groups.

Conclusion No differences were observed between early and rescue Calsurf treatment groups with respect to the reintubation rate within 72 hours of age and the incidence of bronchopulmonary dysplasia.

Keywords

continuous positive airway pressure - neonatal respiratory distress syndrome - bronchopulmonary dysplasia - surfactant

Note

All the authors contributed equally to the study.


 

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