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

Zhihui Rong; Liwen Chang; Hongbin Cheng; Huizhen Wang; Xiaofang Zhu; Fen Peng; Qihong Fan; Wei Lu; Rui Pan; Li Xiong; Rong Jiao; Jie Sun; Shiwen Xia; Jijian Xie

doi:10.1055/s-0039-1678530

American Journal of Perinatology, Table of Contents

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

¹Neonatal Intensive Care Unit, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China

,

Liwen Chang

¹Neonatal Intensive Care Unit, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China

,

Hongbin Cheng

²Neonatal Intensive Care Unit, Huangshi Maternity and Children's Healthy Hospital, Huangshi, Hubei, China

,

Huizhen Wang

³Neonatal Intensive Care Unit, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

,

Xiaofang Zhu

⁴Neonatal Intensive Care Unit, Jingzhou Central Hospital, Jingzhou, Hubei, China

,

Fen Peng

⁵Neonatal Intensive Care Unit, University Hospital of Hubei University for Nationalities, Wuhan, Hubei, China

,

Qihong Fan

⁶Neonatal Intensive Care Unit, The First Affiliated Hospital of Yangtze University, The First People's Hospital of Jingzhou, Jingzhou, Hubei, China

,

Wei Lu

⁷Neonatal Intensive Care Unit, The First Clinical Medical School of the Three Gorges University Yichang Central People's Hospital, Yichang, Hubei, China

,

Rui Pan

⁸Neonatal Intensive Care Unit, Xiangyang Central Hospital, Xiangyang, Hubei, China

,

Li Xiong

⁹Neonatal Intensive Care Unit, The First People's Hospital of Tianmen, Tianmen, Hubei, China

,

Rong Jiao

¹⁰Neonatal Intensive Care Unit, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, Hubei, China

,

Jie Sun

¹¹Neonatal Intensive Care Unit, Huanggang Central Hospital, Huanggang, Hubei, China

,

Shiwen Xia

¹²Neonatal Intensive Care Unit, Hubei Maternal and Child Health Hospital, Wuhan, Hubei, China

,

Jijian Xie

¹³Neonatal Intensive Care Unit, Taihe Hospital, Shiyan, Hubei, China

› Author Affiliations

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 26^0/7 and 32^6/7 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

Full Text

References

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