Surfactant administration during endotracheal CPAP: Feasibility, risk factors for failure and short‐term outcomes of DD‐SURF

Abstract

AbstractAimWhereas there is agreement that surfactant should be administered without mechanical ventilation, there is still a debate concerning the optimal method. DD‐SURF combines the benefits of INSURE and less invasive surfactant administration (LISA). The efficacy of this approach has not been evaluated yet.MethodsRetrospective cohort study of all preterm newborns below 300/7 weeks gestational age admitted to the neonatal intensive care unit. Data on surfactant therapy, respiratory support during the first 96 h of life and neonatal morbidities until hospital discharge were collected from the electronic patient charts to evaluate the efficacy and safety of our approach.ResultsIn total, 222 newborns met the inclusion criteria; 174 (78%) received surfactant in the delivery room by the DD‐SURF procedure and 21 infants (10%) were not extubated after surfactant administration (Surf‐and‐vent group). After DD‐SURF, 75% of patients did not require reintubation. Intraventricular haemorrhage and bronchopulmonary dysplasia occured more often in infants after DD‐SURF failure than after successful DD‐SURF.ConclusionDD‐SURF potentially combines the benefits of INSURE and LISA and represents a useful alternative of surfactant delivery with comparable success rates to thin‐catheter surfactant administration.