TY - JOUR
T1 - Surfactant Need by Gestation for Very Preterm Babies Initiated on Early Nasal CPAP
T2 - A Danish Observational Multicentre Study of 6,628 Infants Born 2000-2013
AU - Wiingreen, Rikke
AU - Greisen, Gorm
AU - Ebbesen, Finn
AU - Petersen, Jesper Padkær
AU - Zachariassen, Gitte
AU - Henriksen, Tine Brink
AU - Mølholm Hansen, Bo
N1 - © 2017 S. Karger AG, Basel.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but few studies provide data on this. Since the 1990s, the first approach to respiratory support to preterm infants in Denmark has been early nCPAP combined with surfactant administration by the INSURE method by which the infant is intubated and surfactant administration is followed by rapid extubation to nCPAP if possible.OBJECTIVES: To investigate how often surfactant was administered in preterm infants with a gestational age below 34 weeks treated with early nCPAP as a first approach to respiratory support.METHODS: An observational multicentre study including all inborn infants with a gestational age below 34 weeks admitted to 1 of the 4 level 3 neonatal intensive care units in Denmark in the period from 2000 to 2013.RESULTS: A total of 6,628 infants were included in this study. We found that surfactant was administered in 1,056 of 1,799 (59%; 95% CI: 57-61%), in 821 of 2,864 (29%; 95% CI: 27-31%), and in 132 of 1,796 (7%; 95% CI: 6-8%) of the infants with a gestational age from 24 to 27, 28 to 31, and 32 to 33 weeks and 6 days, respectively.CONCLUSIONS: A large proportion of preterm infants treated with early nCPAP as the first approach to respiratory support was never treated with surfactant.
AB - BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but few studies provide data on this. Since the 1990s, the first approach to respiratory support to preterm infants in Denmark has been early nCPAP combined with surfactant administration by the INSURE method by which the infant is intubated and surfactant administration is followed by rapid extubation to nCPAP if possible.OBJECTIVES: To investigate how often surfactant was administered in preterm infants with a gestational age below 34 weeks treated with early nCPAP as a first approach to respiratory support.METHODS: An observational multicentre study including all inborn infants with a gestational age below 34 weeks admitted to 1 of the 4 level 3 neonatal intensive care units in Denmark in the period from 2000 to 2013.RESULTS: A total of 6,628 infants were included in this study. We found that surfactant was administered in 1,056 of 1,799 (59%; 95% CI: 57-61%), in 821 of 2,864 (29%; 95% CI: 27-31%), and in 132 of 1,796 (7%; 95% CI: 6-8%) of the infants with a gestational age from 24 to 27, 28 to 31, and 32 to 33 weeks and 6 days, respectively.CONCLUSIONS: A large proportion of preterm infants treated with early nCPAP as the first approach to respiratory support was never treated with surfactant.
KW - Continuous Positive Airway Pressure
KW - Denmark/epidemiology
KW - Female
KW - Gestational Age
KW - Humans
KW - Infant, Extremely Premature
KW - Infant, Newborn
KW - Male
KW - Pulmonary Surfactants/therapeutic use
KW - Respiratory Distress Syndrome, Newborn/therapy
KW - Survival Rate
U2 - 10.1159/000451021
DO - 10.1159/000451021
M3 - Journal article
C2 - 28073106
SN - 1661-7800
VL - 111
SP - 331
EP - 336
JO - Neonatology
JF - Neonatology
IS - 4
ER -