A Novel and Promising Method for Prediction of Early Surfactant Requirement in Preterm Infants With Respiratory Distress Syndrome: Pulmonary Near-Infrared Spectroscopy.

INTRODUCTION

Non-invasive monitoring techniques have been used more commonly in neonatal clinical practice. The aim of this study was to evaluate the role of lung near-infrared spectroscopy (NIRS) for determination of the severity of Respiratory Distress Syndrome (RDS) and the requirement of surfactant therapy in preterm infants.

METHODS

A total of 60 preterm infants with RDS were evaluated in terms of the requirement of surfactant therapy, as surfactant group (SG) or no-surfactant group (CG). Lung NIRS (L-NIRS), including both basal (bL-rSO2) and apex (aL-rSO2) lung oxygenation monitoring, was performed.

RESULTS

The mean bL-rSO2 values before surfactant treatment were significantly lower in SG (83 ± 10%) than CG (89 ± 5%), (p < 0.01). The mean bL-rSO2 levels of 85% were found to significantly predict early surfactant requirement with 57% sensitivity and 73% specificity (p = 0.02). The mean bL-rSO2 values in the first 4 h were found to be significantly lower in SG who required repeated surfactant (all p < 0.05).

CONCLUSIONS

L-NIRS ≤ 85% values at NICU admission may be used for determination of surfactant therapy in RDS. In addition, lower mean basal L-NIRS values in the first 4 h of life can also be used to guide repeated doses of surfactant. L-NIRS, either alone or in combination with other methods may be used for management of preterm infants with RDS after confirmation of our results by larger clinical studies.