Short-term outcomes associated with surfactant use in respiratory distress in late preterm to early term infants.

OBJECTIVE

Evaluate surfactant therapy and clinical outcomes including length of hospital stay (LOS), CPAP, and mechanical ventilation in late preterm to early term infants.

STUDY

DESIGN

A single-center retrospective study of 401 eligible infants 33-38 + 6 weeks. Surfactant administration included INSURE (INtubation-SURfactant-Extubation), LISA (Less Invasive Surfactant Administration), and endotracheal with prolonged invasive ventilation.

RESULTS

114 (28%) received surfactant. Surfactant-treated infants had longer LOS (16 ± 11 vs 12 ± 9 days, p < 0.001) compared to non-treated. Infants who received INSURE/LISA (n = 43) had shorter LOS (14 ± 9 vs 18 ± 12 days, p = 0.04) than endotracheal surfactant with prolonged mechanical ventilation (n = 71). Infants who received INSURE/LISA had similar LOS to non-surfactant-treated infants (14 ± 9 vs 13 ± 9 days, p = 0.47).

CONCLUSION

Surfactant administration was associated with longer hospitalization compared to non-treated infants. INSURE/LISA shortened LOS compared to surfactant with prolonged ventilation. In late preterm and early term infants that require surfactant for RDS, less invasive methods reduce LOS.