Surfactant administration by transient intubation in infants 29 to 35 weeks' gestation with respiratory distress syndrome decreases the likelihood of later mechanical ventilation: a randomized controlled trial.
OBJECTIVE
To assess, among premature infants with early respiratory distress syndrome (RDS), the effect of one dose of intratracheally administered surfactant followed by extubation to nasal continuous positive airway pressure (NCPAP) on subsequent mechanical ventilation (MV), when compared with NCPAP alone.


METHODS
Randomized, blinded trial in infants 29 to 35 weeks' gestation with mild-to-moderate RDS requiring supplemental oxygen and NCPAP. Infants were randomized to intubation, surfactant treatment, and immediate extubation (surfactant group N=52), or to no intervention (control group N=53). All infants were subsequently managed with NCPAP.


RESULTS
Need for later MV was 70% in the control group and 50% in the surfactant group. Surfactant group subjects had lower inspired oxygen fraction (FiO(2)) after study intervention and were less likely to require subsequent surfactant. Overall surfactant use, duration of O(2) therapy, length of stay, and bronchopulmonary dysplasia were unaffected.


CONCLUSIONS
Among premature infants with mild-to-moderate RDS, transient intubation for surfactant administration reduces later MV.
Reininger
Ann
A
Strong Children's Research Center, University of Rochester, Rochester, NY 14642, USA.
Khalak
Rubia
R
Kendig
James W
JW
Ryan
Rita M
RM
Stevens
Timothy P
TP
Reubens
Linda
L
D'Angio
Carl T
CT
D001688:Biological Products / Q000008:administration & dosage*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D013997:Time Factors
D001688:Biological Products; C072197:beractant