Safety of surfactant administration before transport of premature infants.
OBJECTIVE
To assess the safety of surfactant administration prior to transport of premature infants.


METHODS
We performed a retrospective review of 24- to 34-weeks premature infants admitted to the Newborn Intensive Care Unit (NICU) between July 1, 1999 and September 30, 2004. Outcome measures were the presence of hyperventilation (PCO2 <40 mm Hg) and/or pneumothorax on admission to the NICU. Factors associated with the presence of hyperventilation and pneumothorax were identified.


RESULTS
955 infants born at 24 to 34 weeks' gestation were admitted to the NICU during the study period. 217 (22.7%) received surfactant prior to transport within 48 hours of birth. The incidence of hyperventilation was 18.9%. Hyperventilated infants had longer transport times, lower birth weights, and lower PCO2 on blood gases obtained prior to transport. Pneumothorax occurred in six subjects (2.9%). Neonates with pneumothorax had lower APGAR scores.


CONCLUSIONS
We found the administration of surfactant prior to transport to be safe as evidenced by a low incidence of pneumothorax. Pneumothorax was more likely to occur in infants who needed significant resuscitation at birth. The incidence of hyperventilation appeared to be high and was inversely associated with birth weight.
Biniwale
Manoj
M
Center for Fetal and Neonatal Medicine and the USC Division of Neonatal Medicine, Los Angeles, CA, USA. biniwale@usc.edu
Kleinman
Monica
M
D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000150:complications / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000517:prevention & control*; D008171:Lung Diseases / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D011030:Pneumothorax / Q000150:complications / Q000503:physiopathology; D011292:Premedication; D011663:Pulmonary Surfactants / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D017751:Safety Management / Q000592:standards; D014187:Transportation of Patients
D011663:Pulmonary Surfactants