Surfactant in spontaneous breathing with nCPAP: neurodevelopmental outcome at early school age of infants ≤ 27 weeks.
OBJECTIVE
In 2001, we implemented the 'surfactant without intubation' (SWI) method to administer surfactant during spontaneous breathing with nasal continuous positive airway pressure in preterm infants. To determine whether application of the SWI method in infants born at ≤ 27 weeks gestational age influences early school age outcome.


METHODS
A historical control cohort was compared to an interventional cohort, when the SWI method had become part of primary respiratory support. According to the overall results of psychometric and neurological examinations, children were classified as showing no functional impairment, minor or major impairments.


RESULTS
Out of 79 surviving children, 54 (68%, two children not completely classifiable) were assessed at a median age of 6 5/12 years [25 (32%) lost to follow-up]. Thirteen of 31 (42%, interventional cohort) vs. 8 of 21 (38%, control cohort) children had no functional impairment, 16 (52%) vs. 9 (43%) showed minor, and 2 (7%) vs. 4 (19%) major impairments.


CONCLUSIONS
There was no statistically significant difference regarding neurodevelopmental school age outcome in children treated after implementing the SWI procedure, even though surviving infants had been more immature and survival rates had increased.
Department of Neonatology, Children's Hospital, University of Cologne, Cologne, Germany.
M
M
Porath
L
L
Korp
D
D
Wendrich
V
V
Dlugay
B
B
Roth
A
A
Kribs
D000280:Administration, Inhalation; D016022:Case-Control Studies; D002648:Child; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000379:methods*; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D059012:Lost to Follow-Up; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology*; D011594:Psychometrics; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D016896:Treatment Outcome
D011663:Pulmonary Surfactants