title: Early rescue administration of surfactant and nasal continuous positive airway pressure in preterm infants <32 weeks gestation.
abstract: OBJECTIVE
  This study reports our institutional experience on the outcome after prophylactic and early rescue endotracheal instillation of surfactant within 20 minutes of birth, followed by extubation and nasal continuous positive airway pressure (NCPAP) in preterm infants <32 weeks gestational age.
  
  
  METHODS
  A total of 142 infants were prospectively studied (42, gestational age from 23 to 27 and 100, from 28 up to 32 weeks). All infants were electively intubated for administration of 200 mg/kg porcine isolated surfactant (Curosurf, Chiesi Farmaceutici SPA, Parma, Italy) as soon as practicably possible (within 20 min after birth) and NCPAP was then initiated.
  
  
  RESULTS
  Extubation and switch to NCPAP at 6 h was successful in 6/42 (14.3%) infants less than 28 weeks gestational age and 75/100 (75%) infants 28-32 weeks gestational age. Out of 81 infants that were successfully extubated, 76 (93.83%) never required re-ventilation. At 96 h of age, need for continuing intubation and ventilation was required by 6/38 (15.8%) alive infants <28 weeks gestational age and 8/100 (8%) infants 28-32 weeks gestational age. Mean duration of NCPAP post-extubation was 38±20 hours for infants 23-27 wks and 29±15 hours for infants 28-32 wks gestational age. The mortality rate was 2.81% (4/142).
  
  
  CONCLUSIONS
  Implementation of prophylactic or early rescue administration of surfactant with NCPAP in infants at high risk for developing RDS in neonatal ICU is a safe modality of respiratory support in preterm infants.
authors.affiliation: Second NICU and Neonatology Department, Aristotle University of Thessaloniki, GPN Papageorgiou, Ring Road Nea Efkarpia, 56403 Thessaloniki, Greece. makourti@med.auth.gr
authors.forename: Christos
authors.initials: C
authors.lastname: Tsakalidis
authors.forename: Maria
authors.initials: M
authors.lastname: Kourti
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Karagianni
authors.forename: Dimitris
authors.initials: D
authors.lastname: Rallis
authors.forename: Maria
authors.initials: M
authors.lastname: Porpodi
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Nikolaidis
mesh_terms: D000280:Administration, Inhalation; D001688:Biological Products / Q000008:administration & dosage; D045422:Continuous Positive Airway Pressure; D005260:Female; D006115:Greece; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; C068291:poractant alfa