title: Effect of multiple INSURE procedures in extremely preterm infants.
abstract: OBJECTIVE
  Our aim was to evaluate whether single and multiple intubation-surfactant-extubation (INSURE) procedures have similar effects on the need of mechanical ventilation (MV) and occurrence of bronchopulmonary dysplasia (BPD) in extremely preterm infants.
  
  
  METHODS
  We studied infants of <30 weeks of gestation with respiratory distress syndrome (RDS) who were treated with single (FiO(2)>0.30 without need of MV) or multiple (FiO(2)>0.40 without need of MV) INSURE procedures.
  
  
  RESULTS
  Seventy-five infants were studied: 53 (71%) received single INSURE and 22 (29%) received multiple INSURE procedures. Infants in the single and multiple groups had similar rates of need of MV (15 vs. 23%) and occurrence of BPD (9 vs. 9%), although the latter were more immature and affected by more severe RDS (higher FiO(2), lower a/ApO(2), and pO(2)/FiO(2)) than the former.
  
  
  CONCLUSIONS
  Single and multiple INSURE procedures were followed by similar respiratory outcome in a cohort of extremely preterm infants. Further studies are warranted to evaluate whether the multiple INSURE strategy enhances the success rate of INSURE in preventing the need of MV and the occurrence of BPD.
authors.affiliation: Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Viale Morgagni 85, Florence, Italy. cdani@unifi.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: Iuri
authors.initials: I
authors.lastname: Corsini
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bertini
authors.forename: Simone
authors.initials: S
authors.lastname: Pratesi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Barp
authors.forename: Firmino F
authors.initials: FF
authors.lastname: Rubaltelli
mesh_terms: D060666:Airway Extubation / Q000009:adverse effects* / Q000379:methods; D001724:Birth Weight / Q000502:physiology; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007440:Intubation / Q000009:adverse effects*; D008297:Male; D011663:Pulmonary Surfactants / Q000008:administration & dosage* / Q000009:adverse effects; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D011663:Pulmonary Surfactants